"'Low Birthrate' Government Must Integrate Infertility Policies... Standardization of Services Needed Across Regions" [Nanimsang Gyeonggi]

⑨ Infertility Policies According to Policy Experts
Local Governments Should Avoid Quantitative Over-Support
"Establish Local Collaboration Systems Including Public Hospitals" Opinions

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 reality of expedition treatment for infertile couples from provinces full of determination to have children in South Korea, which is facing a low birthrate crisis.

As the number of couples receiving infertility treatments rapidly increases due to late social entry and marriage, voices calling for a comprehensive change in the national infertility policy are growing louder. In a situation where the low birthrate issue has emerged as a national challenge, it is necessary to systematically manage support for infertile couples nationwide who are full of will to conceive and give birth. Infertility policy experts interviewed by Asia Economy emphasized that the central government should integrate and manage infertility policies overall and find ways to connect the medical system nationwide from Jeju to Seoul.

A mother and her family are moving while holding their child at a women-only hospital. Photo by Jo Yongjun

Kim Dong-sik, Senior Research Fellow at the Korean Women's Development Institute, said, "If low birthrate is the country's biggest policy issue, the central government must take the lead." Kim is a policy expert who has analyzed support policies for infertile couples and infertility treatment support systems for several years. He currently serves as an advisory member of the Low Birthrate and Aging Society Committee, an advisory member reviewing support for infertility and egg freezing treatment costs in Seoul, a member of the Population, Health and Welfare Association's Low Birthrate and Aging Countermeasures Subcommittee, and a member of the Health Insurance Review and Assessment Service's infertility medical institution evaluation committee.

Kim explained, "The government is expanding various resources and services linked to infertility. Currently, efforts are being made quantitatively," adding, "Such policy expansion should be designed appropriately considering population groups, but since local governments are divided and each offers their own policies, it results in quantitative flooding without qualitative improvement." He continued, "Some regions may flexibly implement policies considering population composition, but ultimately, the central government must handle the big picture."

He also pointed out that standardization of infertility services between regions is necessary to alleviate difficulties faced by infertile couples from provinces. He said, "(The government) should not designate many infertility clinics numerically but select and develop designated clinics qualitatively and standardize them," emphasizing, "Standardization work is needed to objectively evaluate and disclose not only facilities and equipment but also personnel and capabilities, providing information that such clinics exist in the region where patients reside without having to travel to the metropolitan area."

Given the concentration of infertility clinics in the metropolitan area and the increasing number of couples traveling from provinces for infertility treatment, opinions were also presented that a cooperative medical system should be established nationwide considering infertility infrastructure. According to the 'Status and Support Measures for Infertile Couples in Jeju' report released last year by the Jeju Women's Family Research Institute, a survey of 528 people who received infertility treatment support within the last five years showed that 99.1% responded that they want a cooperative medical system where emergency treatment and other services can be linked within the province when receiving treatment at medical institutions outside the province.

A counseling and information center for support related to infertility, pregnancy, and childbirth operated by the Seoul Metropolitan Government is established at the Dongdaemun-gu Public Health Center. Photo by Jo Yongjun

Jeong Yeo-jin, Senior Research Fellow at the Jeju Women's Family Research Institute and author of the report, explained, "During infertility treatments, patients may experience various symptoms such as breathing difficulties, ascites caused by ovulation induction injections and their effects, sudden bleeding, cesarean sections due to miscarriage, headaches caused by propofol injections, weight gain and menstrual pain due to hormones." She added, "It is necessary to build medical infrastructure and establish a cooperative medical system within the region," and said, "I believe a cooperative system can be established centered on public hospitals such as national university hospitals, medical centers, and public health centers."

Kim Myung-hee, President of the Korean Infertile Families Association, suggested finding ways for university hospitals in each region to play an important role for infertile couples locally. She said, "The government needs to support and raise the level of regional university hospitals so they can play a central role in infertility treatments," adding, "At the same time, ways to revitalize regional infertility treatment medical institutions should also be considered." Kim added, "We are currently a 'society creating infertility,'" emphasizing, "Rather than indiscriminately performing assisted reproductive technologies due to low birthrate, it is more important to have healthy children."

Infertility specialists who meet infertile patients daily at the field appealed for additional support to address the economic difficulties they generally face, the challenging environment for taking infertility leave, and psychological distress such as depression. Since there is a lack of movement to improve negative perceptions of infertility, it means the government needs to actively create an atmosphere to support infertile patients and assist them through policies.

Kim Young-sang, Director of Gamja and Snowman Clinic, said, "Economic support related to infertility and expansion of leave are absolutely necessary," adding, "Many patients suffering from depression are seen at hospitals. If the government expands and operates counseling centers for depression to provide emotional support, government support will be helpful." Professor Cho Eun-hye of the Infertility Center at Cha Hospital, Seoul Station, also emphasized, "I often see patients taking leave or quitting jobs for treatments. Since costs snowball as infertility treatments prolong, differences by region should be eliminated and the out-of-pocket rate for infertility treatments under health insurance should be removed."

Lee Jae-ho, Director of Ilsan Maria Hospital, voiced, "While strengthening financial support, the autonomy of doctors must also be guaranteed. If prescriptions are restricted, it confines treatments and prevents various attempts."