Kim Seok-hyun

By Bae Ji-sook
Staff Reporter

Infertility is painful for many couples trying to start a family. The infertility clinic market continues to expand at a great pace, but still many couples express anguish at not being able to have a biological child.

When a couple has regular sex without any contraception for a year and there is no pregnancy, doctors regard it as infertility. ``The chances of getting pregnant after a year is a mere 5 percent,'' Kim Seok-hyun of Seoul National University Hospital says.

Infertility prevalence was more common in Western countries, but nowadays, Korea is seeing a rapid increase. Doctors suspect diet and other environmental factors.

Women getting married later and wanting to have babies later in life could be one reason_ the best age at which to have a child is 24 ― eating a lot of floury, greasy foods could also be a reason.

Having experienced a gynecologic disease could also be a huge influence, with endometriosis or ovary removal increasing among young women here.

Taking oral contraceptive drugs for a long time might also affect one's fertility, he adds. These days the medicines are good and the risks have gotten smaller, but still he says taking the pill for a long time could affect menstruation as well as ovulation.

Lastly, women experiencing miscarriages are also highly likely to suffer problems. Especially the abortion experience could affect one's uterus and other reproductive functions critically, he says.

In Korea, about 1.4 million women are reportedly infertile, according to the governmental data. The figure is equivalent to one out of every seven fertile women being unable to get pregnant.

Infertility was once regarded as only a female problem here, but Kim says about 40 percent of all cases are attributable to males ― usually due to a low sperm count.

However, the exact reason for about 15 percent of total cases is unknown, he says.

For those who suffer from irregular ovulation, simple medication could help and one could easily try for pregnancy. Stimulating the development of follicles in the ovary with gonadotropins and gonadoptropin releasing hormones would help. Such symptoms are often seen in the United States, but here the figure isn't significant.

What makes things complex is when the there is a blockage or other disorder in a Fallopian tube. In these cases, one needs to receive artificial insemination.

In Vitro Fertilization Pro-Embryo Transfer (IVF-ET) is a technique of letting the fertilization of the male's sperm and female's egg occur outside the female body. It was first used to deal with oviduct disorder, but after 30 years of improvement, it is used for male infertility, female endometriosis, and failure of ovulation induction.

Intracytoplasmic sperm injection, where the sperm is injected directly into the egg, is particularly effective. About 500,000 cases of such treatment are being conducted a year worldwide, with one out of every 100 new born babies reportedly a result of the procedure.

The treatment largely involves four stages ― controlling the ovulation process using hormones, removing eggs from the women's body, letting sperm fertilize them in a fluid medium, and transferring the fertilized egg to the female's uterus.

Kim, who sees about an 80 percent success rate in the field, says the IVF treatment is used not only for infertility but preventing hereditary disease. With some tests held before the embryos are conceived, one can predict what kinds of genetic disease the embryos have and pick the healthy ones only, he says.

Also, the treatment is getting better so these days the doctors do not inject multiple fertilized eggs into a women's womb possibly causing the birth of multiple twins. ``In more cases, we are putting one or two only,'' he says.

Korea is one of the top countries in the world for the treatment, but in terms of basic research, it is a bit behind. However, Kim says he and his team are catching up on. They regularly release about 16 reports to the American Society for Reproductive Medicine, with about 10 percent of reports to the society coming from Korea.

In the future, the chances of conception will get higher while techniques for detecting genetic disease at the embryo stage will get more sophisticated, he says.

Infertility treatment, especially IVT-ET, has always been controversial in terms of ethics.

Receiving egg donation or hiring a surrogate mother is restricted here, especially after Hwang Woo-seok stirred the nation with his stem cell research. Egg donation is limited to research purposes and should be provided free of charge.

However, Kim says the society needs to be more flexible here. ``Receiving eggs could be crucial for an infertile couple. When a woman cannot ovulate after treatment, what can she do? However, when getting eggs, using hormones to induce superovulation could cause health problems and hinder further pregnancy. Paying enough money to the donor and strict monitoring could me more appropriate in this case,'' he says.

He also says surrogate mothering is allowed in several countries and Korea needs it, too. ``Shouldn't we let at least some related people, such as a cousin, take the role? When a couple fails IVF six times, then we consider them not adequate for pregnancy. In this case, what should you do?'' he asks.

Kim graduated from Seoul National University, worked at the University of California San Diego as a research fellow and University of Wyoming as a visiting professor. With more than 400 reports to his name in his area, he has served as vice president of the Study Group for Contraception and held the same position for the Korean Andrological Society.

He is also well known as sports enthusiast, especially in Major League Baseball ― he knows every score and catches up with every match on television and the Internet.

bjs@koreatimes.co.kr

Tips From the Doctor
	Genetic factors are one of the most serious attributions to infertility, experts say. But having other issues such as abortion history, a long-period contraception, and other ovulatory problems could be the reason. Therefore, Kim advises women with a gynecological disease history to visit hospitals for infertility clinic treatment, if they fail to get pregnant within six months with an active sex life. Also, women who are having their first child over 35 years of age should visit the doctor too, for their reproduction ability significantly deteriorates. If one has hyper or hypotension; received dermatological treatment; had hormonal changes, also consult a doctor. Avoid drinking alcohol, smoking and a fatty, unhealthy diet, he says.