Retrospective Analysis of Outcomes in the 2023 Busan Korean Medicine infertility Treatment Support Project

Su-Ji Choi; Jiyoon Won; Dong-Hee Lee; Hyun-Min Yoon; Choi, Su-Ji; Won, Jiyoon; Lee, Dong-Hee; Yoon, Hyun-Min

doi:10.13048/jkm.24027

JKM > Volume 45(2); 2024 > Article

Choi, Won, Lee, and Yoon: Retrospective Analysis of Outcomes in the 2023 Busan Korean Medicine infertility Treatment Support Project

Original Article

The Journal of Korean Medicine 2024; 45(2): 96-110.

Published online: June 01, 2024

DOI: https://doi.org/10.13048/jkm.24027

Retrospective Analysis of Outcomes in the 2023 Busan Korean Medicine infertility Treatment Support Project

Su-Ji Choi¹^{, 2}

, Jiyoon Won³

, Dong-Hee Lee²^{, 4}

, Hyun-Min Yoon²^{, 5}^{, *}

¹Department of Obstetrics & Gynecology, College of Korean Medicine, Dong-eui University

²The Busan Association of Korean Medicine

³Department of Meridian & Acupoint, College of Korean Medicine, Dong-eui University

⁴DeunDeun Korean Medicine Clinic

⁵Department of Acupuncture & Moxibustion, College of Korean Medicine, Dong-eui University

Correspondence to: Hyun-Min Yoon, 62, Yanjeong-ro, Busanjin-gu, Busan 47227 Korea, Tel: +82-51-850-8650, Fax: +82-505-182-6883, E-mail: yhmin@deu.ac.kr

Received April 15, 2024 Revised May 10, 2024 Accepted May 10, 2024

Abstract

Objectives

This study aimed to analyze the results and review the outcomes and satisfaction levels of the 2023 Busan Korean medicine infertility treatment support project.

Methods

A total of 137 female and 26 male participated in the Korean medicine infertility treatment support project, which encompassed herbal medicine and pharmacopuncture treatment over 4-month period. Data pertaining to patients’ general, demographic, and fertility-related characteristics were collected before treatment initiation. During treatment, information regarding the treatments administered by Korean medical doctors was recorded, along with post-treatment outcomes and satisfaction levels.

Results

Out of 163 initially enrolled participants, data from 4 female participants were missing, data from 159 participants were analyzed. A total of 113 female and 22 male participants completed the treatment program (Completion rate 84.9%). Of these, 23 female participants achieved pregnancy (Pregnancy rate 20.4%). Participants reported a high level of satisfaction with the treatment support project, with an average satisfaction score of 9.4 out of 10.

Conclusions

The study analyzed the clinical findings of the 2023 Busan Korean medicine infertility treatment support project. These findings provide a basis for developing Korean medicine infertility support projects and related research.

Keywords: Infertility, Acupuncture Therapy, Herbal Medication, Complementary Therapies, Pregnancy Rate, Patient Satisfaction

Fig. 1

Flow diagram of the study

Fig. 2

Age distribution of female participants

Fig. 3

Cumulative pregnancy rates by number of herbal medication administration

Table 1

Basic characteristics of women participants

	Number	Mean	SD	Min	Max
Age (years)	113	36.4	5.1	22	50
Height (cm)	110	161.9	5.2	150	173
Weight (kg)	110	60.3	10.7	43	97.8
BMI (kg/m²)	110	23.0	3.8	16.8	37.1
Spouse age (year)	107	38.2	5.0	28	53
Spouse height (cm)	107	174.9	5.5	163	188
Spouse weight (kg)	105	79.4	11.8	56	130
Spouse BMI (kg/m²)	105	25.9	3.3	19.4	37.2

SD: Standard deviation, BMI: Body mass index

Table 2

Pattern Identification of Infertility (N=109)

Pattern	Frequency (N)	%
Kidney deficiency	55	50.5
Qi Blood deficiency	26	23.9
Liver stagnation	18	16.5
Static blood	14	12.8
Dampness-phlegm	11	10.1
Dampness heat	1	0.9
Others	5	4.6

Of 109 patients, 21 patients were diagnosed to have two patterns.

Percentages were divided by the number of patients, ie, 109.

Table 3

Prescriptions for infertile women participants (N=113)

Prescription	Frequency
JogyeongJongok-tang	258
Samul-tang	59
Danggui Shaoyao-san	57
Taeeumjowi-tang	30
Onkyung-tang	26
Sipjeondaebo-tang	23
Yukmijihwang-tang	21
Nangong-jeon	15
Soshiho-tang	14
Danggwisayeokgaohsuyusaenggang-tang, Mihudeungsikjang-tang	13
Gyejibokryeong-hwan, Guibi-tang	12
Yeonggangchulgam-tang, Ojayeonjong-hwan	11
Palmulgunja-tang	10

Table 4

Pregnancy result (N=113)

Age	Under 34	34~37	38~40	Above 40	Total
Pregnant participants	12	7	3	1	23
Total participants	31	33	23	26	113
Pregnancy rate (%)	38.7	21.2	13.0	3.8	20.4

Table 5

Analysis of Differences in Female Characteristics by Pregnancy Success and Failure

Characteristics	Pregnancy result	N	Mean±SD	U	P-value
Age (years)	No	90	37.3±4.7	526.5	<0.001
Age (years)	Yes	23	32.9±4.8	526.5	<0.001

Height (cm)	No	89	162.0±5.3	885.0	0.708
Height (cm)	Yes	21	161.5±4.7	885.0	0.708

Weight (kg)	No	89	60.9±10.5	703.5	0.079
Weight (kg)	Yes	21	57.5±11.3	703.5	0.079

BMI (kg/m²)	No	89	23.2±3.7	701.0	0.076
BMI (kg/m²)	Yes	21	22.1±4.3	701.0	0.076

Average menstruation cycle (days)	No	84	30.5±10.9	1149.5	0.159
Average menstruation cycle (days)	Yes	23	30.9±4.4	1149.5	0.159

Menstrual pain severity (NRS)	No	90	4.0±2.2	1146.0	0.426
Menstrual pain severity (NRS)	Yes	23	4.4±2.4	1146.0	0.426

Duration of menstrual pain (days)	No	90	2.2±3.2	1191.5	0.254
Duration of menstrual pain (days)	Yes	23	2.5±2.0	1191.5	0.254

Length of contraception (month)	No	90	9.4±18.5	1226.5	0.123
Length of contraception (month)	Yes	23	9.6±12.4	1226.5	0.123

Length of marriage period (months)	No	90	26.4±22.6	849.5	0.187
Length of marriage period (months)	Yes	23	18.4±16.2	849.5	0.187

Number of previous artificial insemination (N)	No	90	0.5±1.1	1079.5	0.666
Number of previous artificial insemination (N)	Yes	23	0.7±1.8	1079.5	0.666

Number of previous IVF (N)	No	90	1.7±2.5	751.5	0.020
Number of previous IVF (N)	Yes	23	0.5±1.4	751.5	0.020

Age of menarche (years)	No	92	13.4±2.1	1022.0	0.748
Age of menarche (years)	Yes	22	13.6±1.6	1022.0	0.748

IVF: in vitro fertilization

Table 6

Results of the average satisfaction analysis by question (N=96)

Questions	Mean±SD
The benefits of the KM infertility project	9.7±0.8
The need for the KM infertility project	9.6±0.9
The image of the KM infertility project	9.6±0.9
Improvement in personal health status through the KM infertility project	9.4±1.0
Treatment duration of the KM infertility project	9.0±1.4
Promotion of the KM infertility project	8.4±2.1
Overall satisfaction with the KM infertility project	9.5±0.9

SD: Standard deviation, KM: Korean medicine

Table 7

Appropriate treatment duration as reported by the subjects (N=95)

Treatment duration	N	%
3 month	15	15.8
4 month	33	34.7
6 month	45	47.4
12 month	1	1.1
Until pregnancy occurs	1	1.1

Table 8

Ranking of challenges faced during project participation based on weighted analysis

Difficulty	1st	2nd	3rd	Weighted score	Rank
Time burden	70	17	23	267	1
Emotional burden	12	26	24	112	2
Physical burden	7	24	22	91	3
Social burden	4	15	11	53	4
Financial burden	1	12	13	40	5
Service insufficiency	2	2	3	13	6

Respondents were asked to rank their most challenging issues during project participation, with ‘1st’ indicating the most challenging, ‘2nd’ the second most challenging, and ‘3rd’ the third most challenging. Rankings are based on the cumulative weighted score.

Appendix 2

Prescriptions used in participants who became pregnant

N*	Prescriptions
1	조경종옥탕
2	조경종옥탕, 비화음, 계지가작약생강인삼신가탕, 시호계지탕, 십전대보탕
3	양격사물탕, 시호거금가령탕
4	계지반하생강탕, 선천귀일탕, 독활지황탕
6	태음조위탕, 조경종옥탕, 육린주
7	팔물탕, 보중익기탕, 조경종옥탕, 난궁전
8	갈근황금황련탕, 도핵승기탕, 시호계지탕, 온경탕, 시호가작약탕, 도담탕, 조경종옥탕, 계지복령환, 치자시탕, 창출생화탕, 인삼양위탕, 소시호탕, 당귀작약산, 시호가용골모려탕, 보중익기탕, 귀비탕, 온담탕, 비화음

* Number of prescriptions administered before each participant becomes pregnant

Appendix 3

한의난임사업 만족도 조사 결과

항목 종류	응답자 수	문항	설문 결과
만족도	96	한의난임사업에 대한 필요성에 대해서 어떻게 생각하십니까?	9.6±0.9
만족도	96	한의난임사업의 유익성에 대해서 만족하십니까?	9.7±0.8
만족도	96	한의난임사업의 이미지에 대해서 만족하십니까?	9.6±0.9
만족도	96	한의난임사업의 홍보에 대해서 만족하십니까?	8.4±2.1
만족도	96	한의난임사업의 본인 건강상태 개선에 대해서 만족하십니까?	9.4±1.0
만족도	96	한의난임사업의 치료기간에 대해서 만족하십니까?	9.0±0.4
만족도	96	한의난임사업을 종합적인 측면에서 어떻게 생각하십니까?	9.5±0.9
치료법 만족도	96	한의난임사업에서 받은 침치료에 만족하십니까?	9.4±1.2
치료법 만족도	96	한의난임사업에서 받은 약치료에 만족하십니까?	9.5±1.1
치료법 만족도	96	한의난임사업에서 받은 뜸치료에 만족하십니까?	8.9±2.0
적정 치료기간	95	한의난임사업의 치료기간은 어느 정도가 적당하다고 생각하십니까?	3 개월: 15 명 (15.8%) 4 개월: 33 명 (34.7%) 6 개월: 45 명 (47.4%) 기타: 2 명 (2.2%)
사업 참여 시 힘든 점	96	한의난임사업을 수행하는데 있어서 힘들었다고 생각되는 항목 1 순위를 선택해주세요.	시간적 부담: 70(72.9%) 정서적 부담: 12(12.5%) 신체적 부담: 7(7.3%)
사업 참여 시 힘든 점	96	한의난임사업을 수행하는데 있어서 힘들었다고 생각되는 항목 2 순위를 선택해주세요.	정서적 부담: 26(27.1%) 신체적 부담: 24(25.0%) 시간적 부담: 17(17.7%)
사업 참여 시 힘든 점	96	한의난임사업을 수행하는데 있어서 힘들었다고 생각되는 항목 3 순위를 선택해주세요.	정서적 부담: 24(25.0%) 시간적 부담: 23(24.0%) 신체적 부담: 22(22.9%)
재참여 의사	96	다음 기회에도 이런 사업이 있다면 적극 참여할 의사가 있으십니까?	9.7±0.9

연속 변수는 평균 표기하고 범주형 변수는 응답자 수와 %로 표기하였다.

참고문헌

1. The Society of Korean Obstetrics and Gynecology. (2012). Korean medicine obstetrics and gynecology. Seoul. Euiseongdang.

2. Feng, J, Wang, J, Zhang, Y, Zhang, Y, Jia, L, & Zhang, D, et al. (2021). The efficacy of complementary and alternative medicine in the treatment of female infertility. Evidence-Based Complementary and Alternative Medicine, (2021). https://doi.org/10.1155/2021/6634309

3. Kim, C, Kim, D, Park, M, Jang, B, Jung, H, & Jo, J. (2016). A study on the actual condition of the participants of local governments’ korean medicine supporting projects for infertile couples. Research report. Ministry of Health and Welfare, 2016, 1-110.

4. Choi, M-S, Lee, D-N, & Kim, D-I. (2013). A survey study on use condition of korean medical institution and demand of korean medical treatment project of infertility in infertile couple. The Journal of Korean Obstetrics and Gynecology, 26(2), 151-165. https://doi.org/10.15204/jkobgy.2013.26.2.151

5. Hwang N, Lee S, Jang I. (2015). Analysis and evaluation of supporting project for infertility couples in 2014. Korea Institute for Health and Social Affairs.

6. Ministry of Government Legislation. Mother and child health act. Accessed date April 18, 2024. Available from: URL: https://www.law.go.kr/lsSc.do?section=&menuId=1&subMenuId=15&tabMenuId=81&eventGubun=060101&query=%EB%AA%A8%EC%9E%90%EB%B3%B4%EA%B1%B4%EB%B2%95#undefined

7. Lee, H-S, Jung, H-J, Choi, S-J, & Kim, D-I. (2023). Analysis of the results of the 2022 gyeonggi-do korean medicine infertility support project. J Korean Obstet Gynecol, 36(4), 78-95. http://dx.doi.org/10.15204/jkobgy.2023.36.4.078

8. Choi, C-M, Kim, S-H, Song, M-H, Hwang, D-S, Cho, H-B, & Kim, D-I. (2016). Analysis of korean traditional medicinal treatment trend of infertility and development of questionnaire for infertility treatment. The Journal of Korean Obstetrics and Gynecology, 29(2), 29-46. https://doi.org/10.15204/jkobgy.2016.29.2.029

9. Statistics Korea. Population trends of 2022. Accessed date August 30, 2023. Available from: URL: https://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1B8000F&conn_path=I2

10. Jo, J, Kim, T-H, Hyun, MK, Kim, H, & Kim, DI. (2016). Traditional korean medicine for female infertility: A review of results from infertility support programs in korea. European Journal of Integrative Medicine, 8(5), 847-853. https://doi.org/10.1016/j.eujim.2016.07.026

11. Chou, PY, Chen, CM, Wang, CC, Tai, CJ, Lin, YK, & Tang, YJ. (2023). Characteristics and effects of chinese herbal medicine in the management of female infertility: A hospital-based study. Complementary Medicine Research, 30(6), 481-491. https://doi.org/10.1159/000534590

12. Almog, B, Shehata, F, Shalom-Paz, E, Tan, SL, & Tulandi, T. (2011). Age-related normogram for antral follicle count: Mcgill reference guide. Fertility and sterility, 95(2), 663-666. https://doi.org/10.1016/j.fertnstert.2010.08.047

13. Meldrum, DR, Silverberg, KM, Bustillo, M, & Stokes, L. (1998). Success rate with repeated cycles of in vitro fertilization–embryo transfer. Fertility and sterility, 69(6), 1005-1009. https://doi.org/10.1016/S0015-0282(98)00083-1

14. Kim, H-S, LH-J, , JS-J, , & CD-I, . (2023). Analysis of the results of the 2022 gyeonggi-do korean medicineinfertility support project. J Korean Obstet Gynecol, 36(4), 78-95. https://doi.org/10.15204/jkobgy.2023.36.4.078

15. Heo J. (2010). Donguibogam. Hadong. South Korea. Donguibogamchulpansa.

16. Choi, S-J, & Kim, D-I. (2023). Utilization of traditional herbal medicine formulas for unexplained female infertility in korea: A retrospective study. BMC Complementary Medicine and Therapies, 23(1), 369. https://doi.org/10.1186/s12906-023-04192-5

17. Alam, F, Khan, TA, Amjad, S, & Rehman, R. (2019). Association of oxidative stress with female infertility-a case control study. JPMA The Journal of the Pakistan Medical Association, 69(5), 627.

18. Hwang, N. (2011). Physical, psychological and social-economic burden and demands of infertile women. Health Welf Issue Focus, 74(74), 1-8.

19. de Lacey, S, Sanderman, E, & Smith, CA. (2021). Ivf, acupuncture and mental health: A qualitative study of perceptions and experiences of women participating in a randomized controlled trial of acupuncture during ivf treatment. Reproductive Biomedicine & Society Online, 12, 22-31. https://doi.org/10.1016/j.rbms.2020.08.004

20. Ng, EHY, So, WS, Gao, J, Wong, YY, & Ho, PC. (2008). The role of acupuncture in the management of subfertility. Fertility and Sterility, 90(1), 1-13. https://doi.org/10.1016/j.fertnstert.2008.02.094

21. Balk, J, Catov, J, Horn, B, Gecsi, K, & Wakim, A. (2010). The relationship between perceived stress, acupuncture, and pregnancy rates among ivf patients: A pilot study. Complementary therapies in clinical practice, 16(3), 154-157. https://doi.org/10.1016/j.ctcp.2009.11.004

22. Gaitzsch, H, Benard, J, Hugon-Rodin, J, Benzakour, L, & Streuli, I. (2020). The effect of mind-body interventions on psychological and pregnancy outcomes in infertile women: A systematic review. Archives of women’s mental health, 23(4), 479-491. https://doi.org/10.1007/s00737-019-01009-8

23. Clifton, J, Parent, J, Seehuus, M, Worrall, G, Forehand, R, & Domar, A. (2020). An internet-based mind/body intervention to mitigate distress in women experiencing infertility: A randomized pilot trial. PloS one, 15(3), e0229379. https://doi.org/10.1371/journal.pone.0229379