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  • Hi, my name is Sue Pascoe and I am a staff writer at the Palisadian Post, which

    嗨,我叫蘇-帕斯科,我是帕利薩迪安郵報的一名工作人員,該郵報是

  • is a weekly newspaper newspaper in the Pacific Palisades [Los Angeles, CA], and I do the monthly

    是太平洋帕利塞德[洛杉磯,CA]的一份週報報紙,我做每月的

  • "Healthy Column"

    "健康欄目&quot。

  • and uh... I'm nothing healthy right now, but [Sue Laughs]

    我現在什麼都不健康,但[Sue Laughs]。

  • anytime one of our readers has an issue about fertility, about

    任何時候,我們的讀者都有一個關於生育的問題,關於。

  • miscarriages, about anything to do with reproductive, I go to speak to one of the

    流產,任何與生殖有關的事情,我都會去找其中一個人說。

  • top fertility specialists in the United States, Dr. Ingrid Rodi, to help me

    美國頂尖的生育專家,英格麗-羅迪博士,幫助我。

  • clarify, so that I am able to explain to our readers what's going on.

    澄清,以便我能夠向我們的讀者解釋'是怎麼回事。

  • and today

    而今

  • I'm wondering -

    我想知道

  • 'What do you do if you're infertile? What - How do you know if you're infertile?'

    '如果你'不孕不育,你該怎麼辦?什麼--你怎麼知道你是否'不孕?&#39。

  • and

  • I thought maybe Dr. Rodi could help us.

    我想也許羅迪醫生可以幫助我們。

  • well um -

    嗯嗯 -

  • the first thing that

    首先

  • that couples need to know is that when they're considering

    夫婦需要知道的是,當他們'考慮到

  • getting pregnant

    懷孕

  • they should consult their

    他們應該諮詢他們的

  • family doctor or gynecologist

    婦科醫生

  • for preconception counseling. That means going in before they actually get

    進行孕前諮詢。這意味著在他們真正得到之前去

  • pregnant

    懷孕

  • to determine if there are any changes in the medications that they need, or if they have

    以確定他們所需的藥物是否有任何變化,或者他們是否有。

  • any medical problems that might

    任何可能的醫療問題

  • complicate their pregnancy

    孕期複雜化

  • and if there are any genetic

    如果有任何遺傳

  • mutations that they're at risk for

    突變,他們'的風險。

  • and

  • the gynecologist will go over all those things and

    婦產科醫生會檢查所有這些事情,並。

  • give them the go-ahead -

    搶先一步

  • Start her on

    讓她開始

  • vitamins and on

    維生素和

  • folic acid -

    葉酸 -

  • SP: Oh so you should be taking vitamins even before you conceive?

    SP:哦,那你在懷孕前就應該吃維生素了?

  • IR: Yes, at least about

    IR:是的,至少是關於

  • three months before.

    三個月前。

  • There's also- SP: But it used to be so easy! Couldn't you just go and get pregnant

    還有'的--SP:但是以前是很容易的啊!你就不能去懷孕嗎?

  • and that was it? Why do I have to go see my doctor before i even try?

    就這樣?為什麼我還沒試就得去看醫生?

  • IR: Well, you know, you want to optimize,

    IR:嗯,你知道,你要優化。

  • you know the

    你知道

  • the chance that

    機會

  • the pregnancy is going to be

    懷孕將是

  • as easy as possible and that the baby's going to be as healthy as possible.

    儘可能的輕鬆,寶寶會盡可能的健康。

  • and once -

    和一次-

  • you know - the couples have been given the go-ahead

    你知道--這對夫婦已經被準許了。

  • IF the woman is under thirty,

    如果該婦女未滿30歲;

  • they're usually -

    他們通常 -

  • it's usually suggested that they try for a year.

    它'的通常建議他們嘗試一年。

  • SP: Okay, now by 'trying for a year' -

    SP:好的,現在通過'嘗試一年'------。

  • What does that mean?

    這意味著什麼?

  • IR: That means either - SP: I mean how many times am I having sex a week? What are we

    IR:這意味著要麼--SP:我的意思是我一週有多少次性生活?我們是什麼?

  • talking here? IR: Right. That means either

    在這裡說話?紅外線。是的。這意味著要麼

  • just having sex regularly, meaning

    只是定期做愛,意思是

  • three to four times a week

    一週三次到四次

  • or using an ovulation prediction kit

    或使用排卵預測工具

  • which tells her

    這告訴她

  • when she's going to ovulate.

    當她'要排卵的時候。

  • So- SP: Okay, so

    所以,SP。好吧,那麼

  • we've all seen it on TV - 'Honey! Honey! I'm ovulating! Come home quick!' Is that

    我們都在電視上看到過--"親愛的!親愛的!"。親愛的!我在排卵了!快回家吧!'是嗎?

  • really accurate?

    真的準確嗎?

  • IR: Well it's very helpful.

    IR:嗯,它'很有幫助。

  • Especially if couples

    特別是如果夫妻

  • are frequently out of town

    經常出遠門

  • and they're really trying to maximize

    和他們真的想最大限度地提高

  • the timing,

    的時機。

  • then the kit is very helpful.

    那麼這套裝備就很有幫助。

  • SP: Okay, so then

    SP:好的,那麼

  • I'm under thirty and I'm having sex regularly or I'm using an ovulation kit - now

    我在三十歲以下,我經常做愛,或者我在使用排卵工具--現在。

  • there is an old wives tale too, that after you have sex, if you're a woman you should put

    有一個古老的妻子的故事了,你有性行為後,如果你是一個女人,你應該把你的性行為。

  • your feet up -

    抬腳

  • does that actually have any truth to-

    這是否真的有任何事實,以

  • IR: No SP: Oh, okay so - IR: As long as everything is where it is supposed to be

    IR:沒有SP:哦,好吧,那麼--IR:只要一切都在它應該在的地方。

  • you don't have to do anything. SP: You don't have to lay down for another hour, okay.

    你不'不必做任何事情。SP:你不用再躺一個小時,好嗎。

  • [Sue snaps her finger] Drat. Okay so now I'm under thirty and having sex regularly for a year

    [蘇打了個響指]可惡。好吧,所以現在我'30歲以下,定期做愛一年

  • and i haven't gotten pregnant.

    我還沒有懷孕。

  • IR: Okay, so then, the couple comes back.

    IR:好的,那麼,這對夫妻就回來了。

  • Or - if the woman is trying to get pregnant on her own - she comes back

    或者--如果女人想自己懷孕--她回來了。

  • and we look for for those areas which are considered deal breakers so

    我們要尋找那些被認為是破壞交易的領域,所以

  • you need to be ovulating

    你需要排卵

  • SP: Why wouldn't I be ovulating? Doesn't every woman ovulate?

    SP:為什麼我不會排卵呢?不是每個女人都會排卵嗎?

  • IR: Not every woman ovulates, and not every woman ovulates regularly.

    IR:不是每個女人都會排卵,也不是每個女人都會定期排卵。

  • SP: Oh, really? IR: So- SP: So if I'm one of those people that doesn't have a period

    SP:哦,真的嗎? IR:所以- SP:所以,如果我'是那些人之一,不'有一個時期。

  • every month, would I be one of those 'irregular ovulators?' IR: Yes.

    每個月,我會不會是那些'不規則的排卵器?' IR:是的。

  • SP: Is that normal?

    SP:這正常嗎?

  • No, it's normal to have a period every month.

    不,每個月來一次月經很正常。

  • And if a woman is having a period

    如果一個女人來了月經

  • where the interval is more than five weeks

    間隔時間超過五週

  • then she may ovulate but she doesn't ovulate regularly.

    那麼她可能會排卵,但她不定期排卵。

  • or at least not

    至少沒有

  • or at least not every four weeks.

    或至少不是每四個星期一次。

  • can you as a doctor

    您作為醫生能

  • change that then? So that she can ovulate more regularly?

    那就改變這種情況?讓她能更有規律地排卵?

  • IR: Yes, there are medications we can give her to ovulate more regularly,

    IR:是的,我們可以給她服用一些藥物,讓她的排卵更加規律。

  • - in most cases.

    - 在大多數情況下,。

  • okay so one of the things is then, if I come in, having that problem, you

    好吧,所以其中一件事是,如果我進來,有這個問題,你。

  • check for regular ovulation.

    檢查是否正常排卵。

  • IR: Right, the next thing we need to know is

    IR:好的,接下來我們需要知道的是。

  • if the man has sperm

    男方有精子

  • and whether he has an adequate number of sperm.

    以及他是否有足夠數量的精子。

  • And we do a semen analysis for that.

    而我們為此做了精液分析。

  • SP: Okay,

    SP:好的。

  • so,

    所以,

  • what would be adequate number?

    多少才算夠?

  • IR: Well- SP: I thought it only took one?

    IR:嗯--SP:我以為只需要一個人?

  • IR: Yeah, it only takes one, BUT uh... they have a long way to swim all the way from the cervix all the way up

    是的,只需要一個人,但是... ... 他們有很長的路要走,從子宮頸一直往上游。

  • to where fertilization occurs.

    到受精的地方。

  • so you need actually more than one.

    所以你需要的其實不止一個。

  • IR: You need about- SP: Or you need a SUPER super sperm to get the job done. spurted

    IR:你需要大約--SP:或者你需要一個SUPER超級精子來完成任務。 噴出的

  • IR: Right so you need - the normal semen analysis would have

    IR:對,所以你需要--正常的精液分析會有。

  • twenty million

    兩千萬

  • per CC.

    每一CC:

  • and the usual volume is about-

    而通常的音量大約是-

  • at least two CCs per ejaculate.

    每次射精至少有兩個CC。

  • SP: Okay, now so when you say 'CC' - how are we talking - a teaspoon full? Or

    SP:好的,現在當你說'CC'--我們怎麼說--滿滿一茶匙?或者是

  • are we talking a pin head? What are we talking?

    我們說的是針頭嗎?我們在說什麼?

  • IR: Several drops certainly

    IR:幾滴當然

  • SP: Several drops, okay.

    SP:幾滴,好吧。

  • IR: So that's measured in the lab

    紅外線:所以,這'是在實驗室裡測量的

  • so they measure that.

    所以他們測量。

  • SP: Okay so my partner who might not be thrilled about this will go to a lab

    SP:好吧,所以我的搭檔可能不會激動,他會去實驗室。

  • and produce a little

    併產生一點

  • petrie dish full of semen to be looked at. IR: Exactly.

    充滿精液的Petrie盤子被看。IR:沒錯。

  • and then we also need them to be swimming

    然後我們還需要他們會游泳

  • in the forward direction.

    在前進方向。

  • SP: No backstrokers?! IR: No backstrokers, well as long as they go forward [both laugh]

    SP:沒有仰泳?IR:沒有仰泳,好吧,只要他們往前走就行[兩人都笑了] 。

  • so we look at

    所以我們看

  • both the count,

    既是數。

  • the motility, and how many of them look normal.

    動性,又有多少人看起來正常。

  • So one of the things that we're looking at is

    所以,我們正在尋找的事情之一是,我們'。

  • whether the,

    是否:

  • whether the sperm

    精子

  • have normal heads

    頭腦正常

  • SP: [pointing at diagram] One's a two header.

    SP:[指著圖]一個'是兩個頭。

  • Some of the sperm have two heads?

    有些精子有兩個頭?

  • IR: some of them have two heads and -

    紅外線:其中一些有兩個頭,還有--------。

  • SP: Will that give you twins, if you have two heads?

    SP:如果你有兩個頭,那會不會給你生雙胞胎?

  • IR: they typically don't do much of anything.

    IR:他們通常不會做太多的事情。

  • and some of these have two tails.

    而其中一些有兩個尾巴。

  • so you really want- SP: This one looks like a pointy head

    所以你真的想--這個看起來像個尖頭

  • he's not a good swimmer then either.

    那他'也不是一個好的游泳運動員。

  • IR: No, all of these -

    IR:不,所有這些--

  • this is the normal one [points] and all of these are not so good.

    這個是正常的[分],這些都不是很好。

  • SP: So could one of them make it up there or probably not? IR: Probably not.

    SP:那他們中能不能有一個人上去,或者可能不能?IR:可能不會。

  • This is the

    這就是

  • best way to get up there.

    最好的方式去那裡。

  • okay, so if you go in then and you find out that

    好吧,所以,如果你去的時候,你發現,

  • the problem is the sperm

    禍從口出

  • then what do you do? IR: Then there are specialists

    那你是做什麼的?IR:那就有專家

  • who evaluate the male and see

    評估男性並看到

  • if there's anything they can do to improve the situation

    如果有什麼他們可以做的,以改善這種情況。

  • if not then we sometimes have to

    不然的話,我們有時就得

  • treat the

  • woman to compensate for the problems in the man. One of those treatments is

    女人來彌補男人的問題。其中一種治療方法是

  • insemination

    授精

  • 'Artificial insemination' or 'in Vitro Fertilization.'

    '人工授精'或'體外受精.&#39。

  • SP: Okay so now

    SP:好的,所以現在

  • so I'm sorry to sort of goad this, but I haven't heard much about

    所以,我'對不起,排序的慫恿這一點,但我還沒有聽說過太多關於

  • what - how can a man

    什麼--一個人怎麼能

  • improve? I mean what -

    改善?我是說...

  • just not be as stressed as much? Would that

    只是沒有那麼大的壓力?會不會

  • make better sperm? IR: Well, one of the

    製造更好的精子?IR:嗯,其中一個

  • things the male

    男人的事

  • fertility specialist will look at is whether he's on any medications that

    不孕不育專家會看是否他's在任何藥物,以

  • have a bad effect on the sperm.

    對精子有不良影響。

  • Men who

    男子

  • smoke marijuana

    吸食大麻

  • often have sperm that are pretty slow swimmers so- [Sue Laughs]

    往往有精子是相當緩慢的游泳者,所以-- [蘇笑]。

  • SP: And they get munchies on the way up, I'm sure.

    SP:而且他們在上路的時候會吃到零食,我'肯定。

  • IR: Yeah - it's not enough for contraception

    IR:是啊--這還不夠避孕的。

  • so I don't mean to suggest that marijuana is contraception, but it may slow them down.

    所以我不是說大麻是避孕,但它可能會讓他們慢下來。

  • so they have an

    所以他們有

  • evaluation of their hormones

    評估他們的荷爾蒙

  • and a physical exam

    和體檢

  • and if all of that turns out to be normal, we can

    如果所有這些都是正常的,我們可以

  • inject the sperm into the egg

    注精入卵

  • during in vitro fertilization.

    在體外受精過程中。

  • SP: Okay, so now we've gone through:

    SP:好的,所以現在我們'已經通過了。

  • a possible ovulation problem, a possible sperm problem,

    可能是排卵問題,可能是精子問題。

  • what else might you evaluate me for? You find out that I am ovulating fine, the sperm

    你還可以評估我什麼?你發現我排卵很好,精子... ...

  • seems to be fine, and we are still not getting pregnant.

    似乎很好,我們還是沒有懷孕。

  • IR: So you really need the

    IR:所以你真的需要

  • fallopian tubes to be open.

    輸卵管要通暢。

  • SP: Oh, can you ovulate even if the fallopian tubes are not open? IR: Yes.

    SP:哦,輸卵管不通暢也能排卵嗎?IR:是的。

  • So the fallopian tubes need to be open because the eggs come from

    所以輸卵管需要打開,因為卵子來自於

  • the ovary,

    卵巢。

  • fertilization occurs in the fallopian tube, and then the embryo

    在輸卵管內受精,然後胚胎

  • goes down

    下降

  • to the uterus.

    到子宮。

  • And if the fallopian tubes are blocked,

    而如果輸卵管堵塞。

  • you can ovulate, but you can't fertilize the egg.

    你可以排卵,但你可以'不受精卵。

  • SP: Where does the egg go then, if they are blocked? IR: It just disintegrates.

    SP:那如果它們被堵住了,卵子會去哪裡?IR:它就會解體。

  • SP: and then that means sperm can never get to the egg. IR: Right.

    SP:那就意味著精子永遠無法進入卵子。IR:對。是的。

  • SP: What causes blocked fallopian tubes?

    SP:什麼原因導致輸卵管堵塞?

  • IR: There are a number of causes - a woman could have a ruptured appendix,

    IR:原因有很多--女性可能是闌尾破裂。

  • and that infection can cause

    而感染可導致

  • a blockage of her

    堵塞

  • fallopian tubes. She could have a

    輸卵管。她可能有一個

  • sexually transmitted disease,

    性傳播疾病;

  • such as, chlamydia or gonorrhea

    如:衣原體或淋病

  • and that could block a tube.

    而這可能會堵塞管道。

  • She could have endometriosis, and have a blockage as a result of that.

    她可能有子宮內膜異位症,並是以發生堵塞。

  • So it is very important to find out whether the fallopian tubes are open

    所以瞭解輸卵管是否通暢是非常重要的。

  • because otherwise

    否則

  • you can't get pregnant on your own.

    你不能自己懷孕。

  • SP: What if you find that they are blocked? Then what do you do?

    SP:如果你發現他們被封殺了怎麼辦?那你該怎麼辦?

  • IR: In some cases you can open them, but in the majority

    IR:在某些情況下,你可以打開它們,但在大多數情況下。

  • of the cases you undergo in Vitro Fertilization

    您接受體外受精的案例中

  • which can bypass the fallopian tube so we

    它可以繞過輸卵管,所以我們的。

  • remove the eggs,

    取出雞蛋。

  • fertilize them in a dish, and then we put them into the uterus. So, we bypass

    在盤子裡給它們施肥,然後我們把它們放到子宮裡。所以,我們繞過

  • the fallopian tubes.

    輸卵管。

  • SP: Okay, so what else could be a problem then?

    SP:好吧,那還會有什麼問題呢?

  • IR: Those are the major ones, those are the ones that

    IR:這些都是主要的,這些都是。

  • we call 'Deal Breakers' because

    我們稱之為'Deal Breakers'因為

  • you know, if you don't have sperm, if you don't ovulate,

    你知道,如果你不'有精子, 如果你不'不排卵。

  • and if you have blocked fallopian tubes - those are

    如果你有輸卵管堵塞 - 這些都是。

  • serious problems.

    嚴重的問題。

  • SP: How about - Say, I am 45 now.

    SP:怎麼樣--說,我現在45歲了。

  • I have been ovulating, I am 45, I look very youthful, I have kept myself in

    我一直在排卵,我今年45歲了,我看起來很年輕,我一直保持著自己在

  • great shape,

    形狀很好。

  • I've got a younger partner, so his sperm is fine,

    我'有一個年輕的夥伴,所以他的精子很好。

  • we know the fallopian tubes [are fine] -

    我們知道輸卵管[是好的]。

  • Why would not be getting pregnant then?

    那為什麼會不懷孕呢?

  • IR: Well because we know that

    IR:嗯,因為我們知道

  • it takes

    需要

  • more eggs

    更多的雞蛋

  • or more cycles, or more trying

    或更多的週期,或更多的嘗試

  • to actually get to the one egg that's going to be normal

    要真正到一個蛋,要正常的

  • because with age the percentage of eggs

    因為隨著年齡的增長,雞蛋的比例

  • that are affected by

    受影響的

  • all kinds of abnormalities goes up.

    種種異常情況上去了。

  • SP: But I am so youthful!

    SP:可是我太年輕了!

  • i mean I can do a triathlon, I can do - I mean why would my eggs i didn't even any why would why eighties

    我的意思是,我可以做一個鐵人三項,我可以做 - 我的意思是,為什麼會我的雞蛋,我甚至沒有任何 為什麼會為什麼80年代?

  • not be as youthful as I appear to be, even though I am thirty-five?

    雖然我已經三十五歲了,但並不像我外表那樣年輕?

  • IR: We're not sure but we think it was an

    IR:我們'不確定,但我們認為這是一個。

  • evolutionary advantage

    進化優勢

  • not to have babies in our forties and fifties. So-

    在我們四五十歲的時候不生孩子。所以...

  • SP: Are you saying that even if I can keep my biceps relatively good, there is

    SP:你的意思是說,即使我能保持比較好的肱二頭肌,也有

  • no exercise to keep these eggs young?

    沒有運動來保持這些雞蛋的年輕?

  • IR: No,

    IR:沒有。

  • the only thing you can do is not smoke cigarettes

    你唯一能做的就是不抽菸。

  • and not get radiation or chemotherapy to your ovaries. Those things ACCELERATE the loss of

    而不是讓你的卵巢接受放療或化療。這些東西加速損失的

  • fertility

    生育力

  • but otherwise, your ovaries are on their own time clock.

    但除此之外,你的卵巢是有自己的時間鐘的。

  • SP: They sort of every year get older, no matter what's going on with my life.

    SP:他們算是每年都在變老,不管我的生活發生了什麼'。

  • IR: Right. SP: Okay, so then that

    IR:對。SP:好的,那麼這

  • probably would be a key thing that you would ask too, if I come in - is my age.

    可能會是一個關鍵的事情,你會問太,如果我進來 - 是我的年齡。