So that is a myth.

所以這是個神話。

IVF guarantees pregnancy.

試管嬰兒保證懷孕。

Oh boy.

哦，孩子。

It's a tough myth for patients to hear eating pineapple can increase fertility, that's a good one.

對病人來說，聽到吃菠蘿可以增加生育能力是一個艱難的神話，這是一個好的神話。

Pineapple by itself.

菠蘿本身。

If you have infertility is unlikely to reverse your infertility.

如果你有不孕症是不太可能扭轉你的不孕症。

I'm dr Cindy.

我是Cindy博士。

I am a fertility specialist based in las Vegas Nevada and I work with patients who are seeking to boost their fertility, preserve their fertility or build their families.

我是一名位於內華達州拉斯維加斯的生育專家，我為那些尋求提高生育能力、保持生育能力或建立家庭的患者工作。

Hello, I'm dr Sriram Ellis Warapu and I'm a urologist at U.

你好，我是Sriram Ellis Warapu博士，我是美國大學的泌尿科醫生。

C.

C.

L.

L.

A.

A.

My focus is on reproductive medicine for men as well as individuals born with testicles such as trans women.

我的工作重點是男性的生殖醫學，以及天生有睪丸的人，如變性婦女。

And today we'll be debunking myths about infertility, tight underwear is bad for sperm counts.

而今天我們將揭穿關於不孕不育的神話，緊身內衣對精子數量不利。

So there have been a number of studies looking at this issue for many decades and the inevitable question is boxers versus briefs.

是以，幾十年來一直有許多研究在關注這個問題，不可避免的問題是平口褲與內褲。

In truth, it doesn't matter a whole lot.

事實上，這並不重要。

And we know that if the testicles are a little bit warmer that they are more at risk of having sperm count issues or sperm motility issues, which is the way the sperm moves in the body.

而且我們知道，如果睪丸有點變暖，他們就更有可能出現精子數量問題或精子活力問題，也就是精子在體內的運動方式。

But in general it shouldn't matter too much.

但一般來說，這不應該太重要。

Just pick what's comfortable if you're going to be going on vacation and using hot tubs every day for hours a day.

如果你要去度假，每天都要使用熱浴盆，而且每天都要用上幾個小時，那麼就選個舒服的吧。

I would recommend against that if you're going to be trying to get pregnant because prolonged warmth and repetitive warmth affecting the testicles can drive sperm counts down and I have seen that in my practice sex position matters.

如果你想懷孕，我建議不要這樣做，因為長時間的溫暖和重複的溫暖影響睪丸，會使精子數量下降，我在實踐中看到，性愛姿勢很重要。

So that is a myth.

所以這是個神話。

No matter what position you engage in.

無論你從事什麼職位。

If you ejaculate, you have the sufficient propulsion of the semen to make it up to the cervix anyway.

如果你射精，無論如何你都有足夠的精液推進力使其到達子宮頸口。

You do it.

你來吧。

And a number of people around the world have actually studied it.

而世界各地的一些人實際上已經研究了它。

And no one position has been proven to be better than another.

而且沒有一個位置被證明比另一個更好。

Putting your legs up after sex can increase your chance of pregnancy.

性生活後把腿抬起來可以增加懷孕的機會。

That is also a myth.

這也是一個神話。

Long before I even understood what pregnancy entailed.

早在我甚至明白懷孕意味著什麼之前。

I was seeing imagery on tv and stuff of people almost on a handstand upside down.

我在電視和其他東西上看到人們幾乎是倒立的形象。

And I think the thought is, do we need to counteract gravity?

而我想的是，我們是否需要抵消重力？

But the truth is, you don't need to lay and sit upside down or anything like that.

但事實是，你不需要躺著和倒坐或類似的東西。

IVF guarantees pregnancy.

試管嬰兒保證懷孕。

Oh, boy.

哦，孩子。

Yes, that is definitely a myth.

是的，這絕對是一個神話。

And it's a tough myth for patients to hear the IVF does present the highest chances of pregnancy.

而對於患者來說，聽到試管嬰兒確實有最高的懷孕機率，這是一個艱難的神話。

Absolutely.

絕對的。

There are a number of factors that play into IVF success.

試管嬰兒的成功有很多因素。

One of them has to do with the age of the eggs being used.

其中之一是與所使用的雞蛋的年齡有關。

It also has to do with the quality of the sperm and the egg when they come together, it has to do with the embryo that is ultimately formed.

它還與精子和卵子結合時的品質有關，它與最終形成的胚胎有關。

It also has to do with the genetics of the embryo and the chromosome makeup.

這也與胚胎的遺傳學和染色體構成有關。

But then on top of that, it has to do with the womb in which the embryo will be placed.

但除此之外，它還與將放置胚胎的子宮有關。

And a number of factors that are not yet fully known.

還有一些尚不完全清楚的因素。

So we know the immune system plays a role.

所以我們知道免疫系統發揮了作用。

Diet, exercise probably play a role but we're still investigating that.

飲食、運動可能起到一定的作用，但我們仍在調查。

So the biggest thing to know is it's not 100% stress causes miscarriages.

是以，要知道的最大事情是，不是100%的壓力導致流產。

I think we're starting to get get away from the term miscarriages were starting to use the term early pregnancy loss.

我想我們已經開始擺脫流產這個詞，開始使用早孕丟失這個詞。

Is that right?

是這樣嗎？

That's correct.

這是正確的。

And I think it's because your miscarriage also comes with certain connotations where blame is also ascribed and the truth is both early pregnancy losses.

而且我認為這是因為你的流產也帶有某些內涵，在這裡也會被指責，而事實是兩次早孕的損失。

There's nothing the individual could have done about it at all.

個人對此根本無能為力。

And so now we call it early pregnancy loss before the end of the first trimester versus 2nd and 3rd trimester pregnancy loss.

是以，現在我們把前三個月結束前的早孕丟失與第二和第三個月的孕期丟失相提並論。

We do not believe stress causes los I know in everyday common conversation people believe that um we know stress can impact one's immunity.

我們不相信壓力會導致失去，我知道在日常的普通談話中，人們認為嗯，我們知道壓力會影響一個人的免疫力。

But we also know that many people around the world across millennia have gotten pregnant and remain pregnant despite tremendous stress.

但我們也知道，幾千年來，世界上許多人在巨大的壓力下仍然懷孕，並保持懷孕。

So we know it's not simply stress.

所以我們知道這不是簡單的壓力。

Nowadays though, we know the number one reason for pregnancy loss is chromosome all differences in the formed embryo.

不過現在，我們知道懷孕失敗的頭號原因是已形成的胚胎中的染色體都有差異。

And so that's called an employee, 67% of first trimester of pregnancy losses are due to chromosomal issues within the embryo itself.

是以這被稱為員工，67%的懷孕前三個月的損失是由於胚胎本身的染色體問題。

Other reasons would be if the thyroid was not functioning well if vitamin D.

其他原因是如果甲狀腺功能不好，如果維生素D。

Is low if there's a fibroid in the uterus if you have a uterus and you've had two or more pregnancy losses.

如果你有子宮，並且有兩次或更多的妊娠失敗，那麼子宮內有子宮肌瘤的話，是低的。

You should be evaluated for many decades.

你應該接受幾十年的評估。

We always expected that it would be the individual with the womb and the eggs to be the one that gets evaluated for pregnancy loss.

我們一直期望是擁有子宮和卵子的人接受懷孕損失的評估。

Now the tide is shifting and individuals who contribute the sperm are also being evaluated when there's a pregnancy loss in the couple.

現在，這一趨勢正在轉變，當一對夫婦出現懷孕失敗時，貢獻精子的個人也被評估了。

There's emerging data that things like DNA fragmentation where the DNA that are normally supposed to be very tightly wrapped up in the sperm are somehow unraveled and might have little breaks in the DNA strands.

有新的數據表明，像DNA碎片這樣的東西，通常應該非常緊密地包裹在精子中的DNA以某種方式被解開，並可能在DNA鏈中出現小的斷裂。

And those brakes can contribute to the pregnancy loss, freezing your eggs guarantees that you can have kids later myth.

而那些剎車會導致懷孕失敗，冷凍卵子可以保證你以後能有孩子的神話。

And the myth is in the word guarantee.

而神話就在保證這個詞裡。

If you freeze your eggs you can stop the clock.

如果你凍結了你的卵子，你可以停止計時。

And so you're basically freezing the youngest version of yourself at that point, however, there's no guarantee that eggs, even when frozen, will thaw and yield a light board baby.

是以，在這一點上，你基本上是在冷凍最年輕的自己，然而，不能保證雞蛋，即使是冷凍的，也會解凍併產生一個光板寶寶。

So it's really a conversation that needs to happen with your specialist based on your age, based on your egg number, not every egg that's thought after freezing will survive the thought.

是以，這確實是一個需要與你的專家進行對話的問題，基於你的年齡，基於你的卵子數量，不是每一個冷凍後的卵子都能存活下來的想法。

Not every egg that is injected with sperm will actually yield and embryo, not every embryo that's created, meaning not every fertilized egg will ultimately form a pregnancy.

不是每一個被注射了精子的卵子都會真正產生和胚胎，不是每一個被創造的胚胎，意味著不是每一個受精卵都會最終形成懷孕。

But on top of that affordability is an issue of access to clinics that have great protocols and great success rates with their eggs cause you really need a clinic that has a good track record of successfully find eggs and having pregnancies from thought eggs peeing or showering after having sex will lower your chance of pregnancy by the time you even get up off the bed and make your way to the bathroom, sperm have made their way up the uterus and are on their way to an egg.

但除此之外，負擔能力也是一個問題，那就是能否接觸到有很好的協議和很好的卵子成功率的診所，因為你真的需要一個有成功找到卵子並從認為的卵子中懷孕的良好記錄的診所。 在你甚至從床上爬起來去衛生間的時候，精子已經進入子宮，正在前往卵子的路上，小便或洗澡會降低你懷孕的機會。

And so that should not be a form of contraception.

是以，這不應該是一種避孕方式。

Now, what can decrease your chance of pregnancy is if you're someone who douches after sex.

現在，可以減少你的懷孕機會的是，如果你是一個在性生活後沖洗的人。

And so we strongly recommend against douche in general.

是以，我們強烈建議一般情況下不要使用沖洗劑。

It doesn't work for your vaginal microbiome.

它對你的陰道微生物群不起作用。

It doesn't work for your general health myths.

它對你的一般健康神話不起作用。

We hear the most sperm quality doesn't decline with age.

我們聽說最多的是精子品質不會隨著年齡增長而下降。

We have this term that we use a lot in medicine called advanced maternal age.

我們有一個在醫學上經常使用的術語，叫做高齡產婦。

So there was not this term advanced paternal age, but that is starting to emerge.

是以，以前沒有高級父系年齡這一說法，但現在開始出現了。

And there's a lot of data now that is showing that individuals with sperm that is older, say in the 5th, 6th, 7th decades of life and beyond is more at risk of forming embryos that have chromosome abnormalities, getting exercise, eating well are things that can improve the general biology of an individual.

現在有很多數據顯示，個人的精子年齡較大，例如在生命的第五、第六、第七個十年及以後，形成有染色體異常的胚胎的風險更大，鍛鍊身體、吃好東西是可以改善個人的一般生物學狀況。

Certainly if it's good for the heart and it's good for the brain, then it's probably good for the penis and the scrotum and the testicles as well.

當然，如果它對心臟有好處，對大腦有好處，那麼它可能對陰莖、陰囊和睪丸也有好處。

We talked about egg freezing, but sperm freezing has its role, particularly for individuals who may not be in a relationship or may not be thinking of a family at this time.

我們談到了卵子冷凍，但精子冷凍也有其作用，特別是對於那些可能沒有戀愛關係或目前可能沒有考慮建立家庭的人來說。

But later on down the road they might want to produce a family.

但以後他們可能想組建一個家庭。

It's impossible to get pregnant after 35.

35歲以後不可能懷孕。

It is possible to get pregnant after 35.

35歲以後是有可能懷孕的。

The truth is though, that the chance of pregnancy progressively declines as the age of the egg increases.

但事實是，隨著卵子年齡的增加，懷孕的機會逐漸減少。

And so you might find greater and greater need for fertility treatments.

是以，你可能會發現對生育治療的需求越來越大。

But when you're born, if you're someone born with ovaries you'd have somewhere between one million to two million eggs.

但是當你出生時，如果你是一個生來就有卵巢的人，你會有一百萬到兩百萬個卵子。

And those ovaries, usually by age 30 70% of those eggs are gone and by age 40 97% of those eggs are blonde at the same time, those eggs are also aging.

而這些卵巢，通常在30歲時，70%的卵子已經消失，到40歲時，97%的卵子是金黃色的，同時，這些卵子也在老化。

And so what we see is that the chance of pregnancy declines very quickly and then for some people it declines even faster.

所以我們看到的是，懷孕的機會非常迅速地下降，然後對一些人來說，下降得更快。

So if you have endometriosis, if you're someone who's maybe have surgeries on the ovaries are needed to be on medications, chemotherapy radiation, all of those things can also further the decline in the egg number.

是以，如果你有子宮內膜異位症，如果你是一個也許在卵巢上做過手術的人，需要服用藥物，化療輻射，所有這些事情也會進一步導致卵子數量的下降。

So my recommendation is, if you have ovaries at age 30 you should at least be asking your doctor to do a check of your egg number or what's called your ovarian reserve.

所以我的建議是，如果你在30歲時有卵巢，你至少應該要求醫生對你的卵子數量或所謂的卵巢儲備進行檢查。

The best way to get pregnant is to have sex every day.

懷孕的最好方法是每天都有性生活。

It comes down to the ambulatory cycles and making sure that you're sort of timing things and tracking things, particularly if you're trying to conceive deliberately, we always get this question and I want to know what your thoughts are.

這涉及到流動週期，並確保你對事情的時間安排和跟蹤，特別是如果你想故意受孕，我們總是收到這個問題，我想知道你的想法是什麼。

Should the couple be trying to conceive every other day during ovulation or every day during ovulation?

這對夫婦應該在排卵期每隔一天嘗試受孕，還是在排卵期每天嘗試受孕？

I say every other day.

我說每隔一天。

And it's because one we need to give the sperm and semen enough time to sort of re accumulate.

這是因為我們需要給精子和精液足夠的時間來重新積累。

So we can get those millions of sperm um in the ejaculate.

所以我們可以在射精中獲得那些數以百萬計的精子嗯。

So that's the first thing.

所以這是第一件事。

The other is sperm healthy sperm actually survive in the female genital tract for up to five days.

另一種是精子健康的精子實際上在女性生殖道內存活長達5天。

So once the egg is released from the ovary, think of the fallopian tube as an arm with a catcher's mint at the end the catcher's mitt captures the egg, pulls it into the arm and then the egg sits around there for 12 to 20 hours waiting for sperm.

是以，一旦卵子從卵巢中釋放出來，把輸卵管想象成一條手臂，末端有一個捕手的手套，捕手的手套捕捉卵子，把它拉到手臂上，然後卵子在那裡坐了12到20個小時，等待精子。

And then if you have intercourse anywhere within the next 24 hours, sperm will also get to the eggs.

然後如果你在接下來的24小時內的任何地方進行性交，精子也會進入卵子。

So that's why we say every other day around population.

所以這就是為什麼我們在人口周圍說每隔一天。

So what that means is if you're someone who articulates on day 14, you should really be trying to have a starting date 12 and a 14, day 16.

是以，這意味著如果你是一個在第14天闡述的人，你應該真正嘗試有一個開始日期12和14，第16天。

I usually say go out to day 18.

我通常說出去到第18天。

There is this movement now, particularly on the internet discussing what's called abstinence from pornography, masturbation and orgasm or PMO.

現在有這樣的運動，特別是在互聯網上討論所謂的戒除色情、手淫和高潮或PMO。

It's also a movement called no fat.

這也是一個叫做無脂肪的運動。

And those individuals say to have the best reserve of sperm or the best sort of power with erections or orgasm that they should conserve for days, weeks, months at a time.

而這些人說，要想擁有最好的精子儲備或最好的勃起或性高潮的力量，他們應該一次保存幾天、幾周、幾個月的時間。

This stuff is not Scientific at all.

這東西一點都不科學。

And in fact after a week of storing up the sperm may not necessarily be healthy.

而事實上，經過一個星期的儲存，精子不一定是健康的。

You are most fertile 14 days after your period starts.

在月經開始後14天，你的生育能力最強。

That is only true if someone has a 28 day cycle, if your cycle is 35 days, you're actually going to articulate on day 21.

這隻有在一個人有28天週期的情況下才是真的，如果你的週期是35天，你實際上會在第21天闡明。

If your cycle is 25 days, you're actually going to ovulate on day 11 after your period.

如果你的週期是25天，你實際上會在月經後第11天排卵。

For some people, they ovulate on day nine after their period.

對於一些人來說，他們在月經後的第9天排卵。

If they have like a 22 23 day cycle.

如果他們有像22 23天的週期。

So it really takes getting to know your body, know your cycle, track your cycle.

所以這真的需要了解你的身體，瞭解你的週期，跟蹤你的週期。

So you can truly understand your frequency for your cycle.

所以你可以真正瞭解你的週期的頻率。

You can never have Children after a vasectomy.

輸精管切除術後，你永遠不可能有孩子。

It is in fact possible.

這事實上是可能的。

There are a number of ways to conceive a pregnancy after a vasectomy.

輸精管切除術後有很多方法可以受孕。

The simplest way to think about it is to get a vasectomy reversal.

最簡單的思考方式是做輸精管切除術逆轉術。

There are ways of getting pregnant after a vasectomy that don't involve reversing the vasectomy.

有一些在輸精管切除術後懷孕的方法，不涉及逆轉輸精管切除術。

One of those ways is to go looking for sperm in the testicles Or in the epidermis, which is the storage organ behind the testicles that holds the sperm that can be as simple as a 10-15 minute procedure that's done in the office.

其中一個方法是去尋找睪丸中的精子或表皮中的精子，表皮是睪丸後面的儲存器官，可以是一個簡單的10-15分鐘的程序，在辦公室完成。

But that sperm will then have to be used with in vitro fertilization, eating pineapple can increase fertility.

但這些精子隨後將不得不用於體外受精，吃菠蘿可以提高生育能力。

That's a good one.

這是個好問題。

Pineapple by itself.

菠蘿本身。

If you have infertility is unlikely to reverse your infertility.

如果你有不孕症是不太可能扭轉你的不孕症。

We know that pineapples have watermelon inside of them, which is a compound that is known to be a blood thinner to a certain degree, but it's very, very weak and you'd have to eat so much pineapple to even have enough talent to have a little effect.

我們知道菠蘿裡面有西瓜，這是一種已知的化合物，在一定程度上是一種血液稀釋劑，但它非常非常弱，你必須吃這麼多菠蘿，甚至有足夠的天賦來產生一點影響。

But if you're looking to add it as an adjunct to your meals etcetera, go for it, you should be having a meal balanced in protein complex, carbohydrates and fiber.

但是，如果你想把它作為一種輔助手段添加到你的膳食中等等，那就去做吧，你應該在膳食中平衡複合蛋白質、碳水化合物和纖維。

So getting your usual multivitamins and full it into your diet because full it is really important for once you're pregnant.

是以，獲得你通常的多種維生素，並將其納入你的飲食中，因為一旦你懷孕，充分它真的很重要。

But technically no pineapple and by itself does not boost fertility.

但嚴格來說，沒有菠蘿和本身並不能提高生育能力。

You can't have Children.

你不能有孩子。

If you're unable to ejaculate, you can have Children uh from your own biological material.

如果你不能射精，你可以用你自己的生物材料生下孩子呃。

If you cannot ejaculate if the inability to ejaculate is a medical condition because of prior surgery or because of a medication one is taking or if they were born with that condition, there may be ways of reversing that condition.

如果你不能射精，如果不能射精是一種醫療狀況，因為之前的手術或因為一個人正在服用的藥物，或如果他們天生就有這種狀況，可能有辦法扭轉這種狀況。

There are individuals who come to me who the problem is not so much ejaculation, but the problem is erectile dysfunction for those individuals we can use medications.

有些人來找我，他們的問題不是射精，而是勃起功能障礙，對於這些人我們可以使用藥物。

There's injections.

還有就是注射。

There's hormone treatments, There's a variety of things that can be done to sort of treat or cure the erectile dysfunction more common in my practice is premature ejaculation and there are different kinds of therapy, different kinds of medication that we can try to prolong the ejaculate Torrey.

有激素治療，有多種方法可以用來治療或治癒勃起功能障礙，在我的實踐中，更常見的是早洩，有不同種類的治療方法，不同種類的藥物，我們可以嘗試延長射精時間，托里。

Um latency time, You can't get pregnant right after stopping birth control.

嗯，潛伏期，你不能在停止避孕後立即懷孕。

That is a yes and no.

這是一個肯定和否定的說法。

It depends on the type of birth control.

這取決於生育控制的類型。

So when we use the term birth control were referring to tablets were referring to injections were referring to I.

是以，當我們使用節育一詞時，我們指的是藥片，是指注射，是指I。

U.

U.

D.

D.

S.

S.

Once we remove the I.

一旦我們刪除了I.

D.

D.

You can start working on getting pregnant the following month.

你可以在下個月開始為懷孕而努力。

If you're someone who was doing the shot, like the depo Provera shot, it can take up to a year for your ovaries to wake up and start ovulating.

如果你是一個正在打針的人，如depo Provera針，你的卵巢可能需要長達一年的時間來喚醒並開始排卵。

Again, if you're someone who was on a progesterone only pill, you're usually able to coagulate again within a month to two months of discontinuing.

同樣，如果你是一個只服用黃體酮藥片的人，你通常能夠在停藥後一個月到兩個月內再次凝結。

If you were on birth control for an extended period of time or what we call the combined oral contraceptive pills.

如果你長期服用避孕藥或我們所說的聯合口服避孕藥。

It could take up to a year myths.

這可能需要長達一年的神話。

Parents used globally.

父母在全球範圍內使用。

If you've already had Children, then you'll always be fertile.

如果你已經有了孩子，那麼你就會一直有生育能力。

That is a myth.

那是一個神話。

And in fact there's something called secondary infertility.

而事實上，有一種東西叫做繼發性不孕。

Secondary infertility refers specifically to people who already were able to have a child without any difficulty and then later on go on to develop issues.

繼發性不孕特別是指那些已經能夠毫無困難地生下孩子的人，後來又出現了問題。

So we've talked about age related changes with sperm.

所以我們已經談到了與年齡有關的精子變化。

So just because someone with sperm has caused pregnancy before, it does not mean that they cannot now have issues with their sperm.

是以，僅僅因為有精子的人以前造成過懷孕，並不意味著他們現在的精子不能有問題。

In fact, 50% of the time when we're seeing infertility, it involves not just something with the person who makes eggs, but something going on with the person who's making this irregular periods, cycles are a sign of infertility.