• Clinical and Experimental Reproductive Medicine
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• 제33권1호
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• pp.45-52
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• 2006

목 적: 자궁내막증과 이로 인한 불임의 원인인 면역학적 인자 중 세포-매개성 면역계의 변화 양상을 규명하기 위하여 자궁내막증 환자와 자궁내막중이 없는 환자의 복강 액을 채취하여 면역 세포의 분포양상을 비교 분석하고자 IL-6와 TNF-${\alpha}$를 측정하였다. 연구방법: 자궁내막증으로 육안적 또는 조직검사로 확진된 환자 또는 불임검사를 위해 진단적 복강경을 시행한 34명을 연구군으로 등록하였으며 본 연구 이전에 자궁내막증과 관련된 어떠한 치료도 받은 적이 없거나 복강경 시술이나 개복수술과정에서 자궁내막증 소견과 증상이 없는 환자 37명을 대조군으로 하였다. 두 군의 복강 액을 추출한 다음 30분 이내에 $400g{\times}10$분 동안 원심분리 후 상층액만 검사용기에 모아 밀봉한 후 $-70^{\circ}C$ 냉동실에 보관하여 IL-6와 TNF-${\alpha}$의 농도를 "sandwich" enzyme-linked immunosorbent assays (ELISA: R & D Systems, Minnepolis, MN)로 측정하였다. 결 과: 1. 복강 액의 IL-6의 농도는 자궁내막증으로 확진된 연구군에서는 $38.9{\pm}19.7pg/ml$으로 대조군의 $22.4{\pm}10.2pg/ml$보다 유의하게 증가하였고 (p=0.02), TNF-${\alpha}$의 농도도 자궁내막증이 있는 여성에서 $20.6{\pm}8.6pg/ml$로 대조군의 $6.2{\pm}3.5pg/ml$보다 유의하게 증가하였다 (p=0.01). 2. 자궁내막증여성의 생리주기별 농도에서 IL-6은 증식기보다 분비기에 유의하게 증가한 반면 (p=0.01), TNF-${\alpha}$는 차이가 없었다 (p>0.05). 3. IL-6은 가임여성보다 불임여성에서 유의하게 증가하였고 (p=0.03), TNF-${\alpha}$는 두 군 간에 유의한 차이는 없었다 (p>0.05). 4. IL-6과 TNF-${\alpha}$ 모두 대조군과 자궁내막증 병기 I과 II는 통계학적인 유의성은 없었으나 병기 III과 IV는 유의하게 증가하였다 (p<0.05). 결 론: 자궁내막증인 환자의 복강 액에서 IL-6와 TNF-${\alpha}$가 증가하여 자궁내막증의 생성과 유지, 증상발현에 관여하며 불임의 유발 요인으로 여겨지나 향후 많은 환자를 대상으로 한 연구와 자궁내막증과 각종 cytokine과의 상호 연관관계에 대한 연구가 더 많이 필요하리라 사료된다.

• 대한한방부인과학회지
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• 제30권1호
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• pp.56-67
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• 2017

Objectives: The purpose of this study is to elucidate infertility women's experience in psychological stress and to suggest effective infertility stress management methods. Methods: Twenty five infertility women who participate in Korean Medicine Pilot Project for Infertility completed questionnaires and Infertility Stress Scale, also, we have interviewed. Results: The Mean degree of stress of the infertile women was 2.24 point with Infertility Stress Scale. In focused interview, the infertility stress was considered to be within the aspects of intra and interpersonal. In regards to intrapersonal aspect, infertility women described the grief with lowered self-esteem and anxiety with obsession for fertility. As for the interpersonal aspect, infertility women were distressed by the relationship with spouse and in-laws, as well as friend and the public. Conclusions: Doctors in infertility clinic need to consider infertility stress of their patients and conduct effective intervention.

• 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.

• 대한한의학원전학회지
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• 제28권3호
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• pp.107-124
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• 2015

Objectives : The purpose of this study is to identify Yangsaeng level and pattern identification of subfertility in childbearing aged women according to the pregnancy experience. Methods : Data was collected by structured questionnaire distributed to 217 women(125 women experienced pregnancy, 92 subfertile women) in I city from Nov. to Dec. 2014. For data analysis, Chi-square test, Fisher's exact test, t-test and Pearson's correlation coefficients were performed using SPSS version 19.0. Results : Drinking rate and stress level of subfertile group were higher than pregnancy experience group. Subfertile women group have more disease related to reproductive system, irregularities of the menstrual cycle and dysmenorrhea than pregnancy experience group. Subfertile women showed lower scores for Yangsaeng level but higher scores for all types of pattern identification of subfertility more than those in the women experiencing pregnancy. Conclusions : The results of this study indicate that reproductive health program for the childbearing aged women is necessary before serviced by western or oriental medical treatment for subinfertile(infertile) women. These results can be used for a program based on oriental medicine in order to improve women's health.

• Clinical and Experimental Reproductive Medicine
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• 제39권2호
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• pp.68-72
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• 2012

Objective: To investigate the value of stimulated intrauterine insemination (IUI) in women with unilateral tubal occlusion. Methods: Superovulation and IUI was performed during 2003-2010 and the medical records were reviewed retrospectively. Thirty-seven infertile women (52 cycles) with unilateral tubal occlusion diagnosed by hysterosalpingography and without other causes of infertility were selected. One-hundred fourteen patients with unexplained infertility served as a control group (182 cycles). The main outcome was the clinical pregnancy rate per cycle. Results: The pregnancy rate per cycle was similar, 17.3% for the unilateral tubal occlusion group and 16.5% for the unexplained infertility group. The rate of miscarriage (11.1% vs. 23.3%) and ectopic pregnancy (11.1% vs. 6.7%) was similar between the two groups. The pregnancy rate was higher in patients with proximal occlusion (25.0%) compared with distal occlusion (13.9%) or unexplained infertility, but not statistically significant. Conclusion: Stimulated IUI can be suggested as the initial treatment option in women with unilateral proximal or distal tubal occlusion.

• 여성건강간호학회지
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• 제25권1호
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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.

• Clinical and Experimental Reproductive Medicine
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• 제41권2호
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• pp.75-79
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• 2014

Objective: To study the effect of body composition on reproduction in women with unexplained infertility treated with a controlled ovarian hyperstimulation and intrauterine insemination programme. Methods: This prospective observational study was conducted on 308 unexplained infertile women who were scheduled for a controlled ovarian hyperstimulation and intrauterine insemination programme and were grouped as pregnant and non-pregnant. Anthropometric measurements were performed using TANITA-420MA before the treatment cycle. Body composition was determined using a bioelectrical impedance analysis system. Results: Body fat mass was significantly lower in pregnant women than in non-pregnant women ($15.61{\pm}3.65$ vs. $18.78{\pm}5.97$, respectively) (p=0.01). In a multiple regression analysis, body fat mass proved to have a stronger association with fecundity than the percentage of body fat, body mass index, or the waist/hip ratio (standardized regression coefficient${\geq}0.277$, t-value ${\geq}2.537$; p<0.05). The cut-off value of fat mass, which was evaluated using the receiver operating characteristics curve, was 16.65 with a sensitivity of 61.8% and a specificity of 70.2%. Below this cut-off value, the odds of the pregnancy occurrence was found to be 2.5 times more likely. Conclusion: Body fat mass can be predictive for pregnancy in patients with unexplained infertility scheduled for a controlled ovarian hyperstimulation and intrauterine insemination programme.

• Clinical and Experimental Reproductive Medicine
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• 제37권1호
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• pp.73-81
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• 2010

목 적: 클로미펜을 이용한 배란유도 주기에서 불량한 자궁내막 발달을 보이는 불임 여성에서 레트로졸의 효용성을 알아보고자 하였다. 연구방법: 2004년 3월부터 2009년 8월까지 분당서울대학교병원에서 클로미펜을 이용한 배란유도 주기에서 자궁내막 두께가 6.5 mm 이하여서 다음 주기에 레트로졸을 사용하였던 18명의 불임 여성을 선정하였다. 환자들의 평균 연령은 $30.7{\pm}2.8$세, 불임 기간은 $33.1{\pm}26.6$개월이었다. 불임의 인자는 자궁내막증이 1명, 다낭성난소증후군이 5명, 원인불명의 불임증이 12명이었다. 레트로졸은 2.5 mg의 용량으로 월경 3~5일 사이에 시작하여 5일간 투여하였다. 결 과: 이전 클로미펜 사용시와 비교하였을 때 레트로졸 주기에서 우성난포의 개수는 더 적었으나 ($1.1{\pm}0.3$ vs. $2.2{\pm}1.5$, p=0.011) 자궁내막 두께는 유의하게 증가하였으며 ($8.4{\pm}1.7$ mm vs. $5.8{\pm}0.5$ mm, p<0.001) 자궁내막 패턴 중 type C의 빈도는 이전 클로미펜 주기에서 50%이었던 것이 레트로졸 사용시 94.4%로 유의한 증가를 보였다 (p=0.036). 레트로졸을 이용한 배란 유도 주기에서 임신율은 11.1%였다. 결 론: 얇은 자궁내막 발달을 보였던 클로미펜 주기에 비해 레트로졸 사용시 자궁내막이 좀 더 두꺼워지고 패턴이 호전되는 것으로 보아 클로미펜에 불량한 자궁내막을 보이는 여성에서 이차 선택약제로 레트로졸의 사용은 유용한 방법으로 사료된다.

• 여성건강간호학회지
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• 제15권1호
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• pp.43-53
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• 2009

Purpose: This study was to identify what experience meant for the wives that attempted IVF-ET(In Vitro Fertilization-Embryo Transfer) program due to the spouse's infertility and provide fundamental materials to improve nursing interventions. Method: Giorgi's phenomenological method was employed, the subjects were five wives who had ever attempted IVF-ET program due to the infertility of their spouses. In-depth interview and observation method were utilized to gather information from April to December 2003. Result: The significant results from analyzing the interviews can be grouped into 34 themes, 8 categories. The essential themes for the experiences of the wives were 'shocked by the unbelievable reality', 'can't give up the connection to the blood', 'Lack of social education on pregnancy, and childbirth', 'self-pity', 'feelings of both families', 'Being afraid of the unexpected result', 'physical and mental agony', 'Positively coping with the reality. Conclusion: The results show that infertility is not a mere personal matter, and infertile people, their families and society should team up with in tackling it. The physical, psychological and social problems triggered by infertility could be ironed out by making both personal and collaborative approaches to that.

• 임상간호연구
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• 제24권1호
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• pp.44-55
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• 2018

Purpose: This study aimed to explore and understand the experience of decision making among women undergoing or forgoing selective fetal reduction who have higher-order multiple pregnancies through assisted reproductive techniques. Methods: A qualitative study was conducted from August 1, to October 30, 2013. Eight participants were interviewed and the interviews were audio-recorded and transcribed verbatim. Six persons participated in in-depth interviews in person and two participated over the telephone. A thematic analysis was conducted. Results: Four themes were identified and carefully named: Confusion after higher-order multiple pregnancy; Obstacles to choice: Uncertain safety; Weighing between reality and ideality and; Influences of medical professionals. Conclusion: The results demonstrated a wide range of factors considered by women when making decisions about selective fetal reduction, and mothers' feelings of conflict and distress in the decision-making process. The results suggest that it is important for nurses to provide emotional support and consolation, in addition to sufficient information. These findings will help nurses improve their counseling techniques by understanding the situation of infertile couples.