Is Recognition Equivalent to Skill? ... Why People Go to Seoul Even with a Hospital Near Home [Nanimsang Gyeonggi]

⑤ The Belief That 'Seoul Large Hospitals Are Different' Caused by Lack of Information

Editor's NoteIn an era where the total fertility rate is 0.72, long queues form in front of renowned infertility clinics in Seoul. This unprecedented low birthrate trend across time and place seems almost ironic. Last year, there were 250,000 infertility patients nationwide. In a reality where all medical infrastructure is concentrated in Seoul, infertile couples from provinces who embark on 'medical tourism' to have children continue to suffer today. Just receiving treatment is challenging enough, but medical inequality between regions blocks the path of infertile couples who desperately wish to conceive and give birth. We take a closer look at the reality of medical tourism for infertile couples from provinces full of determination to have children in South Korea, which is facing a low birthrate crisis.

"I thought it was a better choice to go straight to a well-known 'major hospital.' Going to an infertility clinic and undergoing in vitro fertilization (IVF) is all about aiming for pregnancy. Rather than trying once or twice in the provinces and suffering mentally and physically, I decided from the start to go to Seoul to increase the chances. Most acquaintances transferred after going to provincial hospitals."

Park Juhyun (pseudonym, 40), who lives in a town in Gangwon-do with a local population of less than 5,000, explained why she started IVF treatment in Seoul this way. Married for four years, she began IVF in January last year. As a 13-year career office worker, she even took a leave of absence this year for IVF treatment. After undergoing treatment while working for a year, the physical and work burdens were significant. The nearest infertility hospital was in Wonju, which was still an hour's drive away, so she thought it was better to go to Seoul, where the doctors are considered 'skilled.'

The reason infertile couples from provinces choose to travel to Seoul for infertility treatment was clear: to succeed in pregnancy as soon as possible. Experts view the success or failure of infertility procedures as a race against time. This is because analyses show that age significantly affects fertility for both men and women. If there is a skilled hospital in the region, there is no need to travel far, but anxious patients are swayed by the perception that 'Seoul hospitals have higher pregnancy success rates.' Major hospitals recognized as leading infertility centers in Korea, such as Maria Hospital and CHA Hospital, which have dozens of infertility specialists, are mainly based in the metropolitan area. Although there is no official channel to verify pregnancy success rates, patients follow word of mouth and head to so-called 'major hospitals.'

"Isn't it more likely that top students come from academies where many good students attend? It could be that good results come from having many people gathered. But when you're anxious, you have no choice but to rely on that. Only one person I know succeeded at a provincial hospital, but I see many success stories at major hospitals. Naturally, you want to be where the chances are higher."

Relying on Online Testimonials... Seeking Well-Known Hospitals

Lack of information fuels the concentration of infertile couples in the metropolitan area. When choosing hospitals, infertile couples obtain information through unofficial channels such as personal blogs, cafes, YouTube, and acquaintances. Large hospitals with high recognition share various information online, including characteristics of medical staff and commonly used procedures, based on many patients' experiences, thus naturally having wider contact points with patients. Conversely, provincial hospitals with fewer patients find it difficult even to obtain online testimonials.

Choi Yoonji (32), a Jeju resident married for two years, is a six-month pregnant woman who conceived through artificial insemination once last April. She initially decided to start treatment in Jeju due to travel burdens, but there was only one option. There was only one hospital in Jeju that could perform both artificial insemination and IVF. Even within the same region, the round trip from her home to the hospital took three hours. Yoonji regularly visited local mom cafes to gather information. When rumors spread about a new infertility hospital opening in Jeju, someone would inquire at the health center or elsewhere and share the information. She also researched Seoul hospitals for transfer in case of failure.

"At first, it was hard to find information. I relied on portal searches and local cafe searches. People receiving treatment at provincial hospitals naturally worry about the hospital's technical skills and equipment modernization. Even if dissatisfied, there's no way to do anything. Many worry about wasting time in the provinces and missing the optimal time."

A 2021 survey by the Korean Women's Development Institute targeting over 600 women undergoing infertility procedures found that over 80% of respondents cited the internet or acquaintances as sources of information when choosing infertility specialized medical institutions. The response rate for obtaining infertility-related information through online blogs or cafes was significantly high.

Due to lack of information, recognition tends to be equated with skill. Infertile couples from provinces whom the reporter met strongly believed that well-known hospitals excelled in embryo culture technology, which they considered the most important factor for pregnancy through IVF.

When asked by the reporter whether there is a significant difference in embryo culture technology between large hospitals and provincial hospitals, infertility specialists had differing opinions. One specialist at a large hospital said, "In the absence of standards to measure culture technology, hospitals performing a certain number of procedures annually have similar pregnancy success rates." Another specialist evaluated that the more experienced medical staff and laboratory personnel in embryo culture, the more inevitable the difference in technical skills. They also noted, "The average pregnancy success rate at domestic infertility centers is 25-30%, but it varies significantly from 20% to 65% depending on the center."

In a situation where even medical professionals have differing opinions, infertile couples lacking information and knowledge are inevitably placed in an environment where they head to well-known hospitals reputed for good culture technology.

Went to Seoul for Hospital but... Delivery Remains a Concern

Provincial couples who visit infertility hospitals in Seoul mostly move to delivery hospitals after successful pregnancy. It is difficult to continue monthly check-ups in Seoul with a heavy body, and they cannot respond to sudden deliveries while having a hospital far away. Women who conceive through infertility procedures are more likely to be high-risk mothers due to advanced maternal age, multiple pregnancies, etc., so choosing a delivery hospital is also a serious concern. Infertile women staying in regions with a shortage of delivery hospitals face the mission of finding related information. In such cases, they inevitably head to university hospitals, which can be considered major hospitals in the provinces.

Yoonji, who is due to give birth this year, and Juhyun, who is undergoing infertility treatment dreaming of a future with a child, shared their concerns about delivery hospitals with the reporter. Yoonji said, "Compared to the mainland, there are relatively fewer options. I am currently going to a hospital 40 minutes away by car. If I am diagnosed as a high-risk mother, I think I will have to go to Jeju National University Hospital." Juhyun shared her experience of rushing to the only obstetrics and gynecology clinic in a nearby city last year due to bleeding but was greatly disappointed by the poor facilities and inadequate treatment. "Thinking about actual delivery scares me. Delivery can happen suddenly anytime. I was too scared to go to a delivery hospital with only one specialist. I decided I must go to a place with at least two specialists. Since I am of advanced maternal age, I feel like the only option is a university hospital."