I'm a reproductive endocrinologist and fertility specialist and I'm here to answer your questions on twitter.

我是一名生殖內分泌專家和生育專家，我在微博上回答你的問題。

This is fertility support at fertility unit asks do you know how often you should have sex If you're trying to conceive hashtag fertility, you don't have to have sex that much actually twice a week.

這是生育支持在生育組織、部門問你知道你應該多長時間有性生活嗎如果你想懷孕hashtag生育，你不必有性生活那麼多實際上每週兩次。

So have two dates a week because the good sperm will stick around in the fallopian tubes for a few days.

所以每週有兩次約會，因為好的精子會在輸卵管中停留幾天。

So if you have sex twice a week, Then you always have some sperm in the tubes waiting for the eggs.

是以，如果你每週有兩次性生活，那麼你總是有一些精子在輸卵管中等待卵子的到來。

So it's a myth that you have to precisely time intercourse with the release of the egg or that you have to have sex 10 times a day and that makes your fertility higher.

所以說，你必須準確地將性交時間與卵子的釋放時間結合起來，或者說你必須每天進行10次性交，這樣就能提高你的生育能力，這是一個神話。

It actually doesn't.

實際上並沒有。

I think you just get a little tired at wonder tramp asks, does anyone know if hashtag Covid 19 affects hashtag fertility.

我想你只是在奇蹟中有點累了，流浪漢問道，有人知道標籤Covid 19是否影響標籤的生育能力嗎？

Asking for a friend.

求助於朋友。

Everybody wants to know the answer to this question.

每個人都想知道這個問題的答案。

And the truth is Covid 19 does impact fertility.

而事實是Covid 19確實影響了生育能力。

The vaccine does not which is why we really want you to get vaccinated.

疫苗不會，這就是為什麼我們真的希望你去接種疫苗。

We are asking all our patients trying to conceive and pregnant to get fully vaccinated because we know that the vaccine Has been found safe and people trying to conceive both men and women and safe in pregnancy.

我們要求所有試圖受孕和懷孕的病人全面接種疫苗，因為我們知道這種疫苗已經被發現對試圖受孕的男女都是安全的，而且在懷孕期間也是安全的。

We know that COVID 19.

我們知道，COVID 19。

The disease actually does have a powerful negative impact upon your fertility.

這種疾病實際上確實對你的生育能力產生了強大的負面影響。

Especially if you get really ill if you're mildly ill, you will probably feel temporarily bad.

特別是如果你真的生病了，如果你是輕度生病，你可能會暫時感覺不好。

The sperm count might go down for a couple of months, just like any febrile viral illness.

精子數量可能會下降幾個月，就像任何發熱的病毒性疾病一樣。

But then you will recover.

但隨後你會恢復。

You might have irregular periods for a little bit.

你可能會有一點月經不調的情況。

But then again you might recover but severe disease can have a more severe impact upon your fertility.

但話說回來，你可能會恢復，但嚴重的疾病會對你的生育能力產生更嚴重的影響。

At Casey asks, okay guys, I've been watching noVA on PBS.

在凱西問道，好吧，夥計們，我一直在看PBS上的noVA。

A fertility scientists just said on average men today have about half the sperm count our grandfathers did causes environmental obesity, chemicals, etcetera.

一位不孕不育的科學家剛剛說，今天男人的精子數量平均只有我們祖先的一半，原因是環境肥胖、化學品等等。

This is a fascinating question.

這是一個迷人的問題。

People, sperm counts have been declining and I would say compared to like say that like the 1900s, the average sperm count is about half that of what it used to be.

人們，精子數量一直在下降，我想說的是，與20世紀的情況相比，平均精子數量大約是過去的一半。

We don't really know the reason why.

我們真的不知道原因是什麼。

But certainly things like toxins and the environment and our lifestyle probably have something to do with this.

但可以肯定的是，像毒素和環境以及我們的生活方式可能與此有一定關係。

Scientists are definitely working on this because we can't have sperm disappearing altogether.

科學家們肯定在努力研究這個問題，因為我們不能讓精子完全消失。

The good news is people are still making millions of sperm, I don't think we're gonna completely get down to zero for everybody that soon.

好消息是人們仍然在賺取數百萬的精子，我不認為我們會在那麼短的時間內完全降至零。

But I think this does emphasize that we should all try to lead a healthy lifestyle and avoid toxins.

但我認為這確實強調了我們都應該努力過一種健康的生活方式，避免毒素。

An egg freezing project asks, does freezing your eggs mean that you definitely want Children in the future Or is egg freezing more about having the option later on in life.

一個冷凍卵子的項目問道，冷凍卵子是否意味著你將來肯定想要孩子，或者說冷凍卵子更多的是為了在以後的生活中擁有選擇。

Let me know your thoughts.

讓我知道你的想法。

Mother nature kind of designed us to have 10 kids by the age of 25.

大自然為我們設計了一種在25歲之前生10個孩子的方式。

That's kind of how our our bodies are designed 10 kids by the age of 25 die of exhaustion by age 35 to 40.

我們的身體就是這樣設計的，25歲之前的10個孩子在35到40歲之前就會死於疲憊。

That's it.

就這樣了。

Obviously we don't do that anymore.

很明顯，我們不再那樣做了。

People are, you know, going to school, they're getting jobs, they're living life and having babies later.

人們，你知道，正在上學，他們正在找工作，他們正在過生活，以後會有孩子。

And that means you're having babies when your eggs are less fertile.

而這意味著在你的卵子生育能力較差的時候，你卻在生孩子。

People are really interested in freezing eggs to try to preserve their eggs at a younger age at fertility prego asks, how come men don't have a fertility clock?

人們對冷凍卵子以試圖在更年輕的時候保存卵子的做法真的很感興趣，在fertility prego問，為什麼男人沒有生育時鐘？

Ha ha emoji men definitely have a fertility clock.

哈哈，表情包男人絕對有一個生育時鐘。

You cannot delay childbearing forever.

你不能永遠延後生育。

Maybe you should think about freezing your sperm before you turn 40 because once you are 40 we do see some higher risks for older men having Children with schizophrenia and autism.

也許你應該考慮在40歲之前冷凍你的精子，因為一旦你到了40歲，我們確實看到一些年齡較大的男性生出患有精神分裂症和自閉症的孩子的風險更高。

So you do seem to have a fertility clock.

所以你似乎確實有一個生育時鐘。

The quality of sperm does seem to decline with time.

精子的品質似乎確實隨著時間而下降。

At jenny, Jayapal asks fun fertility question of the day.

在Jenny，Jayapal提出了今天有趣的生育問題。

What's the difference between artificial insemination and official insemination?

人工授精和官方授精之間有什麼區別？

Hashtag actual question.

Hashtag實際問題。

So official insemination doesn't actually exist.

所以官方的人工授精實際上並不存在。

Artificial insemination is the process of putting sperm into the female by any means other than sexual intercourse.

人工授精是通過性交以外的任何方式將精子放入女性體內的過程。

It's artificial.

它是人為的。

You're getting the sperm in an artificial way.

你是以人工方式獲得精子的。

Now there's a lot of ways to do artificial insemination.

現在有很多方法可以進行人工授精。

The way fertility specialists typically do artificial insemination.

生育專家通常做人工授精的方式。

We wash the sperm get rid of all the semen because the semen is the liquid.

我們清洗精子，擺脫所有精液，因為精液是液體。

It's like a tidal wave coming out of the penis.

這就像潮水一樣從陰莖中湧出。

It helps the sperm get out of the penis and into the body or into the specimen cup.

它有助於精子從陰莖中出來，進入身體或進入標本杯。

But that liquid we really don't need when you have sex.

但在你做愛時，我們真的不需要這種液體。

All those chemicals in the semen are filtered out by the cervix and they do not go into the fallopian tubes where fertilization takes place.

精液中的所有這些化學物質都被子宮頸過濾掉了，它們不會進入受精的輸卵管。

We get just the sperm in a tiny little droplets of fluid and we put it in a little syringe.

我們只得到精子的小液滴，然後把它放在一個小注射器中。

This is called an insemination catheter.

這被稱為授精導管。

This is a particular type of insemination called I Ui intra uterine insemination.

這是一種特殊的人工授精方式，稱為I Ui子宮內人工授精。

And we actually put a speculum in the vagina and then we see the cervix and this little tube goes right through the cervix.

我們實際上將窺陰器放入陰道，然後看到子宮頸，這個小管子直接穿過子宮頸。

The vagina into the cervix.

陰道進入子宮頸。

I don't know if this is actually open.

我不知道這是否真的開放。

No, this is not an actual working model into the uterus.

不，這不是一個進入子宮的實際工作模型。

And then we inject that little tiny bit of fluid in the Good sperm immediately are in the fallopian tubes hanging out waiting for the aec and you might have a little leaking.

然後我們把那一點點液體注入好精子立即在輸卵管裡掛著等待AEC，你可能會有一點滲漏。

You might have a little cramping.

你可能會有一點痙攣。

You might see a little spotting, but you can get right up and go, we don't believe in waiting.

你可能會看到一點斑點，但你可以馬上起來走，我們不相信等待。

That doesn't increase the pregnancy rate at susie savage E asks why does a single round of IVF cost $15,000 in the United States And only $2,000 in Turkey, 6000 in Spain, in India 31 50 in Russia, even 7800 in Mexico one day?

這並沒有提高懷孕率，Susie Savage E問道，為什麼在美國一輪試管嬰兒要花費15000美元，而在土耳其只需要2000美元，在西班牙6000美元，在印度3150美元，在俄羅斯甚至7800美元的墨西哥一天？

Big pharma will pay for their crimes.

大藥廠將為他們的罪行付出代價。

It is way too expensive in the United States.

它在美國太貴了。

Hopefully we can get better insurance coverage.

希望我們能得到更好的保險。

But right now it does tend to cost a lot of money.

但現在它確實傾向於花費很多錢。

The good news is that there are more and more states passing laws to mandate fertility coverage.

好消息是，有越來越多的州通過法律規定生育保險。

We are seeing more and more companies cover it because hey, reproduction and problems with reproduction should be covered.

我們看到越來越多的公司覆蓋它，因為嘿，生殖和生殖問題應該被覆蓋。

Right?

對嗎？

Why is it treated like it's like a nose job like elective plastic surgery these days, reproduction is in sexual for the continuation of the human race.

為什麼現在對待它就像對待隆鼻一樣，就像選擇性的整形手術一樣，生殖是為了人類的延續而在性。

So I'm with you.

所以我支持你。

It shouldn't be so expensive.

它不應該如此昂貴。

It should be covered at Davian Dove.

在戴維安-德芙應該是有的。

Ask so how does a pregnancy test work?

問那麼驗孕棒是如何工作的？

Well at avian dub, I happen to have one right here.

好吧，在Avian dub，我碰巧有一個就在這裡。

You can get them from the drug store or at your doctor's office and usually the urine pregnancy test works by you give a small sample of urine, you follow the directions, you dip this into the urine and then wait for it to turn either positive or negative.

你可以從藥店或你的醫生辦公室得到它們，通常尿液妊娠試驗的工作原理是你提供少量的尿液樣本，你按照訓示，將其浸入尿液，然後等待它變成陽性或陰性。

It's actually measuring something called HCG human chorionic gonadotropin.

它實際上是在測量一種叫做HCG的人類絨毛膜促性腺激素。

That's a hormone that's produced by the placenta.

這是一種由胎盤產生的荷爾蒙。

If that is in your urine, then it shows that you're pregnant.

如果你的尿液中含有這種物質，那麼就表明你已經懷孕了。

You can also get a blood test at the doctor's office.

你也可以在醫生的辦公室進行血液測試。

Once you, once this turns positive, we want you to call us right away at oh my my Fran Fran dear asks, how does someone sign up to donate their uterus to somebody.

一旦你，一旦這個結果變成積極的，我們希望你馬上給我們打電話，哦，我的弗蘭親愛的問，如何有人報名把他們的子宮捐給別人。

I don't want it, transplants are possible.

我不希望這樣，移植是可能的。

Send me the sign up sheet.

把報名表發給我。

You don't transplants.

你不做移植手術。

Is that really a thing?

這真的是一件事嗎？

Yes it is.

是的，它是。

It has been done in the United States.

這在美國已經做了。

It's been done in other parts of the globe.

在全球其他地方也有這樣的做法。

It's still kind of experimental.

這仍然是一種實驗性的。

So you have to go to a big fancy center University of pennsylvania Cleveland clinic where they are, have a big team to do this type of thing.

所以你必須去一個大的花哨的中心賓夕法尼亞大學克利夫蘭診所，他們有一個大的團隊來做這種事情。

So maybe this uterus needs to be transplanted.

是以，也許這個子宮需要被移植。

But yes, uterine transplants are possible.

但是，是的，子宮移植是可能的。

But most people that don't want their uterus just go see their doctor to discuss that at mira gagne's asks is there a law that puts a cap on the amount of embryos doctors are allowed to implant during IVF.

但大多數不想要子宮的人只是去找他們的醫生討論，在米拉-加涅的詢問下，是否有法律規定醫生在試管嬰兒期間允許植入的胚胎數量有上限。

This is surprisingly hard to google.

這個問題出乎意料地難於谷歌。

So a srm the american society for reproductive medicine recommends that we transfer only one embryo at a time because one baby at a time is the healthiest type of pregnancy, twins can be super cute.

是以，美國生殖醫學協會建議我們一次只移植一個胚胎，因為一次一個嬰兒是最健康的懷孕類型，雙胞胎可能是超級可愛的。

But a twin pregnancy is risky for both the mom and the baby.

但雙胞胎懷孕對媽媽和寶寶都有風險。

We are usually transferring just one embryo with IVF.

我們在做試管嬰兒時通常只移植一個胚胎。

IVF does have a higher identical twinning rate.

試管嬰兒確實有較高的同卵雙生率。

So that's probably one of the biggest risks of IVF you can put one embryo in and there's a 2% chance that you could get two babies out if you conceive on your own.

所以這可能是試管嬰兒最大的風險之一，你可以把一個胚胎放進去，如果你自己受孕，有2%的機會可以得到兩個嬰兒。

The chance that your embryo splits the chance that you have identical twins is only .5%.

你的胚胎分裂的機會，你有同卵雙胞胎的機會只有0.5%。

So we should just put one embryo in.

所以我們應該只放一個胚胎進去。

Those are the current guidelines but it's not actually regulated by law at Patrice E.

這些是目前的指導方針，但實際上在Patrice E.，它並沒有受到法律的監管。

5767 oh 99 asked what year was the first test tube baby born in America.

5767哦99問：美國第一個試管嬰兒是哪一年出生的。

That was december 28th 1981.

那是1981年12月28日。

So she is 40 years old.

所以她已經40歲了。

This december 2021.

今年2021年12月。

Her name is Elizabeth Kerr and she's a big fertility advocate and author test tube baby or I.

她的名字叫伊麗莎白-科爾，她是一個大的生育力倡導者和作者試管嬰兒或我。

V.

V.

F.

F.

Baby in vitro fertilization was a revolutionary treatment that has totally transformed our field a field where we really struggled to help people conceive and did not have very much success to a field where we can say if you can stay positive and healthy in mind and body and stick with the program, we can help almost anybody have a healthy baby at jet lag 91.

嬰兒體外受精是一種革命性的治療方法，它完全改變了我們的領域，一個我們真正努力幫助人們受孕並沒有取得很大成功的領域，我們可以說，如果你能保持積極和健康的身心並堅持執行該計劃，我們幾乎可以幫助任何人在時差91時有一個健康的寶寶。

A how much they pay for semen at the fertility place asking for a friend.

A他們在生育地問朋友的精液多少錢。

There's lots of great commercial sperm banks out there.

外面有很多很棒的商業精子庫。

They probably have different rates.

他們可能有不同的費率。

But um I do think you know they compensate you well for giving the sperm.

但是，嗯，我認為你知道他們對你給予精子的補償很好。

You do have to be prepared to give some blood work and sign forms so we can make sure you don't have HIV hepatitis.

你必須準備好做一些血液檢查並簽署表格，以便我們能夠確保你沒有感染艾滋病毒的肝炎。

Things like that.

類似這樣的事情。

We also want to make sure that your sperm is healthy and looks good and we have good sperm counts and and seems fertile and then I think you're paid a pretty good rate.

我們還想確保你的精子是健康的，看起來很好，我們有良好的精子計數，而且似乎可以生育，然後我認為你的報酬是相當不錯的。

A few $100 at mama K.

在K媽媽那裡有幾百美元。

M.

M.

W.

W.

99 asks how long does it take pregnancy symptoms to go away after a miscarriage.

99問：流產後懷孕症狀要多久才能消失？

It usually takes about 2 to 3 months.

通常需要大約2至3個月。

You still have the pregnancy hormones in your body and it takes about 2 to 3 months for those to clear out at H.

你的體內仍有妊娠激素，這些激素需要2到3個月的時間才能在H點清除。

R.

R.

C.

C.

Fertility asks what is a fertility doctor or fertility specialist?

不孕不育問：什麼是生育醫生或生育專家？

Well I'm a fertility specialist.

好吧，我是一名生育專家。

That means I am a board certified O.

這意味著我是一個經董事會認證的O。

B.

B.

G.

G.

Y.

Y.

N.

N.

Obstetrician gynecologist and subspecialty trained in reproductive endocrinology and infertility.

婦產科醫生，接受過生殖內分泌學和不孕不育方面的亞專業培訓。

I see people who want to have a baby but are struggling people who want to be proactive about conception or people who want to freeze their eggs.

我看到那些想生孩子但又在掙扎的人，他們想主動受孕，或者想冷凍卵子的人。

At ab mama nation asks considering reciprocal IVF for round two wife scared retrieval any tips retrieval?

在ab媽媽國問考慮互惠試管嬰兒的第二輪妻子害怕檢索任何提示檢索？

That means egg retrieval what is reciprocal.

這意味著取卵什麼是對等的。

IVF IVF is in vitro fertilization.

試管嬰兒 IVF就是體外受精。

Reciprocal IVF is a way for two women to conceive where one gives the egg and the other carries the embryo there being reciprocal.

互惠試管嬰兒是兩個婦女受孕的一種方式，其中一個人提供卵子，另一個人攜帶胚胎，這是互惠的。

Normally IVF is done in one person you take the eggs out and then you put the embryos in.

通常試管嬰兒是在一個人身上完成的，你把卵子取出來，然後把胚胎放進去。

But this way you have two people involved ones giving the eggs and the other one is carrying the embryo.

但這樣一來，你有兩個人参與其中，一個人提供卵子，另一個人攜帶胚胎。

This is a great option for lesbian couples who want to both be biological moms at tapia.

對於想在tapia都成為親生母親的女同性戀夫婦來說，這是個不錯的選擇。

Izzi asks egg freezing, Anyone here gone through the process.

Izzi問：卵子冷凍，這裡有誰經歷了這個過程？

I haven't actually frozen my eggs but I've been on the other side of it for a lot of people.

我實際上沒有冷凍過我的卵子，但我已經站在了很多人的另一邊。

And egg freezing is becoming more and more common.

而冷凍卵子正變得越來越普遍。

And that's because first of all, egg freezing is much better than it used to be.

這是因為，首先，卵子冷凍比過去要好得多。

We are really really good at freezing eggs.

我們真的非常善於冷凍雞蛋。

Now there's a new technique or a new technology called vitrification with a V.

現在有一種新的技術或新的技術，叫做帶V的玻璃化技術。

That's literally like plunging these eggs down to super freezing cold temperatures negative 195 C at that temperature.

這簡直就像把這些雞蛋下放到超級冰冷的溫度下，在這個溫度下是負195℃。

The molecules are literally stopped in their tracks.

分子簡直是停在了他們的軌道上。

And now the eggs yield pregnancy rates that are basically the same as using fresh X.

而現在雞蛋的懷孕率與使用新鮮X的懷孕率基本相同。

Because we have figured out how to press the pause button.

因為我們已經想出瞭如何按下暫停鍵。

Some insurance companies cover it most of the time.

一些保險公司在大多數時候都會支付。

Not it can cost thousands of dollars.

不是它可以花費數千美元。

So that's something to think about.

是以，這是一個值得思考的問題。

You give yourself injections with tiny needles for about 6 to 10 days.

你用小針頭給自己注射，大約6到10天。

You go to an IVF center, You get an I.

你去一個試管嬰兒中心，你得到一個I。

V.

V.

in your vein.

在你的靜脈中。

They give you a little anesthesia.

他們給你一點麻醉劑。

You go to sleep for about 10 minutes.

你睡了大約10分鐘。

We put a very small needle into through the vaginal wall one on the right side, one on the left side.

我們將一個非常小的針頭穿過陰道壁，一個在右邊，一個在左邊。

Then we pull the eggs out five minutes for the right over five minutes for the left ovary.

然後我們把卵子拉出來，右側卵巢五分鐘，左側卵巢五分鐘。

All the eggs are out, we put them in the freezer.

所有的雞蛋都出來了，我們把它們放在冰箱裡。

You wake up, you feel a little cramp e you eat a little bit, you walk around, go to the bathroom and then you go home and your eggs are frozen.

你醒來的時候，你覺得有點抽筋，你吃了一點，你走來走去，去了洗手間，然後你回家，你的卵子被冷凍了。

I do think all women who are concerned about fertility, concerned about getting older and not ready to have a baby, but think they might want to in the future to think about egg freezing as an option for preserving their fertility.

我確實認為所有擔心生育能力的婦女，擔心年紀大了還沒有準備好生孩子，但認為她們將來可能會想生孩子，可以考慮把冷凍卵子作為保護她們生育能力的一種選擇。

It may give you more options because your eggs are their most fertile when you're under 30.

它可能會給你更多的選擇，因為當你在30歲以下時，你的卵子是它們最肥沃的。

And we think the ideal time to freeze eggs is somewhere between your late twenties and early thirties at anthropologie asks, can we stop calling pregnancy over 35 geriatric?

而我們認為冷凍卵子的理想時間是在你二十多歲和三十出頭之間的某個地方，在anthropologie問，我們能不能不要把35歲以上的懷孕稱為老年病？

Absolute.

絕對的。

Why do people call pregnancy over 35 geriatric?

為什麼人們把超過35歲的懷孕稱為老年病？

You are still young as you get older.

隨著年齡的增長，你仍然是年輕的。

We do start thinking about more risks.

我們確實開始考慮更多的風險。

So age of the pregnant woman is associated with certain risks.

所以孕婦的年齡與某些風險有關。

And doctors like to know That they have to do different things to lower those risks when they are treating somebody over 35.