• 국제지역연구
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• 제22권1호
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• pp.215-235
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• 2018

출산율 제고에 대한 정책적 고민은 OECD국가들의 공통된 관심사일 뿐 아니라 세계 최하위인 출산율을 기록하고 있는 한국의 최대 관심사이기도 하다. 많은 국가 예산을 투입해왔고 출산율 관련 여러 연구들이 진행되어 왔음에도 불구하고 한국의 출산율은 계속 감소 추세이다. 따라서 본 연구는 기존 출산율 연구에서 다루어져 왔던 출산율에 영향을 주는 세부적 요인들의 영향력 및 효과성 검증과 유럽 선진국가들의 사례를 통한 정책적 접근의 문제점을 인지하고 출산율과 삶의 질에 관한 거시적이고 구조적 접근을 통해 전체적 흐름을 다시 파악하고자 함에 그 목적이 있다. 즉 선진국의 높은 삶의 질은 출산율을 높이는지, 삶의 질과 출산율이 모두 높은 국가 모델은 어느 나라이며 그 나라의 출산에 대한 사회 및 정책적 흐름은 어떠한지를 살펴보았다. OECD국가들의 삶의 질 요인(BLI)와 CIA출산율 자료를 이용하여 분석한 결과, 삶의 질 수준이 높은 국가 중에도 출산율이 낮은 국가가 많다는 사실을 확인할 수 있었다. 그러나 삶의 질 수준과 출산율이 모두 높은 국가가 한국이 지향해야 할 국가 모델임을 인지하고 본 연구에서 새로 도출된 아이슬란드, 아일랜드, 뉴질랜드의 사례와 삶의 질 수준은 높지만 출산율이 낮은 독일의 사회적 특성을 비교해 본 결과 앞의 세 나라는 양성평등에 대한 인식 수준이 높게 나타났고 그 결과로 성별에 따른 임금 차이는 낮게 나타났음을 확인하였다. 반면에 독일의 경우는 성별에 따른 임금 불평등이 비교적 더 크게, 출산율은 더 낮게 나타남으로써 양성평등을 위한 인식전환이 출산율에 주요한 영향을 미치고 있음을 확인했다. 부모- 자식 간의 '상승관계(synergy)' 에 기초하여 가정 및 노동시장에서 양성평등 의식을 고양하는 것이 정책의 최우선 순위가 되고, 여타의 삶의 질을 높이는 요소를 적극 활용하여야 한다는 결론을 도출하였다. 즉 출산율 정책의 우선순위와 인프라적 지원을 동시에 추진하기 위해 국가의 출산율 목표를 '임신 가용한 여성의 출산율 제고'에서 '국민이 행복한 사회를 만드는 것' 으로 재설정하여 행복한 사회가 되어가는 과정에서 스스로 출산을 결정할 수 있는 시스템을 만들어야 할 것이다.

• 대한간호학회지
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• 제43권3호
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• pp.312-320
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• 2013

Purpose: The purpose of this study was to test a model for quality of life among infertile women. This model was based primarily on the concept of the Fertility Quality of Life by Boivin et al. (2011) and the Infertility Resilience Model by Rindenour (2009). Methods: Fifteen measurable variables were used to estimate quality of life. They included endogenous variables such as fertility quality of life and resilience, and exogenous variables such as infertility related stress, depression, marital adjustment, and family support. Data sets (n=203) used for analysis were collected in a general hospital which had, on average, 400 assisted reproductive technologies per month. Results: The assessment of the modified model indicated acceptable fit, with $x^2/d.f$=2.07, GFI=.90, AGFI=.89, NFI=.89, CFI=.91, RMSEA=.07. Depression, infertility related stress, marital adjustment, resilience, and family support had direct influences on quality of life. Conclusion: The results of this study should contribute to the development of nursing intervention programs to enhance quality of life using factors that affect fertiQol (fertility quality of life) of infertile women.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10871-10874
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• 2015

Background: Gestational trophoblastic neoplasia (GTN) is a malignant disease which occurs in women of reproductive age. Treatment of GTN has an excellent outcome and further pregnancies can be expected. However, data concerning quality of life in these cancer survivor patients are limited. This study aimed to assess quality of life in women who were diagnosed with GTN and remission after treatment, and to determine factors that may affect quality of life status. Materials and Methods: This cross sectional study was conducted from July 2013 to May 2014 in the Gestational Trophoblastic Disease Clinic, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Patients who were diagnosed GTN and complete remission were recruited. Data collection was accomplished by interview with two sets of questionnaires, one general covering demographic data and the other focusing on quality of life, the fourth version of Functional Assessment of Cancer Therapy (FACT-G). Descriptive statistics were used to determine general data and quality of life scores. Students t-test and one way ANOVA were used to compare between categorical and continuous data. Results: Forty four patients were enrolled in this study. The overall mean quality of life score (FACT-G) was 98.2. The overall FACT-G score was not significantly correlated with age, education level, stage of disease, treatment modalities, and time interval from remission to enrollment. However, patients who needed further fertility showed significant lower FACT-G scores in the emotional well-being domain (p=0.02). Conclusions: Overall quality of life scores in post-treatment gestational trophoblastic neoplasia patients are in the mild impairment range. Patients who desire fertility suffer lower quality of life in the emotional well-being domain.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권4호
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• pp.340-346
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• 2022

Purpose: The treatment and long term clinical outcomes of anorectal malformations (ARM) in children have always been the focus of pediatric surgeons. This study aimed at reporting our experience as far as long-term follow-up of ARM in children is concern. Methods: We enrolled patients treated between 1999 and 2019, and established selection criteria to choose appropriate subjects. A validated questionnaire was used to determine long-term quality of life outcomes. Results: Out of a total of 48 patients treated within the study period, 28 were enrolled in this study. Among the latter, more than 35% had at least one long-time complication, and more than 90% had a good lifestyle. Urinary and fecal continence was achieved in more than 95% of the patients using medical devices. Conclusion: This study aimed to bring up new concepts; taking into consideration all aspects of life in patients with ARM, from school life to sexuality, while evaluating fecal and urinary continence. This is essential for the improvement of the skills of the different specialists involved in the management of these patients, and for the implementation of strategies that can improve postoperative function. Most especially, it will also help improve communication between doctors to ensure an adequate transition of these children into adult life.

• Clinical and Experimental Reproductive Medicine
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• 제40권4호
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• pp.174-176
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• 2013

Klinefelter syndrome is the most common genetic form of male hypogonadism, but the phenotype becomes evident only after puberty. It is characterized by infertility, small testes, sparse body and facial hair, increased body weight, gynecomastia, increased LH and FSH, and a low level of testosterone. Early recognition and treatment of Klinefelter syndrome can significantly improve the patient's quality of life and prevent serious consequences. Here, we report an infertile man with a rare variant of Klinefelter syndrome with a 47, XY, i(X)(q10) karyotype.

• Asian-Australasian Journal of Animal Sciences
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• 제33권11호
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• pp.1763-1769
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• 2020

Objective: This study was conducted to investigate the effect of L-carnitine on the pig semen characteristics during storage. Methods: Spermatozoa samples were examined for spermatozoa quality and then randomly divided into 5 groups: 0 (control), 12.5, 25, 50, and 100 mM L-carnitine. Sperm motility, plasma membrane integrity and antioxidant parameters (total reactive oxygen species, total antioxidant capacity, and malondialdehyde) were evaluated after 0, 3, 5, and 10 day cooled-storage at 17℃. Moreover, ATP content, mitochondria activity as well as sperm-binding and in vitro fertilizing ability of preserved boar sperm were also investigated. Results: Supplementation with 50 mM L-carnitine could effectively maintain boar sperm quality parameters such as sperm motility and membrane integrity. Besides, we found that L-carnitine had positive effects on boar sperm quality mainly through improving antioxidant capacities and enhancing ATP content and mitochondria activity. Interestingly, by assessing the effect of L-carnitine on sperm fertility and developmental potential, we discovered that the extender containing L-carnitine could improve sperm quality and increase the number of sperms bounding to zona pellucida, without improving in vitro fertility and development potential. Conclusion: These findings suggested that the proper addition of L-carnitine to the semen extender improved boar sperm quality during liquid storage at 17℃.

• 한국인구학
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• 제8권2호
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• pp.79-92
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• 1985

Fertility has been declined since 1966 (see Table 1). This fertility reduction was duely caused by age at first marriage, induced abortion and contraceptive practice which has been largely increased in recent years. Although tbe proximate determinant such as induced abortion, age at marriage and breastfeeding can and do have an effect on fertility, the principal cause of the reduction in fertility in Korea during the fertility transition can be supported by correlation between level of fertility and contraceptive prevalence (See Fig. 4). Taking a regression equation between fertility (TER. Y) and prevalence level (X), the total fertility rate in 1984 was estimated as 1.9 and 2.1 based on lenear and expotential function shown as follow; $Y_1$=5.709-0.0549 X and $Y_2$_______80________ 1+e2.433+0.017X ($R^2$=O. 93) ($R^2$=0. 96) Where $Y_1$ and $Y_2$ denote total fertility rates obtained through two equations respectivelly. The peak of contraceptive prevalence was assumdd as 80 percent which is almost upper limit in human society. On the other hand, an observed value of 1984 fertility level obtained from five month period shows 2.1 which is coincident with logistic fitting after the adjustment of response error assumed around 10 to 20 percent, At any rate, fertility of Korean women will have been reached replacement level (2.1) by 1985.Thus policy for family planning program must be reviewed toward the direction of integrated approach particularly with MCH program inasmuch as fertility in Korea has already shown population replacement level that require more good quality of service in family planning and their There must be an advanced level of fertility in Korea because wide use of contraception and induced life abortion and age at marriage will effect modern fertility which shows up and down trend between 2.1 and 1.5 in general.

• Clinical and Experimental Reproductive Medicine
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• 제42권1호
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• pp.22-29
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• 2015

Objective: Sperm must be properly prepared in in vitro fertilization (IVF)-embryo transfer (ET) programs in order to control the fertilization rate and ensure that embryos are of high quality and have appropriate developmental abilities. The objective of this study was to determine the most optimal sperm preparation method for IVF. Methods: Patients less than 40 years of age who participated in a fresh IVF-ET cycle from November 2012 to March 2013 were included in this study. Poor responders with less than three mature oocytes were excluded. Ham's F-10 medium or sperm-washing medium (SWM) was used in combination with the density-gradient centrifugation/swim-up (DGC-SUP) or SUP methods for sperm preparation. A total of 429 fresh IVF-ET cycles were grouped according to the media and methods used for sperm preparation and retrospectively analyzed (DGC-SUP/Ham's F-10, n=82; DGC-SUP/SWM, n=43; SUP/Ham's F-10, n=181; SUP/SWM, n=123). Results: There were no significant differences among these four groups with respect to the mean age of the female partners, duration of infertility, number of previous IVF cycles, and retrieved oocytes. We determined that both the DGC-SUP and SUP methods for sperm preparation from whole semen, using either Ham's F-10 or SWM media, result in comparable clinical outcomes, including fertilization and pregnancy rates. Conclusion: We suggest that both media and both methods for sperm preparation can be used for selecting high-quality sperm for assistive reproductive technology programs.

• Clinical and Experimental Reproductive Medicine
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• 제43권3호
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• pp.174-180
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• 2016

Objective: To investigate psychological distress and fertility quality of life (FertiQoL) in infertile Korean women, and to investigate whether a correlation exists between psychological distress and FertiQoL. Methods: Participants in this study were made up of 141 infertile women and 65 fertile women. We conducted a survey on psychological distress (using the Depression Anxiety Stress Scales [DASS]-42 questionnaire) and administered a FertiQoL questionnaire. The levels of stress hormones (adrenocorticotropic hormone [ACTH] and cortisol) in serum were assessed. Results: The scores for depression ($13.7{\pm}8.4$), anxiety ($10.7{\pm}6.4$), and stress ($18.0{\pm}8.3$) among the infertile women were significantly higher than the scores for depression ($9.4{\pm}7.5$), anxiety ($6.6{\pm}6.0$), and stress ($12.2{\pm}8.3$, p<0.001) among the fertile women. There was no difference in the scores for depression ($13.5{\pm}8.2$, $13.8{\pm}8.6$), anxiety ($10.0{\pm}6.2$, $11.5{\pm}6.6$) and stress ($17.7{\pm}8.4$, $18.4{\pm}8.1$) between younger (${\leq}34$) and older (${\geq}35$) participants. The mind-body (r =-0.495) and emotional (r =-0.590) subscales showed a higher negative correlation with stress compared with other scales of psychological distress. At the same time, the social (r =-0.537) and relational (r =-0.385) subscales showed a higher negative correlation with depression. Levels of cortisol and ACTH in infertile women were $9.1{\mu}g/mL$ and 11.9 pg/mL, respectively, which are within normal ranges. Conclusion: The levels of psychological distress and quality of life in infertile Korean women seem to require psychological intervention. This study provides a baseline measurement of psychological distress and FertiQoL in infertile women in Korea, which will be available for developing psychological interventions for infertile Korean women.