• 제목/요약/키워드: Secondary infertility

검색결과 43건 처리시간 0.027초

불임 스트레스 척도 개발에 관한 연구 (A Study on the Development of an Infertility Stress Scale)

  • 김선행;박영주;장성옥
    • 대한간호학회지
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    • 제25권1호
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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.

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불임 검사시 자궁난관 조영술의 진단 정확도 (The Accuracy of Hysterosalpingography for Evaluating Female Infertility)

  • 박준철;김종인;이정호
    • Clinical and Experimental Reproductive Medicine
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    • 제32권3호
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    • pp.223-230
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    • 2005
  • Objective: This study was performed to evaluate the accuracy of hysterosalpingography (HSG) for evaluating female infertility patients by comparison with hysteroscopic and laparoscopic examination. Methods and Material: Total 219 infertile patients were retrospectively analyzed between January 1, 2002 and December 31, 2003. Ninety seven patients (44.3%) were primary infertility, 122 patients (55.7%) were secondary infertility. We performed hysteroscopic and laparoscopic examination on next cycle when HSG revealed any abnormal finding, and 3~6 cycles later if HSG was normal. Results: The accuracy of HSG was 65.2% compared with hysteroscopic examination (sensitivity 88.4%, specificity 46.4%, false positive rate 53.6%, false negative rate 11.6%). The most common abnormal finding of hysteroscopy was uterine synechia (67.4%) followed by endometrial polyp, uterine anomaly (e.g. uterine septum), endometrial hyperplasia. Compared with laparoscopic examination, the accuracy of HSG was 76.9% (sensitivity 98.9%, specificity 70.6%, +LR 3.36, -LR 0.02). The positive predictive value of normal patent tube was excellent (99.6%) but that of proximal tubal blockage was only 46.7%. The unilateral tubal obstruction of HSG was poor accuracy (+LR 3.85 -LR 0.68) and 70% of those was patent by laparoscopic examination. Laparoscopic examination also revealed that 53% of patients had peritubal adhesion and 37% of patients has additional pelvic findings, especially endometriosis. Among the patients had normal HSG, 53.5% patients with normal ultrasonography was diagnosed endometriosis (25.6% of them had endometriosis stage I-II). Conclusion: Normal HSG shows a high negative predictive value. Nevertheless, the incidence of associated pelvic disease in the normal HSG group is high enough to warrant diagnostic laparoscopy if nonsurgical treatment is unsuccessful. Because HSG has poor accuracy in predicting distal tubal blockage and peritubal adhesion, and poor positive predictive value of proximal tubal blockage, laparoscopic examination could be considered in abnormal HSG group.

지시적 심상요법이 체외 수정을 받는 여성의 스트레스와 불안에 미치는 효과 (Effects of Guided imagery on Stress and Anxiety of Women Receiving in Vitro Fertilization)

  • 배춘희;장순복;김수;강인수
    • 여성건강간호학회지
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    • 제17권2호
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    • pp.178-186
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    • 2011
  • Purpose: The purpose of this study was to identify effects of guided imagery on stress including cognitive, affective, marital and social, and anxiety among women receiving in vitro fertilization (IVF). Methods: Data were collected between April, 21 and June, 17, 2008. The participants in this study were 57 women (26 for the experimental group, 31 for the control group) receiving IVF for primary or secondary infertility in one of the outpatient infertility centers in Seoul. The guided imagery (Suk, 2001) was provided through audio CD to the experimental group by themselves 8 minutes per day for 2 weeks. Data were analyzed by SPSS 12.0 windows program. Results: After guided imagery, the experimental group showed significantly lower affective stress and total stress scores. Anxiety scores increased significantly in the control group, but not in the experimental group after treatment. Conclusion: The findings suggest that guided imagery is an effective nursing intervention for reducing stress especially affective stress and anxiety among infertile women receiving IVF in outpatient infertility center.

Analysis of the Result of Korean Medicine Treatment for Female Subfertility Using Herbal Medicine, Acupuncture and Moxibustion Treatment

  • Jeong, Jae-Cheol;Choi, Min-Sun;Yoon, Sang-Ho;Kim, Dong-Il
    • 대한한의학회지
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    • 제36권2호
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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.

Late physical effects of childhood cancer survivors

  • Lee, Young-Ho
    • Clinical and Experimental Pediatrics
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    • 제53권4호
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    • pp.477-480
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    • 2010
  • Advances in research and medical and supportive care have contributed to a growing population of adults formerly treated for childhood cancer. History of cancer and its therapy can have significant life-long health implications. Late effects of cancer therapy can be insidious on onset, occur outside the pediatric age, and contribute to premature morbidity and mortality. In this review, I have focused on the key long-term effects of pediatric cancer therapy, particularly on the metabolic syndrome, including cardiopulmonary complications, infertility, and secondary neoplasm.

체외배양 중인 생쥐 난소에서 초기난포 조절인자의 발현 (mRNA Expression of the Regulatory Factors for the Early Folliculogenesis in vitro)

  • 윤세진;김기령;정형민;윤태기;차광렬;이경아
    • Clinical and Experimental Reproductive Medicine
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    • 제32권3호
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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.

난관수종액이 정자의 운동성에 미치는 영향에 관한 연구 (Study on the Effect of Hydrosalpinx Fluid on Sperm Motility)

  • 김태철;이상훈;김동호;배도환;허민
    • Clinical and Experimental Reproductive Medicine
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    • 제26권1호
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    • pp.21-29
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    • 1999
  • This study was performed to identify the effect of the hydrosalpinx fluid on sperm motility. It has been reported that the patients with hydrosalpinx show the outstandingly lower success rate than other patients having infertility by different factors. It is unclear that the cause of it is influenced by hydrosalpinx fluid directly or by secondary chronic inflammation of endometrium. We wanted to know if the hydrosalpinx fluid influences sperm motility parameters directly such that it is related to the development of infertility. Therefore, using computer assisted semen analyzer (CASA), we observed, from February to July, 1997, how sperm motility, sperm progressive motility, sperm curvilinear velocity, sperm lateral head displacement, sperm straightness and sperm linearity change after treating normal sperm with hydrosalpinx fluid to evaluate sperm function on infertility. The result was that the study group (n=32) has the tendency to differ from the control group (n=32) on sperm motility, progressive motility, curvilinear velocity, lateral head displacement, straightness and linearity. We concluded that the hydrosalpinx fluid, with varying degree, directly has the harmful effects on sperm motility parameters, that is, curvilinear velocity, lateral head displacement and linearity of sperm which are related to the hyperactivation, hence decreased capacitation.

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정부 난임부부 지원사업 참여 대상자의 우울에 영향을 미치는 요인 (Factors Influencing the Depression Level of Couples Participating in the National Supporting Program for Infertile Couples)

  • 황나미;장인순
    • 지역사회간호학회지
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    • 제26권3호
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    • pp.179-189
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    • 2015
  • Purpose: The purpose of this study was to identify factors influencing depression of participants in the National Supporting Program for Infertile Couples (NSPI) who received a treatment of IVF (in vitro fertilization) or IUI (intra-uterine insemination). Methods: Using the 2013 NSPI Satisfaction On-line Survey data, secondary data analyses were conducted on 830 cases of IVF and 706 cases of IUI. Descriptive statistics, independent t-test, ${\chi}^2$ test, and logistic regression were performed using SPSS/WIN 21.0. Results: Logistic regression analysis showed that non-pregnancy status (OR=3.05), unexplained infertility (OR=4.29), relationship trouble with spouse (OR=3.57), and relationship trouble with the in-law family (OR=2.78) were significant factors predicting the depression level in the IUI treatment group. Non-pregnancy status (OR=5.28), childlessness (OR=1.92), financial support helpful hardly or not at all (OR=2.63), relationship trouble with spouse (OR=3.28), relationship trouble with the in-law family (OR=2.83), and unemployment (OR=1.60) were significant factors in the IVF treatment group. Conclusion: To reduce infertile women's depression, adequate attention and care need to be paid to these psychological symptoms. It is suggested to develop counseling and couple-therapy along with methods to enhance social support (including that from the in-law's family).

자궁내 인공수정 시술을 받은 고령 난임여성과 비고령 난임여성에서의 임신성공 확률 및 영향 요인의 비교: 2016년 보조생식술 국가지원사업기준 (Comparison of Clinical Pregnancy Rates and Affecting Factors Between Elderly and Young Infertile Females After Intra-Uterine Insemination: Benefited by 'National Medical-aid Program for ART (assisted reproductive technology) in 2016)

  • 장인순;김동영;김정식
    • Journal of Korean Biological Nursing Science
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    • 제22권3호
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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.