"When Typhoons Hit, Patients Can't Reach Hospitals"...Why Did an Infertility Specialist Go to Jeju?[Infertility Competition]

④ Stories of 3 Infertility Specialists in the 수도권 Area

Editor's NoteIn an era of a total fertility rate of 0.72, long queues have formed in front of famous infertility clinics in Seoul. This unprecedented low birthrate trend throughout history 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 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 provinces full of determination to have children in South Korea, which is facing a low birthrate crisis.

"Patients living in Jeju-do often cannot come for treatment due to the weather. When the monsoon season or typhoons hit and flights are canceled, there is no way around it. Around holidays, it is also difficult for patients to get plane tickets, causing them hardship."

Kim Young-sang, director of Gamja-wa Nunsaram, a specialized infertility hospital located 10 minutes by car from Gimpo Airport in Gangseo-gu, Seoul, answered the reporter's question last month about the difficulties of treating patients from provinces like this. Since the hospital is near the airport and accessible by subway directly from the train station and express bus terminal, patients even come from Jeju-do, which requires crossing the sea. There are only four infertility treatment medical institutions in Jeju with about 3,000 infertility patients (as of March this year), and only one of them offers in vitro fertilization (IVF). Director Kim said, "We try to find ways so that patients can come less often," and sometimes use treatment methods that allow relatively flexible scheduling among infertility procedures.

Asia Economy analyzed the results of the government's second evaluation of infertility treatment medical institutions in 2022 and found that in 2021, there were 233 government-designated infertility treatment medical institutions (excluding those closed after evaluation) with a total of 1,488 obstetrics and gynecology specialists affiliated. Among them, 60.7% (903 specialists) were affiliated with 111 infertility treatment institutions in the Seoul metropolitan area including Seoul, Gyeonggi, and Incheon. The fewer infertility treatment institutions in a region, the fewer obstetrics and gynecology specialists there are.

When infertile couples from provinces come after much hardship, the medical staff also worry alongside them. Specialists said they feel sorry every time they see patients who leave early in the morning, arrive at Seoul hospitals, wait for a long time, receive a short consultation, and then have to return home by afternoon flight, and they try to find solutions. The representative infertility treatment method, IVF, requires patients to visit the hospital at least five times within one or two months. Since the schedule is not set at the patient's convenience but according to the patient's biological rhythm for ultrasound examinations and so on, no matter how much the medical staff try, there are limits to reducing the number of patient visits.

"Among my patients, some come from provinces. I usually tell them not to come if possible. I know how hard it is. I recommend local hospitals where there is no significant technical difference. But if they still come, I try to find ways to reduce hospital visits. There are limits. I have to prescribe medication by predicting the patient's condition (which cannot be confirmed by examination). In that process, the doctor's experience certainly affects the outcome."

Lee Jae-ho, director of Ilsan Maria Hospital and an infertility specialist, often meets patients from Jeju during consultations and understands their difficulties. With the intention of reducing information disparities, he went to Jeju himself last April. He held a talk concert to provide a place where provincial infertility patients could resolve their questions. Having run a YouTube channel for five years to provide medical knowledge to infertility patients, he conducted a survey on which region to visit, and Jeju was chosen as the top region. According to the National Health Insurance Service, there are about 3,000 infertility patients in Jeju (as of 2023). Director Lee plans to hold another session early next year to address questions from infertile couples in provinces.

When asked why patients receiving infertility treatment must visit hospitals frequently, infertility specialists answered, "To increase the success rate of treatment." Infertility treatment is basically conducted by continuously monitoring hormonal changes and proceeding according to the situation. For example, to retrieve eggs, a key procedure in IVF, it is necessary to determine the most mature time of the eggs according to the hormonal cycle, so patient examinations are essential. During these examinations, unexpected variables may be found, leading to changes in treatment direction, and emergency situations after treatment may require sudden visits.

Given this situation, infertility hospitals in Seoul with good transportation accessibility become popular destinations for infertile couples from provinces. The Seoul Station Cha Hospital Infertility Center, located right in front of Seoul Station, is always crowded with patients. When the reporter visited last month, infertile couples waiting with travel bags were seen everywhere. Professor Cho Eun-hye of this hospital said, "I feel that the number of infertile patients from provinces is continuously increasing." She explained, "Compared to provinces, Seoul has more hospitals and medical staff, so there is a wider range of choices, and the perception that hospital size and system affect pregnancy outcomes leads patients to Seoul."

The specialists the reporter met believed that long-distance travel by infertile couples from provinces could affect treatment outcomes. Although no specific research has been conducted to measure this, they estimated that physical burden, stress, and financial burden could also influence treatment results. Professor Cho explained, "Due to limited transportation options, there are economic, time, and physical burdens. If patients cannot come because of transportation, we have to reschedule, which sometimes leads to choosing alternative options during treatment."