• 대한가정학회지
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• 제44권11호
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• pp.1-12
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• 2006

The purpose of this study was to examine how married women with a child perceived the low-fertility issue in order to increase the success of policy decisions for increasing the fertility rate and to present alternatives. The study subjects were 327 married women with a child who resided in Dongjak-gu, Seoul. After the survey was conducted, the collected data were analyzed with SPSS 11.5 program. The findings of the study were as follows. First, the married women who already had one child found it ideal to have two children. In fact, however, 36.4% had determined not to have another child, and only one parent wanted to have a second child in 26.9%. Second, they took a dismal view of the government's fertility encouragement policies, and they considered it necessary for the government to pursue a more down-to-earth measure. Third, economic aid for child rearing and education was identified as the most critical way to boost the childbirth rate. In conclusion, current national policies aimed at increasing the low-fertility rate are redundant if they are only designed to publicize government action. Actions need to be taken to assist married women in taking better advantage of the existing policies.

• Journal of Acupuncture Research
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• 제35권4호
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• pp.200-206
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• 2018

Background: To evaluate whether ${\geq}3$ adjunct acupuncture sessions accompanying embryo transfer, increases the chance of pregnancy amongst post-myomectomy women aged ${\geq}35$ years. Methods: This was a prospective study carried out at Nordica Fertility Center. Following written informed consent, 75 patients undergoing assisted reproduction therapy and who had good quality embryos, were age-matched and grouped into post-myomectomy (n = 24) and normal women who had no evidence of fibroids or previous myomectomy (n = 51). Between 1 and 3 sessions of acupuncture were performed on 6 post-myomectomy and 19 infertile women who had not undergone myomectomy, while > 3 acupuncture sessions were performed on 18 post-myomectomy and on 32 normal patients, approximately 25 minutes before and after embryo transfer. Results: A positive pregnancy test was defined as ultrasonographic evidence indicating presence of a fetal sac 6 weeks after embryo transfer. Of the 5 post-myomectomy women who were pregnant, only 1 (20.0%) received 1-3 adjunct acupuncture sessions whilst the remaining 4 (80.0%) received > 3 acupuncture sessions. Of the 11 normal pregnant women, 5 (45.4%) received 1-3 adjunct acupuncture sessions while 6 (54.5%) received > 3 adjunct acupuncture sessions. Conclusion: Pregnancy rates in infertile post-myomectomy women may be improved by > 3 adjunct acupuncture sessions.

• Clinical and Experimental Reproductive Medicine
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• 제48권1호
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• pp.1-10
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• 2021

In Korean women, a westernized lifestyle is associated with an increased risk of breast cancer. Fertility preservation has become an increasingly important issue for women with breast cancer, in accordance with substantial improvements in survival rate after cancer treatment. The methods of controlled ovarian hyperstimulation (COH) for fertility preservation in breast cancer patients have been modified to include aromatase inhibitors to reduce the potential harm associated with increased estradiol levels. Random-start COH and dual ovarian stimulation are feasible options to reduce the total duration of fertility preservation treatment and to efficiently collect oocytes or embryos. Using a gonadotropin-releasing hormone agonist as a trigger may improve cycle outcomes in breast cancer patients undergoing COH for fertility preservation. In young breast cancer patients with BRCA mutations, especially BRCA1 mutations, the possibility of diminished ovarian reserve may be considered, although further studies are necessary. Herein, we review the current literature on the practical issues surrounding COH for fertility preservation in women with breast cancer.

• Clinical and Experimental Reproductive Medicine
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• 제48권1호
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• pp.11-26
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• 2021

Advances in anticancer treatments have resulted in increasing survival rates among cancer patients. Accordingly, the quality of life after treatment, particularly the preservation of fertility, has gradually emerged as an essential consideration. Cryopreservation of embryos or unfertilized oocytes has been considered as the standard method of fertility preservation among young women facing gonadotoxic chemotherapy. Other methods, including ovarian suppression and ovarian tissue cryopreservation, have been considered experimental. Recent large-scale randomized controlled trials have demonstrated that temporary ovarian suppression using gonadotropin-releasing hormone agonists (GnRHa) during chemotherapy is beneficial for preventing chemotherapy-induced premature ovarian insufficiency in breast cancer patients. It should also be emphasized that GnRHa use during chemotherapy does not replace established fertility preservation methods. All young women facing gonadotoxic chemotherapy should be counseled about and offered various options for fertility preservation, including both GnRHa use and cryopreservation of embryos, oocytes, and/or ovarian tissue.

• Clinical and Experimental Reproductive Medicine
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• 제39권3호
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• pp.118-124
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• 2012

Objective: To review the outcomes of preimplantation genetic diagnosis (PGD) using zona drilling with acid Tyrode's solution (chemical zona pellucida drilling, chemical ZD) and those of partial zona dissection (PZD). Methods: Clinical outcomes of seventy-one couples undergoing 85 PGD cycles from January 2005 to December 2010 were included. Blastocyst formation and the hatching rate, clinical pregnancy rate, ongoing pregnancy rate, implantation rate, and fetal gender ratio of the PZD and chemical ZD groups were compared. Results: Application of PZD resulted in a significantly higher rate of clinical pregnancy (40.7% vs. 15.4%, p=0.022), ongoing pregnancy (35.6% vs. 11.5%, p=0.023), and implantation (18.1% vs. 5.7%, p=0.007) compared with chemical ZD. Among non-transferred embryos, the rate of blastocyst formation on day 5 (49.1% vs. 39.5%, p=0.016) and hatching on day 6 (47.2% vs. 26.5%, p<0.001) were also significantly higher in the PZD group. Conclusion: The mechanical zona dissection (ZD) method showed better outcomes than chemical ZD in terms of the blastocyst development and pregnancy rate. In this study, the fact that chemical ZD was conducted in different period from mechanical method should be considered in interpreting the result.

• Journal of Genetic Medicine
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• 제17권1호
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• pp.21-26
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• 2020

Purpose: To evaluate the additive value of prenatal chromosomal microarray analysis (CMA) in assessing increased nuchal translucency (NT) (≥3.5 mm) with normal karyotype and the possibility of detecting clinically significant genomic imbalance, based on specific indications. Materials and Methods: Invasive samples from 494 pregnancies with NT ≥3.5 mm, obtained from the Research Center of Fertility & Genetics of Hamchoon Women's Clinic between January 2019 and February 2020, were included in this study and CMA was performed in addition to a standard karyotype. Results: In total, 494 cases were subjected to both karyotype and CMA analyses. Among these, 199 cases of aneuploidy were excluded. CMA was performed on the remaining 295 cases (59.7%), which showed normal (231/295, 78.3%) or non-significant copy number variation (CNV), such as benign CNV or variants of uncertain clinical significance likely benign (53/295, 18.0%). Clinically significant CNVs were detected in 11 cases (11/295, 3.7%). Conclusion: Prenatal CMA resulted in a 3% to 4% higher CNV diagnosis rate in fetuses exhibiting increased NT (≥3.5 mm) without other ultrasound detected anomalies and normal karyotype. Therefore, we suggest using high resolution, non- targeting CMA to provide valuable additional information for prenatal diagnosis. Further, we recommend that a genetics specialist should be consulted to interpret the information appropriately and provide counseling and follow-up services after prenatal CMA.

• Clinical and Experimental Reproductive Medicine
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• 제47권4호
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• pp.237-244
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• 2020

Endometrial cancer (EC) in young women tends to be early-stage and low-grade; therefore, such cases have good prognoses. Fertility-sparing treatment with progestin is a potential alternative to definitive treatment (i.e., total hysterectomy, bilateral salpingo-oophorectomy, pelvic washing, and/or lymphadenectomy) for selected patients. However, no evidence-based consensus or guidelines yet exist, and this topic is subject to much debate. Generally, the ideal candidates for fertility-sparing treatment have been suggested to be young women with grade 1 endometrioid adenocarcinoma confined to the endometrium. Magnetic resonance imaging should be performed to rule out myometrial invasion and extrauterine disease before initiating fertility-sparing treatment. Although various fertility-sparing treatment methods exist, including the levonorgestrel-intrauterine system, metformin, gonadotropin-releasing hormone agonists, photodynamic therapy, and hysteroscopic resection, the most common method is high-dose oral progestin (medroxyprogesterone acetate at 500-600 mg daily or megestrol acetate at 160 mg daily). During treatment, re-evaluation of the endometrium with dilation and curettage at 3 months is recommended. Although no consensus exists regarding the ideal duration of maintenance treatment after achieving regression, it is reasonable to consider maintaining the progestin therapy until pregnancy with individualization. According to the literature, the ovarian stimulation drugs used for fertility treatments appear safe. Hysterectomy should be performed after childbearing, and hysterectomy without oophorectomy can also be considered for young women. The available evidence suggests that fertility-sparing treatment is effective and does not appear to worsen the prognosis. If an eligible patient strongly desires fertility despite the risk of recurrence, the clinician should consider fertility-sparing treatment with close follow-up.

• 한국인구학
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• 제5권1호
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• pp.133-144
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• 1982

One of the primary objectives of Korean family planning program is to assist parents in having the number of children they want, both by providing fertility-en-hancing services to infecund and subfecund women and by providing fertility-limitation services to fecund women. As far as fertility-enhancing services to infecund and subfecund women is concerned, there has been little effort from the national family planning program, So far, there is no any basic data on infertility prevalence rate among the Korean women. Therefore, an attempt has been made to review data of 1976 and 1978 fertility and family planning surveys in order to estimate the level of infertility rate among the Korean women. In the 1978 survey 3. 7 percent of the current married women responded that they were physically infertile while in the 1976 survey physically infer-tile women was calculated as 3 percent of the total ever married women which is similar level of 1978 data of 3.7 percent. Mean age at first marriage of Korean women is 23 and most of the women are married in the high fecund age. Only 0.3 percent of the respondents married age 30. in addition, the rate of women with no children among the ever married women whose married duration is more than 5 year is very low;2. 5 percent among 5-9 years, 1. 4 percent among 10- 14 years; 1.8 precent among 15-19 years; 1.0 percent among 20-24 years; and 0. 7 percent among 25 or more years of marriage duration. If we consider those data shown above, it is manifest that infertility rate of Korean women is less than 5 percent level which is much lower than the 10 percent level of infertility rate in the United States of America. However, this kind of estimation is still not able to show definite data on fertility rate. Therefore, a nationwide planned survey should be carried out as early as possible to figure out the real situation of infertility rate in Korea.

• Clinical and Experimental Reproductive Medicine
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• 제47권4호
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• pp.306-311
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• 2020

Objective: The aim of this study was to determine whether co-administration of a gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG) for final oocyte maturation improved mature oocyte cryopreservation outcomes in young women with decreased ovarian reserve (DOR) compared with hCG alone. Methods: Between January 2016 and August 2019, controlled ovarian stimulation (COS) cycles in women (aged ≤35 years, anti-Müllerian hormone [AMH] <1.2 ng/mL) who underwent elective oocyte cryopreservation for fertility preservation were retrospectively analyzed. Results: A total of 76 COS cycles were triggered with a GnRH agonist and hCG (the dual group) or hCG alone (the hCG group). The mean age and serum AMH levels were comparable between the two groups. The duration of stimulation, total dose of follicle-stimulating hormone used, and total number of oocytes retrieved were similar. However, the number of mature oocytes retrieved and the oocyte maturation rate were significantly higher in the dual group than in the hCG group (p=0.010 and p<0.001). After controlling for confounders, the dual-trigger method remained a significant factor related to the number of mature oocytes retrieved (p=0.016). Conclusion: We showed improved mature oocyte collection and maturation rate with the dual triggering of oocyte maturation in young women with DOR. A dual trigger appears to be more beneficial than hCG alone in terms of mature oocyte cryopreservation for young women with DOR.

• 대한간호학회지
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• 제54권1호
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• pp.59-72
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• 2024

Purpose: This cross-sectional study aimed to identify factors influencing the intention for continual fertility treatments among women undergoing assisted reproductive technology (ART). Methods: A total of 197 women were recruited through convenience sample from fertility hospitals in Gyeonggi-do and Busan, South Korea. Data were collected using a self-report questionnaire incorporating measures of uncertainty; Depression Anxiety Stress Scales; Fatigue Severity Scale; Coping Scale for Infertility-Women; spousal support; treatment environment; and intention for continual fertility treatment. Descriptive statistics, chi-square tests, t-tests, and logistic regression analysis were conducted using IBM SPSS 26.0. Results: As many as 70.6% of the participants expressed an intention for continual fertility treatments. Logistic regression analysis revealed that factors such as uncertainty (odds ratio [OR] = 0.44, 95% confidence interval [CI] 0.20~0.95), active coping (OR = 4.04, 95% CI 1.11~14.71), treatment environment (OR = 2.77, 95% CI 1.26~6.07), and the duration of marriage (OR = 2.61, 95% CI 1.24~5.49) were significantly related with this intention. Conclusion: These findings underscore the significance of uncertainty management, having proactive coping strategies, having supportive treatment environments, and considering the duration of marriage concerning women's intention for continual fertility treatment in the context of ART. The implications of these results extend to the development of nursing intervention programs aimed at providing crucial support for women undergoing ART and seeking to continue their infertility treatment.