1 in 7 Couples Faces Infertility 'Pain'... "Over 40, Start Treatment Immediately After Marriage" [Nanim Sang Gyeonggi]

② Current Status of Infertility Patients in Korea

Editor's NoteIn an era of a total fertility rate of 0.72, long queues have formed in front of well-known infertility clinics in Seoul. This unprecedented low birthrate trend throughout history seems almost ironic. Last year, the number of infertility patients nationwide exceeded 250,000. In a reality where all medical infrastructure is concentrated in Seoul, infertile couples from provincial areas who travel for 'expedition treatment' to have children continue to suffer today. Just receiving treatment is difficult 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 actual conditions of expedition treatment for infertile couples from provincial areas who are full of determination to have children in South Korea, which is facing a low birthrate crisis.

The number of couples diagnosed with infertility and having children through representative infertility procedures such as artificial insemination and in vitro fertilization (IVF) is steadily increasing. Infertility is defined as the failure to conceive within one year of regular unprotected intercourse (or within six months for women aged 35 or older). As marriage is delayed due to focusing on employment, pregnancy is postponed while dreaming of housing stability and engaging in economic activities, naturally delaying childbirth and increasing the number of couples struggling with infertility.

Infertility-related project sketch - The Seoul Station Infertility Center of Cha Women's Medical Research Institute. Photo by Jo Yongjun jun21@

According to the latest data obtained by Asia Economy from the National Health Insurance Service, the number of infertility patients nationwide exceeded 250,000 last year. The number of women diagnosed with infertility (medical diagnosis: sterility) at hospitals reached 160,000, and men numbered 90,000. By age group, those aged 35-39 were the largest at 88,685, followed by 30-34 at 83,702, and 40-44 at 49,990. The number of patients who received infertility treatments such as artificial insemination and IVF was approximately 139,000 last year, with total medical expenses amounting to 392.1 billion KRW. The average medical expense per person was about 2.82 million KRW.

Considering that the number of patients diagnosed with infertility was 228,000 in 2018 (according to last year's announcement by the Health Insurance Review & Assessment Service), and the number of patients who received infertility treatments was 120,000, the number of infertility patients increased by 9.6% over six years, and the number of patients receiving infertility treatments increased by 16%. During the same period, the medical expense per infertility treatment patient more than doubled from 1.27 million KRW to 2.82 million KRW. The gender ratio for infertility diagnosis is about 6 to 4, but 95% of infertility treatment patients are women.

The World Health Organization (WHO) estimates the lifetime prevalence of infertility (the proportion of adults who experience infertility at least once in their lifetime) worldwide at about 17.5%. The point prevalence, which refers to the current proportion of people experiencing infertility, is 12.6%. In South Korea, a sample survey conducted by the Korea Institute for Health and Social Affairs 20 years ago in 2003 confirmed a domestic infertility rate of 13.5%, estimating that one in every 7 to 8 couples suffers from infertility.

This rapid increase in infertility patients is interpreted as stemming from structural social issues leading to delayed employment, marriage, and childbirth. Last year, the average age at first marriage was 31.5 years for women and 34.0 years for men, rising by 1.5 years and 1.4 years respectively compared to 2015. The average age at first childbirth was 33.6 years. The proportion of advanced maternal age mothers aged 35 or older was 36.3%, roughly 4 out of 10. Given that age greatly affects fertility, these social structural changes act as factors increasing the number of couples visiting hospitals due to infertility problems.

According to a family and childbirth survey report released by the Korea Institute for Health and Social Affairs in 2021, a survey of 10,000 households nationwide found that 17.2% of women in legal or common-law marriages experienced infertility. The infertility experience rate also increased with higher age at first marriage, with one in three married women aged 35 or older reporting infertility experience.

The later the marriage, the more likely infertility treatments are initiated quickly. A 2021 survey by the Korean Women's Development Institute of about 600 women undergoing infertility treatments showed that the infertility diagnosis rate within two years after marriage was relatively higher for those aged 35 or older compared to those under 35. Also, the higher the age at marriage, the higher the response rate for receiving infertility treatments within one year after marriage. Notably, among women in their 40s, 6 out of 10 respondents reported starting infertility treatments within less than a year after marriage.

Each year, about 10% of newborns are born based on infertility treatments. Kim Young-sang, an infertility specialist and director of Gamja wa Nunsaram, explained, "Because people study for a long time and enter society late, and because marriage costs are high, people work longer before marriage to save money, leading to a vicious cycle of infertility. The increase in infertility patients is not so much an actual rise in infertility but rather an increase in 'older couples,' which results in more infertility patients."