• Journal of Preventive Medicine and Public Health
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• v.15 no.1
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• pp.179-186
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• 1982

The methods controlling the confounding factors were discussed using the data of secondary infertility with induced abortion. Mantel-Haenszel method and logistic model were applied in the analysis to find out which factors were confounding and/or effect modification variables. In the logistic analysis, the main effect of induced abortion, spontaneous abortion, age and interaction effect between induced abortion and spontaneous abortion were chosen as independent variables being regressed into logistic functions. Spontaneons abortion was interpreted as a potential confounder and at the same time potential effect modifier and age was interpreted as potential confounder. Spontaneous abortion was shown to be more important influencing factor than age to the secondary infertility. In the course of logistic analysis, the problem of parameter estimation and hypothesis testing, assessing the fitness of a model, and selection of the best model were briefly explained. For the program of logistic model, FUNCAT Procedure of SAS package was chosen.

• The Journal of Korean Obstetrics and Gynecology
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• v.18 no.1
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• pp.218-233
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• 2005

Purpose : To investigate clinical-epidemologic aspect of infertility patients in Conmaul Oriental Hospital. Methods : From 2003, 5 to 2004, 4, a total 1223(female 943, male 280) patients was recruited, and their medical records were reviewed retrospectively. Results : The mean age of female was $31.83{\pm}3.63$ yesrs, and $34.08{\pm}3.66$ years in male. The mean BMI of female was $20.83{\pm}2.74$, and $24.36{\pm}3.03$ in male. The most common occupation of female was profession, administration, management.The primary infertility was 52.9% and the secondary infertility 47.1%. The most common past history in female was laparotomy. The mean duration of infertility was $3.32{\pm}2.5$ years and $3.9{\pm}2.63$ years in female and male. 83.6% of secondary infertility women experienced abortion. The incidence of patients with both combinded infertility factors of female and male was the most highest, and the most common single factor was ovulatory. 92.4% of female patients took sterility tests, 71.0% of male patients took semen analysis. 50.8% female took ovulation induction, IUI, IVF before coming. 8.91% of female and 72.14% of male were accompanied by their spouse. 61.2% of female took sterility test with their spouse. Female's duration of treatment was longer than man's. The most reliable source of choices was encouragement of family members, acquaintance. Conclusion : In this study, we presented staus concerend with infertility and the characteristics of patients went to oriental hospital. Furthermore, the study about oriental treatments and the results of that treatments is required.

• Women's Health Nursing
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• v.25 no.1
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• pp.99-111
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• 2019

Purpose: To develop nurses' educational needs scale for woman with infertility. Methods: A total of 201 nurses in charge of infertility health services in 4 infertility hospitals and 1 public health center were enrolled for this study. The scale was developed through literature review, in-depth interview, development of preliminary items, verification of content validity, development of secondary items, verification of construct validity, and extraction of final items. Data were analyzed using item analysis, exploratory factor analysis, Pearson's correlation coefficients, and Cronbach's ${\alpha}$. Results: Nurses' educational needs scale for women with infertility consisted of 41 items. Three factors (education for disease and symptom of infertility, supporting and counselling for infertility patients, and education for daily life of infertile patients) explained 63.7% of the total variance. Conclusions: Nurses' educational needs scale for woman with infertility demonstrated acceptable validity and reliability. Its items could be used to assess the level of educational needs for nurses in charge of infertility health services.

• Women's Health Nursing
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• v.26 no.2
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• pp.141-150
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• 2020

Purpose: High-quality nursing care must be provided for women with infertility, and their nursing needs must be identified. Although scales have been developed to assess infertility-related stress, quality of life, and psychosocial status, there is a lack of scales that assess the nursing needs of women with infertility. The purpose of this study was to develop a needs assessment scale for nursing care in women with infertility and to verify its reliability and validity. Methods: The 250 subjects in this study were women with infertility recruited from four hospitals. The scale was developed following the framework of DeVellis, through a literature review, in-depth interviews, development of preliminary items, verification of content validity, development of secondary items, verification of construct validity, and extraction of the final items. Date were analyzed using item analysis, factor analysis, confirmatory factor analysis, Pearson correlation coefficients, and Cronbach's alpha. Reliability was tested using Cronbach's alpha, and validity was evaluated using item analysis, exploratory factor analysis, and criterion validity. Results: The final version of the nursing needs assessment scale for woman with infertility consisted of 18 items. Four factors (physical and psychological nursing needs, needs for information regarding treatment, needs for infertility-related understanding and concern, and supportive needs) explained 66.0% of the total variance. Cronbach's alpha was .92 for the overall instrument and ranged from .88 to .91 for the subscales. Conclusion: These results suggest that this needs assessment scale for nursing care in women with infertility demonstrated acceptable validity and reliability and contained items suitable for assessing the level of nursing care needed by women with infertility.

• The Journal of Korean Obstetrics and Gynecology
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• v.23 no.3
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• pp.184-191
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• 2010

Purpose: Examine changes in the aspect and state of patient with infertility who admitted to Korean oriental hospital. Look at the changes in last 8 years and seek how oriental medicine can approach to infertility patients who admitted to Korean oriental hospital in last 8 years. Methods: Total of 7434 new patients with infertility who admitted to Gynecology of Oriental Hospital, $\bigcirc\bigcirc$ University Medical Center, from October 2002 to December 2009 was compared to infertility patients based on bottom collected data in this study, total of 1061 infertility patients were targeted for this study. Results: 1.There is no distinct increases in age between women who admitted to oriental medicine and patient's average age, it has shown constantly increasing trend in their age though. However, the average age of infertility patients have shown significant increasing range than average age of all infertility patients. 2. After analysis the result of infertility patient's rate of overall patients, the rate of infertility patients are remaining the same or slowing down in 2005, as the starting year(Table 2). The significant relationship was found in diagnosis and treatment of gynecology(Table 4~5) for infertility patients. In 2005 as the starting year, as patients who admitted to oriental hospital after diagnosed or treated at gynecology are increasing, the rate of infertility patients of overall patients admitted to hospital is slowing down, which is decreasing. 3. There is increasing number of patient diagnosed with "unknown cause" who admitted to Gynecology of Oriental Hospital after year of 2005. 4. The increasing number of patient diagnosed with "unknown cause" who admitted to oriental hospital has a tendency to be important factor in infertility treatment of oriental medicine. Conclusion: Unknown causes of infertility patients who admitted to oriental hospital will continuously increase as senses of society, economic, and social climate change.

• Clinical and Experimental Reproductive Medicine
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• v.12 no.1
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• pp.47-70
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• 1985

This study was presented of the 1,872 cases of infertile couples who visited and examined at the sterility clinic of Department of Obstetrics & Gynecology, Seoul National University Hospital from Sept., 1980 to Dec., 1983. Age, duration of infertility, past medical history, and other general factors were analyzed, and the factors responsible for infertility were classified and discussed. Mode of treatment, outcome of pregnancy, pregnancy rate responsible for each factor were also presented. The results were as follows: 1) The infertility was primary in 1,128, or 60.3% and secondary in 744, or 39.7%. 2) The age between 26 and 30 years of age comprised about one half of the total patients. 3) The duration of infertility between 1 and 4 years comprised about three quarters of the total patients, and the mean duration was 3.8 years. 4) The most common medical history in primary infertility was tuberculous disease, and that in secondary infertility was history of previous laparotomy. 5) About two thirds of antecedent pregnancies were abortion. 6) The major etiologic factor of infertility were male factor in 12.3%, tubal factor in 38.8%, ovulatory failure in 25.4%, uterine factor in 8.8%, cervical factor in 5.2%, peritoneal factor in 9.5%, and no demonstrable cause in 11.3%. 7) The types of male factor were azoospermia in 61.6%, oligospermia in 25.8%, low motility in 11.6%, and other abnormality in 1.0%. 8) The types of ovulatory failure were ovarian failure in 7.4%, hypothalamo-pituitary failure in 8.1 %, hypothalamo-pituitary dysfunction (including Polycystic ovarian syndrome) in 30.2%, and hyperprolactinemia in 22.4%. 9) The types of uterine factor were endometrial tuberculosis in 27.5%, uterine synechia in 33.8%, uterine anomaly in 19.7%, myoma and polyp in 9.1 %, and luteal phase defect in 9.9%. 10) The types of peritoneal factor were pelvic adhesion in 80.9% and endometriosis in 19.6%. 11) Surgeries were done in 408 patients, and they were salpingolysis, lysis of extraadnexal adhesion, salpingostomy, fimbrioplasty, ovarian wedge resection for polycystic ovarian disease, tubo-tubal anastomosis, and tubo-uterine implantation in orders. 12) 243 pregnancies were achieved during the infertility work-up, of which livebirth was 46.5%, ectopic pregnancy was 7.4%, spontaneous abortion was 7.8%, and on-going pregnancy or lost to follow-up was 36.2%. 13) Pregnancy rates in various factors were male factor in 18.7%, ovulatory factor in 31.7%, tubal factor in 24.2%, uterine factor in 34.6%, cervical factor in 19.0%, peritoneal factor in 29.0%, combined factors in 10.5%, and unexplained infertility in 37.1%. Pregnancy rate in whole patients was 25.2%.

• Journal of Korean Academy of Nursing
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• v.25 no.1
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• pp.141-155
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• 1995

The objective of this study was to develop a scale to measure stress in infertile couples and to test its reliability and validity. Prior to item generation, a basic decision was made to conceptualize stress in infertile couples as including two dimensions and four subdimensions. The dimensions were, intrapersonal stress including cognitive and affective stress, and interpersonal stress including marital and social stress. Initially 95 items were generated from the inter-view data of 31 primary or secondary infertile women and from a literature review. These items were analyzed through the Index of Content Validity(CVI) and 69 items were selected which met 70% or more of the CVI. This preliminary Infertility Stress Scale were analyzed for reliability and construct validity. Item analysis and factor analysis were applied for construct validity. Forty items were selected through item analysis. This procedure was based on the inter-item correlation matrix, a corrected average inter-item correlation coefficient(.30~.70), a corrected item to total correlation coefficient (.03 or more) and information about the alpha estimate if this item was dropped from the scale. The result of the initial factor analysis including varimax rotation produced eight factors. Five items deleted because of factor complexity(indiscriminate factor loadings). The secondary factor analysis including varimax rotation produced seven factors that coincided with the conceptual framework posed for the scale developed. The seven factors were labeled as ‘meaning of children’,‘worthiness’,‘tenacious linking’,‘marital satisfaction’,‘sexual satisfaction’,‘familial adjustment’ and ‘social adjustment’. The alpha coefficient relating to internal consistency was .93 for reliability The results of this study suggest that the measurement derived from the Infertility Stress Scale is useful in assessing the stress of infertile couples.

• The Journal of Korean Medicine
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• v.36 no.2
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• pp.1-7
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• 2015

Objectives: To report on the result of infertility treatment with Korean medicine in clinical settings. Methods: This study was single arm, retrospective observational study. Analysis of the medical records on thirty four infertile women who were treated by acupuncture, moxibustion, herbal medicine(Jokyungjongoktang-gagambang, Sutaehwan-gagambang). Pregnancy rate(PR) and Live birth rate(LBR) were analyzed as the primary outcomes. Changes of AMH, FSH, LH, $E_2$, $P_4$, endometrial thickness, fat mass, and BMI were also analyzed as the secondary outcomes. Results: A total of 34 patients were treated in the traditional Korean medical clinic. Nine patients were dropped, and 25 subjects completed the final examination at the end of this treatment schedule. Five of 25 subjects conceived during treatment, reaching 20% PR and LBR was also 20%. Except for FSH level, the results of the remaining outcome measures, including LFT, showed no significant changes. No serious adverse event has been reported. Conclusion: Although no significant changes in bio-markers were observed, complex treatment using Korean medicine has shown effectiveness on women's infertility. In addition, the safety of the treatment has been verified.

• Clinical and Experimental Reproductive Medicine
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• v.32 no.3
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• pp.207-216
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• 2005

Objective: To understand the crucial requirement for the normal early folliculogenesis, we evaluated molecular as well as physiological differences during in vitro ovarian culture. Among the important regulators for follicle development, anti-Müllerian hormone (AMH) and FSH Receptor (FSHR) have been known to be expressed in the cuboidal granulosa cells. Meanwhile, it is known that c-kit is germ cell-specific and GDF-9 is also oocyte-specific regulator. To evaluate the functional requirement for the competence of normal follicular development, we investigated the differential mRNA expression of several factors secreted from granulosa cells and oocytes between in vivo and in vitro developed ovaries. Materials and Methods: Ovaries from ICR neonates (the day of birth) were cultured for 4 days (for primordial to primary transition) or 8 days (for secondary follicle formation) in ${\alpha}$-MEM glutamax supplemented with 3 mg/ml BSA without serum or growth factors. The mRNA levels of the several factors were investigated by quantitative real-time PCR analysis. Freshly isolated 0-, 4-, and 8-day-old ovaries were used as control. Results: The mRNA of AMH and FSHR as granulosa cell factors was highly increased according to the ovarian development in both of 4- and 8-day-old control. However, the mRNA expression was not induced in both of 4- and 8-day in vitro cultured ovaries. The mRNA expression of GDF-9 known to regulate follicle growth as an oocyte factor was different between in vivo and in vitro developed ovaries. In addition, the transcript of GDF-9 was expressed in the primordial follicles of mouse ovaries. The mRNA expression of c-kit was not significantly different during the early folliculogenesis in vitro. Conclusion: This is the first report regarding endogenous AMH and FSHR expression during the early folliculogenesis in vitro. In conclusion, it will be very valuable to evaluate cuboidal granulosa cell factors as functional marker(s) for normal early folliculogenesis in vitro.

• Journal of Korean Biological Nursing Science
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• v.22 no.3
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• pp.176-183
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• 2020

Purpose: : The purpose of this study was to evaluate the intrauterine insemination (IUI) success rate and to define the variables for predicting success. Methods: The secondary data analysis was used with data collected from infertile females who underwent IUI in Fertility and IVF (In Vitro Fertilization) clinics, who benefited from the 'National Medical-aid Program for ART (assisted reproductive technology) in 2016', in which the data of 34,920 IUI cases were retrospectively reviewed. The primary outcome measure was the clinical pregnancy rate in elderly and young infertile females. Data were analyzed by descriptive statistics, χ2 test and logistic regression. Results: The pregnancy rate was 12.1% (2,095 cases) in elderly infertile females and 15.6% in young infertile females (2,758 cases) (χ2 = 87.90, p< .001). Using the logistic regression analysis, clinical pregnancy was positively associated with the ovulatory factor (OR= 1.48, p< .001) and male factor (OR= 1.19, p< .05) in elderly infertile females. It was positively associated with the ovulatory factor (OR= 1.30, p= .001) and the peritoneal cavity factor (OR= 0.58, p< .05) in young infertile females. Conclusion: Our results indicate that the pregnancy rate in young infertile females was higher than that in old infertile females, and the IUI is the effective option in pregnancies in all ages with infertility due to the ovulatory factor. Additionally, further studies are necessary to fully describe pregnancy experiences for all the infertile females.