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

和

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

和

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

治

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&#39；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&#39；因為

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

你知道，如果你不&#39；有精子， 如果你不&#39；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-