• Title/Summary/Keyword: Fertility women

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A Theoretical Review on the Natural Family Planning Method (자연적 가족계획 방법에 대한 이론적 고찰)

  • Park, Shin-Ae
    • Research in Community and Public Health Nursing
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    • v.7 no.2
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    • pp.410-419
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    • 1996
  • This study was reviewed from 1000 articles related to family planning from 1970 to 1990 and 20 articles associated with natural family planning from 1980 until the present. The purpose of natural family planning(NFP) is to identify the time ovulation of women themselves, to have intercourse with periodic abstinence, and to deliver a healthy child. The ultimate goal of NFP is to promote the family's health. The NFP method is described as periodic abstinence of intercourse to avoid pregnancy by identifying the ovulation time in the menstration cycle. Clinical symptoms and signs of reflection underlying changes in Estrogen and Progesterone are the change of basal body temperature, the change of cervical mucus and cervix, abdominal pain and breast tenderness. The types of NFP are the calender rthythm method, basal body temperature methods, cervical mucus method, symptothermal method, cyclo-thermal method and home based ovulation test kits. Recently the cyclo-thermal method involved. It is calendar rhythm method applied to B.B.T. For the cervical mucus method, when the estrogen level in the blood concentration is increased, the mucus begins to excrete, the amount of moist mucus increases while the mucus is clear, slippery, and smooth. For 3 days, this timing can be considered contraception. Fertility is at a maximum on the day mucus appears, abstinence for 3 days is a type of contraception. Sexual intercourse on a maximum day of mucus maximizes pregnancy potential. But, the contraception depends on the practice of a perfect rule. For basal body temperature methods, at ovulation time, the temperature increases $0.2^{\circ}C-0.5^{\circ}C$. Through the review of literature a high temperature above $0.2^{\circ}C$ for 3 days indicates that the previous 6 day period was ovulation and fertilization. The Symptothermal method is used to determine the prediction of ovulation through the observation of mucus excretion, high temperature, the change of cervical mucus, low abdominal pain, vaginal discharge, and breast change. Home based ovulation test kits are cervico-vaginal fluid aspiration, test a digital electric thermometer, body fluid(blood, saliva, urine) test kits, They are on the market. However, research on the contraception method is still in progress. For pregnancy it is still too early to use home based ovulation test kits because of deficit of reliability and simplicity more research on the technology is needed. It is suggested that NFP methods be included in nursing curriculum in order to educate NFP users how to effectively use NFP methods. Furthermore, this study has implications for the dissemination of NFP methods in terms of Korean policies of family planning and the support of community welfare agences.

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Subcutaneous Administration of Highly Purified-FSH(HP-FSH) versus Intramuscular Administration of FSH in Superovulation for IVF-ET (체외수정시술을 위한 과배란유도시 Highly Purified Follicle Stimulating Hormone (HP-FSH) 피하주사와 Follicle Stimulating Hormone 근육주사의 비교연구)

  • Bai, S.W.;Kim, J.Y.;Won, J.G.;Jung, C.J.;Chang, K.H.;Lee, B.S.;Park, K.H.;Cho, D.J.;Song, C.H.
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.1
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    • pp.135-141
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    • 1997
  • The early studies demonstrated that the relative amount of FSH was important for stimulating normal ovarian activity and demonstrated the existence of a threshold level for FSH, above which follicular growth was activated. It was found that only a modest increase in circulating FSH level above the threshold (between 10 and 30%) was required to stimulate folliculogenesis. In addition, FSH is primary responsible for initiating estradiol production through the activation of the aromatase enzyme system in granulosa cells, follicular secretion and growth. LH on the other hand, plays a supportive role in ovarian steroidogenesis, stimulating the ovarian thecal cells to produce androgen, the precursor for estradiol synthesis. But there is now an increasing number of reports in the literature demonstrating an adverse effect of LH on fertility and miscarriage in infertile and fertile women. So HP-FSH is the drug of a highly purified FSH preparation which has a higher specific activity and far fewer impurities than FSH. This study was performed to evaluate the efficacy and safety of HP-FSH administered (SC; subcutaneous) versus FSH(IM; intramuscular) for ovulation induction. 20 candidates patients for ovulation induction were participated. All patients underwent pituitary desensitizing with a long gonadotropin-releasing hormone (GnRH) agonist protocol and ovulation induction was started with HP-FSH SC (10 patients; group I) or FSH IM (10 patients; group II). After ovulation, outcome of ovulation induction and local reaction of injection site were compared. There were no difference of outcome of ovulation in two groups except pregnancy rate/embryo transfer. Group I had a higher pregnancy rate/ embryo transfer than Group II (44.4% Vs 28.6%). Pain, redness, tenderness, bruising and itching when the injection received on the first 5 days of treated (50 SC and 50 IM injections) were assessed. There were no significant difference (P>0.05) in the incidence of tenderness, bruising and itching between the IM and SC injection. But IM injection (FSH) had a tendency of higher above incidence. The number of reports of pain, redness were significantly increased in IM injection group (P<0.05). These results indicate that SC administration of HP-FSH has been shown to be as effect for superovulation as traditional gonadotropins, with an improved safety profile due to the removal of extaneous proteins.

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Clomiphene Citrate Challenge Test and Its Clinical Correlation with Prognostic Factors of Ovarian Response (Clomiphene Citrate 부하검사와 난소 반응 예측 인자와의 연관성에 관한 연구)

  • Moon, Shin-Yong;Chae, Hee-Dong;Kim, Kwang-Rye;Suh, Chang-Suk;Kim, Seok-Hyun;Choi, Young-Min;Shin, Chang-Jae;Kim, Jung-Gu;Lee, Jin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.23 no.3
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    • pp.283-292
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    • 1996
  • Objective: To determine the cutoff value of clomiphene citrate challenge test(CCCT) that can predict the normal and abnormal(diminished) ovarian response group and to assess the usefulness of CCCT as a predictor of ovarian reserve. Materials and Methods: From March 1994 to Februry 1996, CCCT was performed to 129 infertile patients and among them, 20 patients whose basal FSH on the third day of menstrual cycle was more than 20 mIU/ml were excluded. At the same time, the same CCCT was performed to the fifteen healthy volunteers with proven fertility to determine the cutoff value of CCCT. Results; 1) A FSH value higher than 23.4 mIU/ml, measured on the 10th day of menstrual cycle, was defined as a abnormal ovarian response. The cutoff value of 23.4 mIU/ml is more than 2 standard deviations(SD) above the mean value of 15 healthy women after CCCT. 2) The abnormal CCCT group, the subpopulation with a FSH value of 23.4 mIU/ml or more, was 7.3%(8/109) and their mean age was higher than the normal CCCT group($36.5{\pm}4.5$ vs. $32.9{\pm}4.8$, P = 0.059). And the percentage of the patients older than 35 years of the abnormal CCCT group was significantly higher than that of the normal CCCT group(62.5% vs. 38.6%, p <0.05). 3) There was no correlation between the hormone values of the third day and the 10th day of menstrual cycle before and after CCCT except between FSH of the third day and the 10th day. Conclusion: The CCCT is a good method to predict the individual ovarian response to COH for ART, especially in the patients who has no other abnormal findings that predict poor prognosis. And it is neccessary to determine the cutoff value of CCCT by the large numbers of randomized study, and combining the previously proven prognostic factors, it can be applicated in many individual centers for evaluate the ovarian response before ART program.

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The Effects of Family Values on Intentions of Marriage and Expected Age at First Marriage (미혼남녀의 결혼의향과 결혼희망연령에 대한 가족 가치관의 영향 추세 연구 : 2005년, 2009년 전국 결혼 및 출산 동향, 조사 자료를 중심으로)

  • Chin, Mee-Jung;Chung, Hye-Eun
    • Korea journal of population studies
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    • v.33 no.3
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    • pp.31-51
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    • 2010
  • This study investigates changes in family values (attitudes toward marriage, children, and traditional sex roles) and examines how the values influence on their intentions of marriage and expected age at first marriage. A sample consists of 5,984 never married men and women drawn from the 2005 and 2009 National Marriage and Fertility Study. The results show that the endorsement on marriage and children has decreased while endorsement on traditional sex role attitude has increased over the past five years. Those who have higher values on marriage, children, and traditional sex role have a higher likelihood of marriage intention. However, the effects of the family values on marriage intention have weakened during the period. The endorsement on marriage lowers the mean ages of the expected first marriage. Comparing the effects of the family values during the period, this study find that normative aspects of the family values have lower effects, whereas individual aspects of the values have stronger effects over time. These findings suggest that the effects of family values vary across sex, time, and the aspect of the values.

Assisted Reproductive Technology in Infertile Patients with Endometriosis (자궁내막증과 동반된 불임환자의 보조생식술을 이용한 치료)

  • Moon, Shin-Yong;Lee, Kyung-Soon;Roh, Jae-Sook;Suh, Chang-Suk;Kim, Seok-Hyun;Choi, Young-Min;Shin, Chang-Jae;Kim, Jung-Gu;Lee, Jin-Young;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.22 no.2
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    • pp.211-220
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    • 1995
  • Though the endometriosis is not always related with infertility, endometriosis causes infertility in some patients. There are many treatment modalities of infertile patients who have endometriosis. In recent years, Assisted Reproductive Technology(ART) have been widely accepted as being a useful tool for the treatment of infertile endometriotic patients. The objective of this study was to evaluate the outcome of ART in infertile endometriotic patients who have been carried out IVF-ET from Jan, 1992 to Dec, 1994 and to compare the results between COH/IUI and IVF-ET in the patients with endometriosis stage I. Tubal disease only patients were grouped(308 patient, 956 cycles) as a control. Endometriosis group was subdivided into 4 groups according to American Fertility Society classification; endometriosis stage I (45 patients, 61 cycles), stage II (26 patients, 39 cycles), stage III (26 pateitns, 37 cycles), stage IV (33 patients, 50 cycles). The outcomes of IVF-ET in endometriosis patients were as follows; The oocyte recovery rates were significantly lower in stage III, IV endometriosis. In case of stage III endometriosis, the fertilization rate was significantly lower than other stages of endometriosis. Clinical pregnancy rates per cycle were not different between the tubal group(22%) and the endometriosis group(25%). According to endometriosis stage, the implantation rate and clinical pregnancy rate were significantly lower in stage IV (5.6%, 16%) compared with other stages (I; 10.0%, 26%, II;9.8%, 31%, III;12.6%, 32%). It suggests that some factor like autoantibodies may inhibit implantation of embryos in stage IV endometriosis. To evaluate the possibility that simply increasing the number of gametes at the site of fertilization might account for pregnancies attributed to IVF-ET, the authors retrospectively analyzed the outcome of couples undergoing IUI during hMG cycles and CC cycles between 1992 and 1994 in the women with endometriosis stage 1. In case of stage I endometriosis, though the COH/IUI group showed lower FSH level and lesser age profile than IVF-ET group, IUI group has resulted in lower pregnancy rates(19.2%) compared with the IVF-ET group(26.2%). In conclusion, endometriotic infertile patients can get comparable pregnancy rates with the tubal factor infertility patients during IVF-ET program. Moreover even in stage I endometriosis, IVF-ET may be an more effective treatment modality than COH/IUI.

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The Changing Shape of Care-time Diamond: Social Care Expansions in the 21st Century in Korea (변화하는 케어-타임 다이아몬드: 한국의 21세기 사회적 돌봄의 확대)

  • An, Mi-Young
    • 한국사회정책
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    • v.19 no.2
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    • pp.137-161
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    • 2012
  • Traditionally, caring for young children and the elderly has been largely assumed and practiced intensively within the family in Korea. The Korean government established residual protection systems for the elderly as well as children whose needs could not be met by their family members alone. However, in the 21st century, a number of social forces have made it necessary to expand the state's intervention in the care provisions. The primary forces include the ageing process, low fertility, change in the women's labour market participation, changes in the family formation and dissolution, and changes in the people's perceptions of familial responsibilities regarding caring for other family members. This paper employs and further develops the idea of the care diamond conceived by the United Nations Research Institute for Social Development Project in relation to the political and social economy of care and applies it to Korea's social care expansions. The analysis demonstrates that the roles of the public and the market sector, in case of child care, increased while those of the third sector decreased. Apropos of the elderly care, the role of the market expanded dramatically, followed by that of and the state and the third sector. Nonetheless, it is important to note that the fundamental characteristics of Korea's care provision for children and the elderly have remained unchanged and even strengthened where the elderly care is concerned. The bulk of personal care demand is still met within the family, particularly by female members of the household.

Pharmacological Effect of Decursin, Decursinol Angelate, and Decursinol Derived from Angelica gigas Nakai (참당귀(Angelica gigas Nakai) 유래 decursin, decursinol 그리고 decursinol angelate의 약리 효과)

  • Kang, Jae Seon
    • Journal of Life Science
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    • v.31 no.12
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    • pp.1128-1141
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    • 2021
  • 'Angelica' is one of the most traditionally consumed medicinal herbs around Northeast Asia including Korea for treatments of various diseases or health care purposes like hematopoiesis, blood circulation for women, sedative, analgesic, and a tonic medicine etc. Angelica gigas Nakai, a Korean native species of Angelica, is clearly different from the others in containing a high concentration of active ingredients like pyranocoumarines including decursin, decursinol, and decursinol angelate. These compounds have various kinds of positive effects such as anti-tumor activity including the precaution of neutropenia occurred during anticancer drug administration, improvements of metabolic disorders, menstrual irregularity, impairment of renal function, respiration improvement, cognition-enhancement, anti-inflammatory effect, anti-oxidative effect, enhancing fertility and so forth. Thus it implies incredible potentialities in future development for foods and drugs. However, certain purity-related qualities and/or overdose in food products can cause side effects like toxicities; therefore, their safety profiles should also be considered. This review focuses on the positive and negative effects of three pyranocoumarines in Angelica gigas Nakai and some possibilities and considerations for future food and drug products development.

A Study on the Space Composition for Department of Delivery in Regional Public Hospital (지역거점 공공병원의 분만부 공간구성에 관한 연구(1))

  • Park, Kyeong Hyeon;Shin, Hwa Kyoung;Chai, Choul Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.28 no.3
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    • pp.47-54
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    • 2022
  • Purpose: This study presents the analysis on space usage of delivery departments in regional public hospitals. The results intention is to achieve improvement of the delivery environment for the mothers and newborns regarding exposure prevention and efficient infection control. The purpose of this study is to provide fundamental data for architectural plans and guidelines for the delivery department. Method: The investigation and analysis were based on research papers, legal systems, public medical statistical data, and the architectural floor plan drawing. For research, 20 regional public hospitals with an operating delivery room were excluded. Regarding data accessibility, 15 regional public hospitals were selected. Results: To overcome the increased vulnerability of the delivery department, the research results of basic data is provided for the establishment to address urgent needs and rapid response. Thus, the research results are as follows: Firstly, the delivery department needs to respond promptly according to the type of patients. For example, in a case of emergency surgery, a connected circulation plan with the related departments is needed. Secondly, for the environment of the delivery area, alleviating anxiety is imperative for pregnant patients and guardians, labor, childbirth, and recovery. Therefore, these needs must be addressed for treatment space and circulation. Lastly, the delivery department is classified into three areas for analysis: access area, treatment area, and support area. In most of the delivery departments of the 15 selected hospitals, there is no space for the access and support area except for the labor and delivery rooms in the treatment area. For the access area, a waiting area, changing room for pregnant women and guardians, and a storage space for contaminated linens are required for infection prevention, safety, and efficiency. For the treatment area, childbirth processes and circulation should have space reserved for labor, delivery, recovery, examination, and treatment. In preparation for an emergency during childbirth, emergency response measures and supporting space needs to be established. For the support area, circulation and rooms are to be designed for medical staff support, activity space, storage and transportation of equipment, and urgent medical treatment. Implications: Along with the low fertility rate and the decrease of medical institutions that operate delivery departments, for the purpose of establishing a public medical service system and a healthy medical environment for mothers and newborns, the researched information demonstrates basic data on space plan of delivery departments in regional public hospitals.

A Study of Guidelines for Genetic Counseling in Preimplantation Genetic Diagnosis (PGD) (착상전 유전진단을 위한 유전상담 현황과 지침개발을 위한 기초 연구)

  • Kim, Min-Jee;Lee, Hyoung-Song;Kang, Inn-Soo;Jeong, Seon-Yong;Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.7 no.2
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    • pp.125-132
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    • 2010
  • Purpose: Preimplantation genetic diagnosis (PGD), also known as embryo screening, is a pre-pregnancy technique used to identify genetic defects in embryos created through in vitro fertilization. PGD is considered a means of prenatal diagnosis of genetic abnormalities. PGD is used when one or both genetic parents has a known genetic abnormality; testing is performed on an embryo to determine if it also carries the genetic abnormality. The main advantage of PGD is the avoidance of selective pregnancy termination as it imparts a high likelihood that the baby will be free of the disease under consideration. The application of PGD to genetic practices, reproductive medicine, and genetic counseling is becoming the key component of fertility practice because of the need to develop a custom PGD design for each couple. Materials and Methods: In this study, a survey on the contents of genetic counseling in PGD was carried out via direct contact or e-mail with the patients and specialists who had experienced PGD during the three months from February to April 2010. Results: A total of 91 persons including 60 patients, 49 of whom had a chromosomal disorder and 11 of whom had a single gene disorder, and 31 PGD specialists responded to the survey. Analysis of the survey results revealed that all respondents were well aware of the importance of genetic counseling in all steps of PGD including planning, operation, and follow-up. The patient group responded that the possibility of unexpected results (51.7%), genetic risk assessment and recurrence risk (46.7%), the reproduction options (46.7%), the procedure and limitation of PGD (43.3%) and the information of PGD technology (35.0%) should be included as a genetic counseling information. In detail, 51.7% of patients wanted to be counseled for the possibility of unexpected results and the recurrence risk, while 46.7% wanted to know their reproduction options (46.7%). Approximately 96.7% of specialists replied that a non-M.D. genetic counselor is necessary for effective and systematic genetic counseling in PGD because it is difficult for physicians to offer satisfying information to patients due to lack of counseling time and specific knowledge of the disorders. Conclusions: The information from the survey provides important insight into the overall present situation of genetic counseling for PGD in Korea. The survey results demonstrated that there is a general awareness that genetic counseling is essential for PGD, suggesting that appropriate genetic counseling may play a important role in the success of PGD. The establishment of genetic counseling guidelines for PGD may contribute to better planning and management strategies for PGD.

A Study on Family Planning Rumors & Practice in Rural Communities (일 농촌지역 가족계획 풍문과 실천에 관한 연구)

  • 추수경
    • Journal of Korean Academy of Nursing
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    • v.8 no.2
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    • pp.63-77
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    • 1978
  • Studies pertaining to influential factors on adoption and practice of family planning are very much needed to lower fertility, for family planning has regarded as only one social acceptable means to curb the accelerated population growth. One of the influential factors is known as rumors on family planning methods that hinder the actual practice of family planning. This study generally aimed at disclosing rumors on family planning methods prevalent in rural communities so that one could gain some in sights to cope with the ill effects of rumors to promote family planning Practice in rural communities in Korea. In order to accomplish the general aims this study formulated following four specific objectives; 1. Find out types and frequencies of rumors exposed of contraceptive methods. 2. Find out the relationship between the rumors exposed and socio-economic and demographic characteristics of new village leaders and health workers. 3. Examine the relationship between family planing rumors and family planning practices. The materials for this study were drawn from the two different sets of data gathered in July and Octorber 1977 respectivily by Center for Population & family Planning, Yon sei University. One is current family planning practice among eligible women reaiding in 4 Myuns in Kwang Wha country and the other is Survey on Rumor on family planning method heard by new village leaders and health workers in the four myuns. The four Myuns were divided into 60 small areas. Current family planning practice rate in each small area and as a whole were calculated. The unit of analysis in this study was not the indviduel person but the 55 small areas. Percentage, average, F-Test t-test and a coefficient of correlation were used for statistical analysis. Results of this study could be summarized as follows: 1. Rumors by different method of contraception: Medical complications, gastro-intestinal disorders, and difficulty in usage one most prevalent rumors about oral pills. Around 49% -77% of the 55 areas were often heard and the most frequent rumor was related medical complications of oral pills. Rumors on medical complications and incomplete effect of intrauterines as contraceptive were heard 51-66% of the 55 small areas. Rumors that vasectomy resulted in family problems, for instance infiedelity of spouse were often heard to 44% of the 55 small areas. 2. Rumors by socio-economic and demographic characteristic of new village leader and health workers: Among the demographic characteristics such as sex, age and sex composition of children, sex and age differentials in frequency of rumors heard more observed, Female new village health workers have heard more frequently than male new village leader. (t = 7.137, p> 0.01, d.f. = 53, a coefficient of correlation 0.27, p>0.05) The Younger age group less than 40 years of age have heard rumors of than the group over 40 years old. (t = 7.18, p>0.01, d.f. = 53, a coefficient of correlation 0.27, p>0.05) However, it was not observable that a consistent sex and age differentials in frequency of rumors heard of each contraceptive mettled, But, more female new village health works heard of rumors about intrauterine device than male new village leaders. (t = 0.497, p> 0.01, d.f. = 53, a coefficient of correlatin 0.32, p>0.01) 3. It was found that there was no statistically significant relationship between the frequency of rumors heard and current family planning practices on the whole, However, frequency of rumors heard about vasectomy appeared to have a positive relationship with current practice of vasectomy. A rather consistent pattern of relationship between“requency of rumors heard”and current family practice rate was demonstrated of 10 graphes which showed the relation between the two variagles. The current family planning practice rate in the“never heard”group and “frequently heard”group was equally lower than that in“often heard”group. The relatively consistent ∩ pattern of relationship needs to be farther investigated, for this pattern is different from the relationship that has been assumed to exist between these two variables.

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