종설(綜說) : 불임(不姙)에 관한 실험연구 동향 분석 -한의학계에서 발표된 학위논문을 중심으로-

양인석 ( In Seok Yang ),임채광 ( Chae Kwang Im ) 대구한의대학교 제한동의학술원 2012 東西醫學 Vol.37 No.4

To develop, standardize and objectify the effective infertility treatments in Oriental Medicine, the tendency of experiments and studies on the infertility was analyzed through the published dissertations in Oriental Medicine field to get the following conclusions: In the annual publishing tendency, the number of dissertations began to increase from 2002 and the dissertations were published every year except 2005. In the publishing situation of institutions, Kyunghee University had published most papers: 11 master dissertations and 13 doctorate dissertations. In the infertility types, 25 dissertations were on the male infertility and 8 were on the female infertility. Before 2003, most of the dissertations were on the female infertility and since 2003 the dissertation on the male infertility have been published more actively. In the medication and the prescription, the studies with single medication were 25, and ones with single prescription were 8 In the studies on the male infertility with single medication, four papers on Ginseng Radix(人蔘) were the most. In the studies on the female infertility, there was one paper each on Cervi Pantotrichum cornu(鹿茸), Foeniculi fructus(小茴香), Evodiae fructus(吳茱萸) and Hominis placenta(紫河車). And in the papers experimented with the prescription, there was a male infertility dissertation each on the Ugui-eum(yougui-yin) and the Palmijihwang-hwan(baweidihuang-wan〕); in case of female infertility, there were 2 dissertations prescribing the Ontoyuknin-tang(wentuyulin-tang) and one each prescribing the Gamiguibi-tang(jiaweiguipi-tang), the Buikjihwang-hwan(fuyidihuang-wan), Sibjeonjeeum-hwan(shiquanjiyin-wan), the Onpo-eum(wenbao-yin), the Yukmijihwang-tang(liuweidihuang-tang), the Changbudodam-hwan(cangfudaotan-wan) and Palmulgunja-tang gamibang(bawujunzi-tang jiaweifang). If there are more diverse studies on medication, prescription, acupuncture/moxibustion and external treatment methods in the future, this will be very helpful for the clinical treatment of infertility.

Classification, causes, diagnosis and treatment of male infertility: a review

Mamuna Naz,Mehnaz Kamal 경희대학교 융합한의과학연구소 2017 Oriental Pharmacy and Experimental Medicine Vol.17 No.2

Infertility refers to the biological inability of an individual to contribute to conception over the course of one year. Male infertility refers to a male’s incapability to cause pregnancy in a fertile female. Approximately 15% of couples are affected by infertility and among them 40–50% cases are attributed to male infertility. Male infertility is mainly categorized into Azoospermia (AS) and Coital infertility (CI). Many studies have supported that different factors such as varicocele, testicular failure, endocrine dysfunction, genital tract infection, testicular disturbances, testicular cancer, hormonal disturbances, retrograde ejaculation, prolonged exposure to heat, obesity, older age, smoking, alcohol, heavy metals, pesticides, oxidative stress, genetic factors and different environmental and nutritional factors reversibly or irreversibly influence male fertility. Male infertility can be diagnosed by different tools. Diagnosing male infertility problems usually involves physical examination, semen analysis, hormone tests, testicular biopsy, urine test etc. There are different pharmacological, non-pharmacological, combination and ethno-pharmacological treatment options for male infertility. The infertility of known etiology has considerable treatment success rate. However, genetic or idiopathic male infertility has optimized and empirical approach. This review summarizes classification, causes, diagnosis and treatment of male infertility. The article is based on English peer-reviewed articles located on Scopus, Pubmed, ScienceDirect etc.

경제활동 참여 기혼여성의 난임시술 경험 관련 요인

전보영,김홍비,정혜인,한채영 한국모자보건학회 2024 한국모자보건학회지 Vol.28 No.2

Purpose: This study aimed to assess the current landscape of infertility treatment among married women engaged in economic activities and analyze the associated factors. Methods: Using data from the 2021 National Family and Fertility Survey in Korea, this study included 1,772 married women aged 20–44 who participated in economic activities. General characteristics were compared based on participants’ experiences with infertility and the use of infertility treatments (assisted reproductive technology). Logistic regression analysis was used to identify the factors associated with infertility and infertility treatment. Results: Among the study participants, 325 had experienced infertility and 122 had undergone infertility treatment. The likelihood of infertility was higher in women aged ≥35 years and those with gynecological problems. Infertility treatment was more probable among infertile women over 40 years of age, with higher levels of education and household income, cohabiting with their spouse for 4–9 years, working less than 40 hours per week, and holding office jobs as opposed to service or sales workers. Respondents who underwent infertility treatment highlighted the following challenges: mental and social prejudice, physical discomfort, pain, financial burden, workplace factors, and time constraints. Conclusion: This study shows that biological factors are important in infertility and underscores the significance of workplace factors and socioeconomic characteristics in the decision to treat infertility. This emphasizes the need for research that supports women pursuing a career or education who encounter the challenges of infertility.

난임 여성의 난임 관련 삶의 질 영향 요인

이영희,박정숙 한국모자보건학회 2019 한국모자보건학회지 Vol.23 No.3

Objectives: The purpose of this study is to determine the infertility stress, resilience, intimacy and infertility- related quality of life of infertility women in an infertility clinic, and to reveal associated factors of infertility-related quality of life. Methods: As a descriptive study, data was collected from 92 infertility women in an infertility clinic. Data was analyzed using t-test, analysis of variance, Pearson correlation coefficients and stepwise multiple regression. Results: Infertility stress, resilience, intimacy and infertility-related quality of life averaged 3.1±0.5, 3.7± 0.3, 3.3±0.3, 3.2±0.5 respectively. The infertility-related quality of life varied with a statistical significance by marital period, the presence of a burdensome person and burdensome person. Infertility-related quality of life had a negative correlation with infertility stress (r=-0.69, p<0.001), and a positive correlation with resilience (r=0.23, p=0.28) and intimacy (r=0.22, p=0.030). Meaningful variables that influenced infertility-related quality of life were 'need for parenthood,' 'social concern in infertility stress' and 'positive factor in resilience,' and infertility-related quality of life was explained 56.6% by the variables. Conclusion: It is suggested to highlight the importance of the infertility-related quality of life and to develop and execute the nursing intervention program for enhancing resilience and decreasing infertility stress of infertility women in infertility clinics.

난임 커플의 난임 스트레스와 난임 관련 삶의 질 간의 자기효과와 상대방효과

김성희,이가연,전혜정 한국가족학회 2021 가족과 문화 Vol.33 No.1

A number of infertility-related research have mainly focused on rather women than men, even though infertility is a joint experience of couples and the responsibility of reproduction should be borne to the couples. Therefore, this research investigates the dyadic associations between infertility-related stress and quality of life in infertile couples. In order to achieve the aim of the study, an online survey was conducted targeting 87 married infertile couples. The SPSS 25.0 program and the Mplus 7.4 program were used for descriptive statistics, t-test, and APIM analysis. The results of this study are as follows: First, the level of infertility-related stress was similar to the median value, and the infertile couples showed higher levels of infertility-related quality of life than the median scale. Infertile men indicated higher levels of infertility-related quality of life compared to their partners. Second, regarding actor effects, infertile-related stress was negatively associated with infertility-related quality of life in both men and women. The partner effect of infertile-related stress on the infertile-related quality of life was significant among only women. The investigation on sub-scales of infertility-related stress showed that men’s infertility-related quality of life improved as their level of infertility-related stress in the domain of need for parenthood rose. On the contrary, men’s infertility-related quality of life dropped as their level of infertility-related stress in the rejection of child-free lifestyle, social, and sexual domain rose. Meanwhile, women’s infertility-related quality of life decreased as their stress in the social, relationship, and sexual domain increased. Finally, this research attempted to promote understanding the experience of infertile couples by providing basic information on them. 난임은 커플 공동의 경험이며 재생산의 책임은 커플에게 모두 부여되지만, 연구를 비롯한난임의 초점은 여성에게 맞추어져 있다. 이에 본 연구는 난임 커플을 중심으로 난임 스트레스와 난임 관련 삶의 질과의 관계에 있어 부부간 자기효과와 상대방효과에 대해 살펴보았다. 이를 위해 온라인상에서 모집한 난임 치료 경험이 있는 커플 87쌍을 대상으로 온라인 설문조사를 진행하였다. 분석은 SPSS 25.0과 Mplus 7.4 프로그램을 사용하여 기술통계, t-test, 행위자- 상대자 상호의존 모형 분석을 실시하였다. 연구 결과는 첫째, 난임 커플의 난임 스트레스는 보통 수준을 나타냈으며, 난임 관련 삶의 질은 커플 모두 척도 중앙값보다 다소 높은 수준을 나타냈다. 또한 난임 관련 삶의 질에 있어서 아내보다 남편의 삶의 질이 높은 것으로 나타났다. 둘째, 남편과 아내 각각 자신의 난임 스트레스가 증가할수록 자신의 난임 관련 삶의 질이 저하되는 자기효과가 나타났다. 반면 상대방효과에서는 아내의 난임 스트레스가 증가함에 따라 남편의 난임 관련 삶의 질은 저하되는 반면, 남편의 난임 스트레스는 아내의 난임 관련 삶의 질에영향을 미치지 않았다. 난임 스트레스의 하위 영역별로 살펴본 결과, 남편의 부모됨의 필요성영역에서의 스트레스 수준이 증가할수록 남편의 난임 관련 삶의 질은 향상된 반면, 남편의 아이가 없는 일상에 대한 거부, 사회 및 성적 영역으로부터 받는 스트레스가 증가함에 따라 남편의 난임 관련 삶의 질이 저하되었다. 한편 아내의 사회적, 관계적 및 성적 영역에 대한 스트레스가 증가함에 따라 아내의 난임 관련 삶의 질이 저하하였다. 이들 결과를 통하여 난임 커플에대한 기초 자료를 제공함으로써 난임 커플에 대한 이해 증진을 도모하고자 하였다.

전라남도 난임 여성 한방치료 지원 사업에 참여한 한의사를 대상으로 한 설문 연구

김수현,이은규,최유진,박경미,조성희,양승정 대한한방부인과학회 2019 大韓韓方婦人科學會誌 Vol.32 No.2

Objectives: The research is aimed at identifying the necessity of the support project of Korean medical treatment in infertility by analyzing the outcome of those subject and providing data for Korean medical treatment in infertility by analyzing the medical treatment of Korean medical doctors involved in the project. Methods: 98 patients who participated in the support project of Korean medical treatment in infertility in Jeollanamdo and 57 Korean medical doctors who participated as therapists were surveyed. Patients were given four months of treatment at local Korean medical clinics. After the treatment was completed, we analyzed the characteristics of the patients' group. And we sent questionnaires to doctors to answer the message. The content of the questionnaire consisted of infertility treatments, a wish for support project. These data were analyzed by frequency and t-test. Results: Analysis of the answer to the questionnaire obtained data on Korean medical treatment in infertility. The most desired thing for future support program was the introduction of husband and wife care. Conclusions: This survey by Korean medical doctors gave us reference data for Korean medical treatment in infertility and the direction in which therapy business should proceed. Objectives: The research is aimed at identifying the necessity of the support project of Korean medical treatment in infertility by analyzing the outcome of those subject and providing data for Korean medical treatment in infertility by analyzing the medical treatment of Korean medical doctors involved in the project. Methods: 98 patients who participated in the support project of Korean medical treatment in infertility in Jeollanamdo and 57 Korean medical doctors who participated as therapists were surveyed. Patients were given four months of treatment at local Korean medical clinics. After the treatment was completed, we analyzed the characteristics of the patients' group. And we sent questionnaires to doctors to answer the message. The content of the questionnaire consisted of infertility treatments, a wish for support project. These data were analyzed by frequency and t-test. Results: Analysis of the answer to the questionnaire obtained data on Korean medical treatment in infertility. The most desired thing for future support program was the introduction of husband and wife care. Conclusions: This survey by Korean medical doctors gave us reference data for Korean medical treatment in infertility and the direction in which therapy business should proceed.

체외수정 시술 시 경증의 자궁내막증과 원인불명의 불임 여성의 비교

김혜옥 ( Hye Ok Kim ),박찬우 ( Chan Woo Park ),송인옥 ( In Ok Song ),궁미경 ( Mi Kyoung Koong ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.2

목적: 체외수정 시 경증의 자궁내막증과 원인불명의 불임여성의 체외수정 결과의 차이가 있는지 비교하였다. 연구 방법: 1997년 1월부터 2004년 4월까지 체외수정 1202주기를 후향적으로 연구하였다. 경증의 자궁내막증 513주기, 원인불명 338주기, 대조군은 난관요인을 가진 351주기를 대상으로 하였다. 제외기준으로는 여성의 나이가 36세 이상, 난자 채취 시 난자가 4개 미만으로 획득된 경우, 기저 난포자극 호르몬이 20 mIU/ml 이상인 경우, 비폐쇄성 무정자증, 다낭성 난소 증후군을 가진 경우를 제외하였다. 결과: 경증의 자궁내막증, 원인불명, 난관 인자의 평균 연령은 각각 31.7±2.3세, 31.8±2.9세, 31.5±2.7세였다. 일차성 불임의 빈도가 경증의 자궁내막증 (72.3%)과 원인불명 (68.5%)이 난관인자 (31.2%)보다 유의하게 높았다 (p <0.0001). hCG 투여일의 혈청 E2 농도와 난자수는 세 그룹간 비슷하였으나, 수정률 (%)은 경증의 자궁내막증에서 62.3±21.2로 원인불명의 66.0±21.6, 난관인자의 68.8±17.6보다 낮았으며, 특히 난관인자와 통계적으로 의미 있는 차이를 보여 주었다 (p<0.0001). 총 배아수는 경증의 자궁내막증에서 8.38±5.0개로 원인불명 9.21±5.5개, 난관인자 9.81±5.2개보다 적었지만 (p<0.0001), 양질의 배아 (good quality embryo)는 세 그룹간 차이가 없었다. 임신율은 경증의 자궁내막증, 원인불명, 난관인자에서 32%, 35.8%, 39.9%, 착상률은 13.5±23.3, 14.3±23.6, 16.1±23.5였으며, 경증의 자궁내막증에서 가장 낮았으나, 유의하지 않았다. 결론: 경증의 자궁내막증을 가진 불임여성은 체외수정 시 원인불명의 불임여성보다 임신율, 착상률, 생존아 출생률에서 유의한 차이가 없었다. 하지만, 수정률의 현저한 저하를 보이므로 장기간의 불임기간을 가진 경증의 자궁내막증과 원인불명의 불임여성에서 체외수정을 좀 더 일찍 고려해 볼 수 있겠다. Objective: The aim of this study is to assess the IVF/ICSI outcomes of infertile women with minimal to mild endometriosis associated and unexplained infertility Method: We performed a retrospective analysis of 513 (IVF/ICSI) cycles with minimal to mild endometriosis associated infertility, 338 cycles with unexplained infertility, 351 cycles with tubal factor infertility as controls between Jan. 1997 and Apr. 2004. Exclusion criteria for study were: age>36 yrs old, the number of oocytes retrieved < 4, basal FSH > 20 mIU/ml, patients with nonobstructive azoospermia, polycystic ovarian syndrome. Results: The incidence of primary infertility was significantly higher in minimal to mild endometriosis (72.3%) and unexplained (68.5%) than tubal factor (31.2%) (p<0.0001). There was no difference in fertilization rate between minimal to mild endometriosis associated infertility and unexplained infertility. But minimal to mild endometriosis associated infertility showed significantly lower fertilization rate and the number of total embryos than tubal factor infertility (62.3±21.2% vs. 68.8±17.6% (p<0.0001), 8.38±5.0 vs. 9.81±5.2 (p<0.0001)). But the number of good quality embryos was similar. Clinical pregnancy rates of minimal to mild endometriosis associated, unexplained, and tubal factor infertility was 32%, 35.8%, 39.9% and implantation rates was 13.5±23.3, 14.3±23.6, 16.1±23.5, respectively. Conclusion: The IVF/ICSI outcomes of minimal to mild endometriosis associated infertility is comparable to those of unexplained infertility with respect to clinical pregnancy rates, implantation rates, and live birth rates. And we suggest that IVF should be considered earlier in patients with minimal to mild endometriosis associated and unexplained infertility because of significantly decreased fertilization rates and longer duration of infertility.

Socioeconomic Status and Successful Delivery after an Infertility Diagnosis: a Nationwide Health Insurance Cohort Study in Korea Conducted from 2005 to 2013

Shin Jaeyong,Lee Sang Gyu,Park Eun-Cheol,남진영 대한의학회 2020 Journal of Korean medical science Vol.35 No.39

Background: The global disease burden of infertility is rising and accessibility to infertility treatments and assisted reproduction is a challenging issue. Therefore, we investigated characteristics of successful delivery after an infertility diagnosis among infertile women. Methods: We designed a retrospective cohort study with the main outcome measure of a delivery medical record after the initial diagnosis of infertility. A total of 10,108 women patients who were diagnosed with infertility between 2005 to 2013 in the National Health Insurance Cooperation Cohort Database of Korea were enrolled. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for subsequent delivery were estimated by applying a Cox proportional-hazard regression model. Results: Approximately 55% of infertile women who reported infertility had a delivery eventually. Infertile women who are aged between 30 to 39 (HR, 0.80; 95% CI, 0.75–0.84), in low income level (HR, 0.77; 95% CI, 0.71–0.84), or diagnosed with diabetes (HR, 0.76; 95% CI, 0.60–0.96) were less likely to report a delivery. Conclusion: These findings highlight demographic, socioeconomic, and medical characteristics of reporting a consequent delivery. Although many previous articles reported an association between socioeconomic status and receiving medical evaluation, there were few studies regarding successful delivery after an infertility diagnosis across socioeconomic status. Thus, the maintaining of support for low socioeconomic status infertile women and their family should be considered after the infertility diagnosis in aspects of financial and social approaches.

난임 시술을 받은 남성의 심리사회적 어려움

문은미,김민아 한국보건사회연구원 2023 保健社會硏究 Vol.43 No.4

Despite the increasing prevalence of infertile couples undergoing infertility treatment, there has been a dearth of attention to the psychosocial challenges encountered by men experiencing infertility. This study aimed to understand the psychosocial challenges of men diagnosed with male-factor infertility who underwent fertility treatment. Through purposive sampling, eight men who had undergone infertility procedures were recruited for in-depth interviews. The case analysis revealed five overarching themes (complex emotions experienced following an infertility diagnosis, heightened stress in family dynamics, difficulties in spousal relationships during infertility treatment, stress and burden associated with disclosing infertility treatment in social relationships, and absence of social support systems during infertility treatment) and 16 subthemes related to challenges faced by infertile men. The findings of the study confirmed the personal, relational, and societal challenges experienced by men during infertility diagnosis and treatment. This study confirmed the importance of implementing interventions at the individual and societal levels to address the psychosocial challenges encountered by infertile men undergoing infertility treatments.

난임 여성의 난임관련 삶의 질 영향요인

김윤미 ( Yun Mi Kim ),노주희 ( Ju-hee Nho ) 한국여성건강간호학회 (구 여성건강간호학회) 2020 여성건강간호학회지 Vol.26 No.1

Purpose: Infertile women experience various physical, psychological, and relational problems that affect their infertility-related quality of life (QoL). This study investigated infertile women’s infertility-related QoL with the goal of identifying how it is influenced by fatigue, depression, and marital intimacy. Methods: A sample of 140 infertile women was surveyed in a cross-sectional study. Data were collected from February to April 2018 using self-report structured questionnaires at three infertility clinics located in Jeonju, Korea. Data were analyzed using the independent t-test, analysis of variance, Pearson correlation coefficients, and stepwise multiple regression analysis in SPSS for Windows version 25.0. The subjects agreed to complete a face-to-face interview, including administration of the Fatigue Severity Scale, Depression Anxiety Stress Scale-21, Marital Intimacy Scale, and the Fertility Quality of Life tool. Results: The mean age of the participants was 35.6±4.3 years. Infertility-related QoL was negatively correlated with fatigue (r=-.42, p<.001) and depression (r=-.56, p<.001), and positively correlated with marital intimacy (r=.30, p<.001). Multiple regression analysis showed that depression (β=-0.44, p<.001), fatigue (β=-0.27, p<.001), and husband’s attitude (β=-0.19, p=.007) had significant effects on the QoL of infertile women, accounting for 40.5% of the variance in infertility-related QoL. Conclusion: The study provides insights into how infertile women’s infertility-related QoL was influenced by depression, fatigue, and their husbands’ attitudes regarding infertility treatment. To improve infertile women’s infertility-related QoL, healthcare providers should consider developing strategies to decrease depression and fatigue in infertile women and to address their husbands’ attitudes.