생식보조의료와 사적생활상의 자기결정권

김민규 부산대학교 법학연구소 2010 법학연구 Vol.51 No.1

This study was conducted as a follow-up study of the researcher's previous research on Assisted Reproductive Technology (Recent Discussions about Assisted Reproductive Technology and the Subject, Dong-A Law Review, Vol.46, Feb. 2010) to find the answer to the problems regarding ART suggested in the findings of the previous study. This study examined legal principles of the formation and application of the autonomy, which is gaining more and more emphasis in personal relationships. This study also investigated the present status of ART and some factors that should be considered in health legislation or paternity law, with the focus on the purview of the autonomy. The findings are as follows:(1) Up to now, regarding Artificial Insemination by Donor (AID) or surrogate maternity, legal scholars have sticked to the principle of mother's right to make a decision. Underlying this argument, there lies the ideology of attaining kinship. However, the present paternity law has its own inherent breakdown of kinship of the real child. Thus, it is necessary to note that a new formation of parents-child relationship that respects “the autonomy of life” can be accepted in the present paternity law. (2) The more important factor when making a legislation for ART is that “the welfare of the child” should not be downplayed. Since the welfare of the child can be realized through the intention of bringing up the child of the people who wants to have a child through AID or surrogate maternity or of their client, it is appropriate to map out the parents-child relationship by respecting of the autonomy. In addition, it goes without saying that the autonomy of the parents who want to have a child on the basis of the intention of bringing up a child can be ensured when secured by “social consensus.”(3) Whether it is AID or surrogate maternity, if it is the final step of fertility treatments, it should be accepted restrictively and exceptionally considering “the intention of bringing up a child and environment (capability)” to maintain the order of reproduction and to reach a social consensus. (4) About 10 years ago, Korean Society of Obstetrics and Gynecology acknowledged AID as well as surrogate maternity based on ethical guidelines for assisted reproduction and has led health legislation or paternity law. From now on, it is important to continue to try to reach a social agreement on ART. (5) Three propositions suggested in the recently submitted legislative bill seem to be moving toward a favorable direction : creating a so-called control tower in order to give medical treatments and manage ART, undertaking a review of the suitability for action with the intervention of a committee or Family Court, and keeping a stable life for the family of the beneficiary by severing the relationship between the donor and the child born through assisted reproduction.

새로운 임신 기술과 '위험', 그리고 아픈 아이들 : 보조생식술 결과의 국제비교를 중심으로

하정옥(Ha, Jung-Ok) 한국가족학회 2012 가족과 문화 Vol.24 No.2

이 논문은 새로운 임신 기술이 수반하는 '위험'에 대해, 특히 체외수정(IVF) 기술로 태어난 아이들 건강 조사 연구를 중심으로 살펴본다. 흔히 시험관아기로 불리는 이 기술은 불임부부에게 자신의 아이를 가질 수 있는 희망을 준 기술로 찬사를 받았고 전 세계에 널리 확산 되었다. 그런데 이로부터 태어난 아이들의 건강에 대한 우려가 유럽과 북미를 중심으로 제기 되었다. 이러한 우려는 아이들에 대한 추적조사 자료와 함께 실증적으로 제기되었고, 이에 대한 대책으로 체외수정 시술에서 한 번에 이식하는 배아의 수에 대한 규제가 이루어졌다. 그런데 한국을 비롯하여 아시아 국가에서는 이러한 추적조사가 거의 이루어진 바 없고 한번에 이식하는 배아의 수도 그동안 별 변화가 없었다. 이와 함께 전체 출생 인구에서 다태아가 차지하는 비율은 급격히 증가하고 있다. 또 다른 한편, 전 세계적으로도 아이들에 대한연구는 많이 이루어진 반면 이 기술이 여성에 미치는 영향에 대해서는 소수의 연구가 있을뿐이다. 이러한 점에서 이 기술 '위험'의 인지와 대책 마련에서 지구적 불균등을, '위험' 문제구성에서 성별 정치의 일면을 읽을 수 있다. 또한 무엇이 '위험'으로 간주되고 어떤 대책이 마련되는가를 보면 기술 위험의 사회적 구성 또한 발견할 수 있다. This paper intends to study the risks of technology, particularly in terms of the health outcome surveys and follow-up of children born through IVF (in vitro fertilization, also known more colloquially as test-tube babies). From the early stage of IVF's development, the disabilities of children born through IVF was the key target for risk management practices, and the follow-up studies of the children born through IVF have been working through samples or complete enumeration surveys in mostly European countries. The results showed that the overall health outcomes of IVF children were relatively poorer than for other children, and the multiple pregnancies and births from multiple embryo implantations was pointed out as the main cause for this. Such an analysis result was followed by legislative or administrative regulation of the number of embryos allowed to be transferred in actual IVF practice. Risk management status differs from country to country. Since the first 'test tube baby' was born in Korea in 1985, 235,000 cases were accumulated between 1992, when official reporting began, and 2007. However, no follow-up study of the children has been conducted nor has the official regulation of the number of embryos been transferred along with the technology. Even today, the rate of transferring 4 or more embryos in an IVF procedure is more than 50% in Korea, and the ratio of multiple-births to the total number of babies born began rapidly increasing in the 2000's. I suggest that the risk of technology should be considered not just as a side effect of technological development but as an essential part of those processes. Furthermore, the social construction of the risks, which considers risk according to the locality's status of technological development, can also be observed.

Surrogate mother, the modest witness of new reproductive technology: Understanding technobiopower in the posthuman era

Ae-Ryung Kim 이화여자대학교 아시아여성학센터 2020 Asian Journal of Women's Studies(AJWS) Vol.26 No.2

This paper explores the complex topography of technobiopower in what has been referred to as the posthuman era, following the commercial surrogacy phenomenon. To do so, I refer to commercial surrogates as the “modest witness” of this situation, a term derived from Donna Haraway’s conceptual toolbox. The modest witness starts from her situated position, and records and informs about what happens. By placing commercial surrogates in the position of modest witness, this paper attempts to visualize the complex and multi-layered network of technobiopower. In the posthuman era where technological possibility re-characterizes birth and death, commercial surrogates are concrete bodies as well as symbolic markers that are captured within the complex network of bio-capital, bio-power, reproductive rights and bio-labor. If discussions on the posthuman emphasize new technological possibilities, deconstruction of traditional systems and advancement into a new world, commercial surrogates— as the “modest witness” of this era— will then reveal and demonstrate the pain that must be endured for obtaining this opportunity and the dominance of technobiopower about which we are not conscious.

Rheotaxis based high-throughput motile sperm sorting device

황보현,이동규,황승준,백중환,김병규 한국정밀공학회 2019 International Journal of Precision Engineering and Vol.20 No.6

A progressive motile sperm sorting device with a diffuser-type microfluidic channel is proposed to improve fertilization in assisted reproductive technologies. When sperm cells swim against a fluid flow, they are positioned according to their motility in specific channel zones. A numerical simulation is carried out in a meso-sized diffuser-type channel which can realize high throughput to verify the working principle and the sorting device is fabricated based on the simulation result. Furthermore, to analyze the condition of the semen and investigate the experimental results, a novel image processing method is proposed. With the proposed analyzing technique, the sperm sorting experiment is performed in the channel using the canine semen sample. As a result, the %motility increases from 59.89 to 69.36%, however, it does not satisfy the reported guideline for canine sperm motility (%motility > 70%). Therefore, we perform a washing process by injecting DPBS fluids to improve indexes related to motility. After double washing procedures, we could increase %motility from 59.89 to 82.24%, motile sperm rate from 33.38 to 53.10% and motility index from 26.35 to 49.44 in Zone A, comparing to the prepared sample.

Case Reports : Successful twin pregnancy by assisted reproductive technology after Laparoscopic-assisted radical vaginal trachelectomy

( Gun Yoon ),( Suk Joo Choi ),( Cheong Rae Roh ),( Doo Seok Choi ),( Jong Hwa Kim ),( Duk Soo Bae ) 대한산부인과학회 2010 Journal of Womens Medicine Vol.3 No.1

Because of the well-established screening program, cervical cancer is now being diagnosed in women at relatively young age and early stages. The conventional treatments for early-stage cervical cancer are abdominal radical hysterectomy (with/without salpingo-oophorectomy) or chemoradiation, which lead to definitive sterility in cases of removing both ovaries and sole radiotherapy. However, for young patients with early-stage cervical cancer who desire a fertility preservation, trachelectomy could be an alternative option. Here, we report a successful twin pregnancy by assisted reproductive technique after Laparoscopy-Assisted Radical Vaginal Trachelectomy (LARVT) to a patient with an early-stage cervical cancer. A 34-year-old nulliparous woman was diagnosed with cervical cancer IB1. She underwent LARVT with permanent transvaginal cerclage without any adjuvant treatment. Two years later, she had a twin pregnancy by a controlled ovarian hyperstimulation with an intrauterine insemination. Transvaginal ultrasonography which followed up serially showed a shortening of cervical length. Therefore, she was hospitalized at 22 5/7 weeks. She was treated with steroid for fetal lung maturation and intermittent tocolytics due to the possibility of preterm labor. At 30th weeks of gestation, she delivered a twin by emergent cesarean section due to an uncontrolled preterm labor. Both babies were admitted to the neonatal intensive care unit for two months, and were discharged without any medical problem. LARVT may be a promising surgical option for treatments of young patients with an early-stage invasive cervical carcinoma, who desire a fertility preservation.

산부인과 전문병원 내원환자의 난임 특성과 보조생식술 유형이 임신에 미치는 영향

김윤정(Yun-Jeong Kim),황병덕(Byung-Deog Hwang) 한국산학기술학회 2016 한국산학기술학회논문지 Vol.17 No.8

본 연구는 난임 치료 시술 유경험자를 대상으로 난임 특성을 파악하고, 특성에 따른 보조생식술의 치료 결과와의 관계를 분석하였다. 울산 일 산부인과전문병원의 협조를 얻어, 2012년∼2013년까지 난임 시술을 받은 344명의 데이터를 수 집하여 분석하였다. 분석방법은 교차분석, 로지스틱 회귀분석을 하였고, 통계적 검정은 χ2-test를 하였다. 난임 대상자 특성은 30대(72.1%)가 가장 많았고, 질병은 없는 경우(70.9%), 출산 자녀도 없음(77.0%)이 가장 많았다. 난임 원인은 연령이 높을수 록 자궁요인이 많았고, 연령이 낮을수록 난소 요인이 많았다. 보조생식술을 시행한 시술은 IUI(51.5%), IVF(23.0%), IUI+IVF(25.6%) 이었고, 보조생식술 시술은 연령(p<.013), 난임 기간(p<.014), 유산경험(p<.008)이 통계적으로 유의하였다. 보 조생식술 시술 결과 임신이 34.9%이었고, 그 중 인공수정은 49.2%, 체외수정은 50.8% 이었다. 성공 시술 평균 횟수는 인공수 정 시술은 1.64회, 체외수정 시술은 1.36회로 체외수정이 인공수정보다 0.28회 낮았다. 따라서 보조생식술 유형에 따른 임신 성공률을 높이기 위해서는 인공수정 시술은 연령이 낮고, 난임 기간이 짧을수록, 출산 자녀가 없는 경우, 체외수정 시술은 연령이 높고, 난임 기간이 길수록, 출산 자녀가 있는 경우 선택해야 한다. 본 연구는 보조생식술을 시행한 전체를 대상자로 분석하였다는 연구적 의의가 있으나, 일 광역시라는 지역적 제한으로 일반화 하기는 어렵다. 이를 기초로 지역별 및 전국 난임 치료자를 대상으로 한 후속 연구가 이루어진다면 난임 원인별 특성을 파악하여, 효율적 치료 방안 구축 마련에 도움이 될 것이다. This study was conducted to identify characteristics observed by staff during infertility treatment, and to analyze the relationship between the result of the treatment according to the ART infertility characteristics. In cooperation with an Obstetrics and Gynecology Hospital in Ulsan, data were collected from 344 people receiving infertility treatment from 2012-1013 and evaluated by cross-analysis, logistic regression analysis, and the χ2 test. Age 30 subjects (72.1%), no disease (70.9%), and no birth children (77.0%) were most common among patients. Causes of infertility factor is the higher the age, followed by uterine factors, ovarian factors were the lower the age.Were assisted reproduction are IUI (51.5%), IVF (23.0%), IUI + IVF (25.6%), assisted reproduction were age (p<.013) infertility period (p<.014), abortion Experience (p<.008) it was not statistically significant. ART pregnancies result was 34.9%, IUI was 49.2%, IVF was 50.8%. The average number of successful IVF treatment was 1.64, while it was 1.36 for IVF. IVF is 0.28 times lower than the IUI. Thus, low in order to increase the success rate of pregnancy according to the assisted reproduction age, nanim period is short, and if you do not have birth children choose artificial fertilization, and high age, IVF If there are nanim period is longer and birth child treatment and you must choose. This study analyzed all subjects who underwent fertility treatment to have research significance. However, it is difficult to generalize, locally called Sun City limits. If this one based on regional and national follow-up study of infertility therapist made it will help to prepare the way of effective treatment for infertility causes.

다태임신에서 질식 선택적 유산술 후의 임신 예후에 관한 연구

김석현(Seok Hyun Kim),서상수(Sang Soo Seo),임경실(Kyung Sil Lim),지병철(Byung Chul Jee),서창석(Chang Suk Suh),최영민(Young Min Choi),김정구(Jung Gu Kim),문신용(Shin Yong Moon),이진용(Jin Yong Lee) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.2

목적: 최근 보조생식술의 발달과 더불어 급증하고 있는 삼태아 이상의 다태임신 예에서 임신 초기에 질식 천자를 이용한 질식 선택적 유산술을 시행하여 합병증, 임신 결과 등의 시술 성적을 규명하고자 하였다. 연구방법: 1993년 7월부터 1998년 12월까지 서울대학교병원 산부인과 불임크리닉에서 과배란유도를 이용한 체외수정시술 등의 보조생식술을 시행받은 후 임신에 성공하였으나 삼태아 이상의 다태임신 환자 및 타병원 불임크리닉에서 보조생식술을 시행받은 후 삼태아 이상의 다태임신을 주소로 본원으로 전원된 환자, 총 70명에서 질식 천자를 이용한 질식 선택적 유산술을 시행하였다. 분만 후 추적 조사가 가능하였던 58명의 환자를 대상으로 의무기록의 후향적 분석을 실시하였다. 대상 환자 58명의 평균 연령은 30.9±2.7세 이었으며, 체외수정시술을 시행받은 환자가 51명(87.9%), 과배란유도 주기에서 인공수정을 시행받은 환자가 7명(12.1%) 이었다. 선택적 유산술 시술 전 삼태아는 37예(63.8%), 사태아는 14예(24.1%), 오태아는 5예(8.6%), 육태아는 2예(3.4%) 이었다. 결과: 선택적 유산술의 시술 시기는 평균 임신 8+3±1+3주 이었으며, 시술 횟수는 평균 1.3±0.6회 이었다. 선택적 유산술 시술 후 55예에서는 쌍태아, 3예에서는 단태아를 남겼다. 쌍태아를 남긴 55예 중 자궁내 일측 태아 사망이 4예(7.3%)에서 일어나 총 51예에서 쌍태아 임신이 유지되었으며, 임신 24주 전에 유산된 경우는 9예 이었고, 나머지 42예는 임신 24주 이후에 분만되었다. 쌍태아 임신 중 자연적인 태아 손실이 일어난 4예와 단태아를 남긴 3예를 합한 총 7예의 단태아 임신에서는 모두 임신 24주 이후에 분만되었다. 임신 24주 이후에 분만된 쌍태아 임신 42예 중 4예에서 심한 미숙으로 인하여 신생아가 모두 사망하였고, 단태아 임신 7예 중 1예에서 심한 미숙으로 신생아가 사망하였다. 출생된 83명의 신생아 중 1명은 무뇌증에 이환되어 곧 사망하였고, 나머지 82명은 출생 후 별다른 합병증 없이 생존하였다. 선택적 유산술 시술 후 4주일 이내에 패혈성 유산이 1예(1.7%)에서 발생하였으며, 임신 24주를 기준으로 한 지연 태아손실율은 13.8%(8/58) 이었다. 임신 24주 이후에 분만된 49예 중 신생아가 사망한 경우는 4예 이었으며, 따라서 선택적 유산술 시술 58예 중 13예에서 태아가 모두 유산되었거나 분만 후 사망하여 22.4%(13/58)의 태아손실율을 나타내었다. 결과적으로 선택적 유산술 시술 후 45예(77.6%)에서 적어도 1명 이상의 태아가 생존하였는데 이들의 평균 분만 주수는 36+3±2+0주 이었다. 태아의 자궁내 발육지연은 33.3%(15/45)에서 발생하였으며, 쌍태아 출산의 경우 두 신생아에서 출생시 체중 차이가 20% 이상되는 체중 불일치(discordancy)의 발생 빈도는 16.7%(6/36) 이었다. 주된 선천성 기형으로는 1예에서 무뇌증이 관찰되었다. 선택적 유산술 시술 전 태아의 수에 따른 태아손실율은 육태아에서 100.0%(2/2), 오태아에서 20.0%(1/5), 사태아에서 28.6%(4/14), 삼태아에서 16.2%(6/37)로서 유의한 차이는 없었다. 시술 전 사태아 이상 군과 삼태아군을 상호 비교한 결과 태아의 분만 주수 및 태아손실율은 각각 유의한 차이가 없었으며, 신생아의 출생 체중은 사태아 이상 군에서 유의하게 낮았다. 결론: 보조생식술시 다태임신을 완전히 예방할 수는 없으며, 특히 삼태아 이상의 다태임신은 모체 및 태아의 이환율 등을 증가시키므로 질식 선택적 유산술은 의학적 뿐만 아니라 사회적, 윤리적으로도 정당화될 수 있는 유용한 시술이라고 사료된다. Objective: To evaluate the maternal and fetal outcomes after transvaginal selective fetal reduction(SFR) in multifetal pregnancy. Materials and Methods: Transvaginal SFR using fetal intracardiac puncture with KCl injection and aspiration of amniotic fluid was performed in 58 multifetal pregnancies achieved after assisted reproductive technology(ART). After transvaginal SFR, 55 twin and 3 singleton pregnancies were evaluated and analyzed retrospectively with the medical records of mothers and babies. Results: Of 58 cases, abortion within 4 weeks after SFR occurred in 1 case(1.7%). Miscarriage of all fetuses occurred in 8 cases(13.8%) from 4 weeks after SFR until 24 weeks of gestation. Perinatal death occurred in 8 newborns from 5 mothers due to extreme prematurity in 7 cases and anencephaly in 1 case. Take-home baby rate, that is, discharge with at least 1 healthy baby, was 77.6%(45/58). Conclusion: Transvaginal SFR is an acceptable and effective management option in the cases of excessive multifetal pregnancy after infertility treatment. The ultimate successful outcomes of reduced multifetal pregnancy may be enhanced by more extensive experience with SFR.

다태임신에서의 선택적 유산술시 복식 천자와 질식 천자의 비교 연구

김석현,문신용,이진용,Kim, S.H.,Moon, S.Y.,Lee, J.Y. 대한생식의학회 1996 Clinical and Experimental Reproductive Medicine Vol.23 No.1

The number of multifetal pregnancies has increased dramatically as a result of the widespread clinical use of ovulation induction and assisted reproductive technology(ART) in infertile patients. In multifetal pregnancies, the adverse outcome is directly proportional to the number of fetuses within the uterus, primarily because of an increased predisposition to premature delivery. It is extremely difficult to counsel patients about the expected outcome of pregnancies involving three or more fetuses. To increase the chances of delivering infants mature enough to survive without being irreversibly damaged by the sequelae of marked prematurity, selective fetal reduction(SFR) to the smaller number of fetuses should be considered in multifetal pregnancies. From January, 1991 to December, 1992, transabdominal SFR in multifetal pregnancies was performed in 22 patients including 13 triplet, 7 quadruplet, 1 quintuplet and 1 heptuplet pregnancies. Transabdominal SFR using intracardiac KCI injection and aspiration of amniotic fluid was carried out in 8-13 weeks of gestation. After procedure, 20 patients were remained as twin pregnancies, and 2 patients as triplet pregnancies. There have been 11 sets of twin delivery including 2 stillbirths, 2 sets of triplet delivery including 1 stillbirth, and 1 singleton delivery. Six cases were delivered after 37 weeks of gestation, 4 cases in 33 - 37 weeks, and 1 case in 30 weeks. Unfortunately, 3 stillbirths occurred in 20-24 weeks of gestation, and 4 cases were aborted. As 7 losses of pregnanancy including 1 case of septic abortion occurred, the delayed fetal loss rate was 38.9%(7/18) in transabdominal SFR. All babies born after 30 weeks of gestation were healthy, and no fetal anomaly directly related to the procedure was encountered. From July, 1993 to February, 1995, transvaginal SFR was performed in 20 patients including 15 triplet, 4 quadruplet and 1 quintuplet pregnancies. Transvaginal SFR using the same method as transabdominal SFR was carried out in 8-11 weeks of gestation. After procedure, 19 patients were remained as twin pregnancies, and 1 patient as singleton pregnancy. There have been 13 sets of twin delivery including 2 stillbirths, and 1 singleton delivery. Six cases were delivered after 37 weeks of gestation, 5 cases in 36-37 weeks, and 1 case in 30 weeks. Unfortunately, 2 still-births occurred in 20 weeks and 21 weeks of gestation, respectively, and 2 cases were aborted. As 4 losses of pregnancy including 1 case of septic abortion occurred, the delayed fetal loss rate was 25.0%(4/16) in transvaginal SFR. No fetal anomaly directly related to the procedure was encountered. It is suggested that transvaginal SFR could be performed more easily and earlier with the lower fetal loss rate as compared with transabdominal SFR. In conclusion, SFR is a rather safe and ethically justified procedure that may improve the outcome of multifetal pregnancies.

난자공여 프로그램에서 난자수혜자의 연령이 임신율에 미치는 영향에 관한 연구

서창석,오선경,김석현,최영민,김정구,문신용,이진용,Suh, C.S.,Oh, S.K.,Kim, S.H.,Choi, Y.M.,Kim, J.G.,Moon, S.Y.,Lee, J.Y. 대한생식의학회 1997 Clinical and Experimental Reproductive Medicine Vol.24 No.2

Oocyte donation program developed to reach the pregnancy in those patients suffering from premature ovarian failure or surgery induced menopause, particularly in their reproductive age. With technical advances and popularity of ART (assisted reproductive technology), the indication of oocyte donation program extended to low responders, and even to naturally menopaused patients that has led them quite successfully to getting in pregnancy. The purpose of this study was to evaluate which one is involved in the decline of fertility between the oocyte and uterine factor. One hundred five cycles of oocyte donation program were performed in 84 patients from Jan., 1993 to Dec., 1996. Oocytes were donated from healthy, young, fertile anonymous donors or relatives or infertile patients with supernumerary oocytes. The study population was divided into 3 groups according to the age of recipients. Group 1 was less than 35 years old, Group 2 was between 35 to 39 years old, and Group 3 was more than 39 years old. The results were as follows: The mean age of oocyte donor was $31.5{\pm}3.3$ (range; 25-36). The mean concentration of basal serum FSH and peak serum estradiol were not different among groups. The mean number of oocytes retrieved from donors, embryos transferred to recipients, and fertilization rate were not different among groups. The clinical pregnancy rate was 37.3% in Group 1, 31.6% in Group 2, and 31.6% in Group 3, respectively. The spontaneous abortion rate was 16.0% in Group 1, 16.7% in Group 2, and 16.7 in Group 3, respectively. The multiple pregnancy rate was 20.0% in Group 1, 16.7% in Group 2, 16,7% in Group 3, respectively, The implantation rate was 11.3% in Group 1, 10.3% in Group 2 and 10.0% in Group 3, respectively. All of the pregnancy outcomes were not different statistically among groups. In conclusion, endometrial receptivity does not seem to be impaired as age increases with transfer of good quality embryos and adequate endometrial preparation.

한국의 배아 감수술 문제와 교도권의 가르침

유성현 한국가톨릭신학학회 2017 가톨릭신학 Vol.0 No.31

발전된 의료 과학 기술은 인간의 삶이 시작되는 순간부터 끝나는 때까지 모든 영역에 밀접하게 연결되어 있다. 그 기술은 인간의 건강한 삶을 위한 목적을 갖고 있다. 그러나 이러한 진보된 의료 과학 기술은 인간 존재의 파괴와 연관되거나, 인간 존엄에 위배되는 수단으로 쓰이기도 한다. 그리고 이러한 기술은 인간의 삶 전체 안에서 인간 존재의 인식에 대한 본질적이고 도덕적인 중대한 문제들을 발생시킨다. 특히, ‘배아 감수술’과 같은 윤리적 문제들과 이와 밀접하게 관련된 의료 과학 기술이 인간의 존엄성과 양심을 침해하고 왜곡시키는 원인이 될 수 있음을 분명히 보여주고 있다. 왜냐하면, ‘배아 감수’는 직접적이고 의도적으로 무죄한 인간을 제거하는 것이며 낙태이기 때문이다. 그것은 목적으로든 수단으로든 중대한 윤리적 무질서를 일으킨다. 따라서 본고는 배아 감수술의 문제와 교도권의 가르침에 대하여 살펴보고자 하였다. 한국에서 배아 감수술을 정확히 파악하는 것은 어렵다. 그러나 보조생식술지원에 관한 정부의 현황자료를 통해 점점 증가하고 있는 것으로 추정할 수 있다. 배아 감수술은 불임 때문에 행해지는 보조생식술로 인한 다태 임신이 원인으로 건강한 배아를 얻고자 하는 바람으로 시행되고 있다. 오늘날 다태 임신(여러 배아가 산모의 자궁에 들어 있는)은 드물지 않은 경우가 되었다. 다태 임신은 일반적으로 불임의 경우에 행하는 난소 자극으로 일어나거나 인공수정에 의존하는 경우에 일어난다. 산모들에 대한 모든 의학적 조치에서와 마찬가지로 인간 배아의 생명과 그 온전함에 대한 존엄성을 유지하며 그들에게 부당한 해를 주지 않고 오히려 그 개체의 건강 증진과 생존과 치료를 위하여 실시하는 의학적 조치에 대해서는 이를 당연히 합당한 것으로 지지하여야 한다. 그러나 이렇듯 인간 출산이 기술적으로도 가능하게 되었다는 것이 같은 이유로 도덕적으로도 수용할 수 있는 것이 되지는 않는다. 따라서 그 최초 생성 단계로부터 인간에 대한 기술적 개입들이 도덕적으로 옳은 것인지 그른 것인지를 평가하려면 생명과 인간 출산의 기본적 가치에 대한 이성적 판단이 불가피하게 되었다. 이러한 문제들을 인식하고 개선하기 위해서는 윤리적 성찰과 더불어 배아 감수술을 객관적으로 감시할 수 있는 시스템의 정립과 그 현황에 대한 주기적 관찰과 연구가 있어야 하며, 동시에 필요한 법제도의 확립을 위한 노력이 이루어져야 한다. 그리고 초기 인간 생명에 대한 인간학적 인식을 가르치는 것이 배아 감수술을 원하는 부부들에게 나아가 난임부부들에게 주어져야 한다. 나아가 그들에게 배아 감수술 외에 양심을 보전하면서 도덕적이고 합법적인 ‘나프로 임신법’과 같은 대체 방법의 확대와 필요한 의료 지원이 병행된다면, ‘배아 감수’라는 심각한 윤리적 무질서를 바로 잡게 될 것이다. Medical technology deals with human life from its beginning to its end. It was born with the aim of curing the human body, always in full respect. Too often, however, this technology bends to the destruction of people and is used as a means to violate human dignity, raising the debate on the thorny bioethical issue of the concept of human existence throughout the life of man. An example is worthy of all: it is because of the total freedom with which man uses this medical technology that an act against life itself is justified, such as abortion. In particular, the medical technique that is called “embryonic reduction” demonstrates evidently for itself that it can be the cause of infraction and distortion of human dignity and consciousness. Because “embryonic reduction”, consists indeed in the direct and voluntary elimination of an innocent human being and constitutes a selective abortion. Therefore, both when it is intended as an end and when it is used as a means, it is always a serious moral disorder. Therefore, this paper of mine wants to trace what are the problems and issues resulting from the medical technique of “embryonic reduction” and proposes to disseminate what is the teaching of the Magisterium regarding this medical technique. It is not possible to know how often the “embryonic reduction” is carried out in Korea but, thanks to some data concerning the current situation and provided by the government regarding the support of ‘Assisted Reproductive Technologies(ART)’, we can only assume that in many they require this “embryonic reduction” technique to control the numbers of implanted embryos and that the trend is increasing. At present the cases of multiple pregnancies have become less rare, when namely the womb is shared by several embryos. These cases usually occurs either due to ovarian stimulation in case of infertility, or due to the use of artificial fertilization. As with any medical intervention on pregnant women, interventions on the human embryo must be considered legitimate, provided they respect the life and integrity of the embryo, and that they do not involve disproportionate risks, but are instead finalized, conversely, to his recovery, to the improvement of his health conditions or to his individual survival. But what is technically possible is not for this reason morally admissible. The rational reflection on the fundamental values of human life and procreation is therefore indispensable to formulate the moral evaluation regarding such technical interventions on the human being from the early stages of its development. To analyze clearly and try to solve this moral question, and to protect the life of the human embryo and the health of the pregnant mother, ethical reflection on this problem should be stimulated and there should be a medical system capable of objectively supervising the medical technique of “embryonic reduction”; and it is also essential to have available a statistical analysis on the percentages of use of this technique, on what is the age group in which most people decide to use it and, last but not least, on the most frequent causes. Laws should also be passed to protect the right to life of the human embryo. In particular, for spouses who decide to resort to “embryonic reduction” or who suffer from infertility, an education should be provided during which the ontological relevance of the human being is studied, from the early stages of his life. The problem of serious moral disorder, caused by the medical technique of “embryonic reduction”, can be solved with the support of a medical treatment program for infertility of the woman or of man and with the diffusion of an alternative technique, respectful of the moral and of the law, such as ‘NaPro Technology(Procreative Natural Technology)’, a service program that maintains, monitors and evaluates women's procreative and gynecological health.