事件记录
Dr. 琼斯: 所以你已经做了一切你能做的准备去组建一个家庭，但现在它并没有发生. 你应该什么时候寻求大发娱乐?
你是一个38岁的女人，你一直在努力怀孕. You stopped your birth control, and it didn't just happen. 你应该什么时候寻求大发娱乐? 这要看情况. 当然, 这取决于, 这取决于很多因素——你的健康和病史，以及男性怀孕的情况. 但大发娱乐通常从年龄开始.
And we're doing this in three parts. So if this isn't your age or the age of the person you're worried about, 看看大发娱乐的其他播客.
Here in 范围 virtual studio with us is Dr. 艾丽卡约翰斯通. 她是生殖内分泌学和不孕症方面的专家，也是犹他大学的副教授.
Age Considerations in Fertility: Guidance for Women Between 35 and 40
So let's say you're between 35 and 40, 也许你38岁了, 这几个月来你一直想怀孕你有点担心. You've been reading ladies' journals and you know the clock's been ticking. 你应该什么时候寻求大发娱乐? And does the age or health of your partner make any difference?
When to Seek Professional Help
Dr. 约翰斯通: 绝对. So for sort of the typical woman between the ages of 35 and 40, we usually recommend trying for about 六个月 before you seek help. 现在，谁是典型的女性? 这是一个健康的女性，通常每25到35天有规律的月经, and a woman who doesn't have serious underlying health conditions.
如果有严重的潜在健康问题，大发娱乐会考虑尽早寻求大发娱乐, 月经不调, 或者是曾经接受过化疗或放疗的女性.
Then when we think about the partner. Some of it, we think about some of the same key things. 一般, 六个月, 但如果他已经接受过癌症化疗，那么他应该尽早寻求大发娱乐, 或辐射, if he's had testicular cancer even that was treated surgically, if he has other serious health problems, 特别是如果他有其他严重的健康问题，可能会影响他的勃起或射精功能. 再一次。, these would all be reasons to seek help so一个r than 六个月.
Choosing Between OB-GYN and Reproductive Endocrinologist
Dr. 琼斯: Who should you see to get help and what will they do?
Dr. 约翰斯通: 在这个年龄段, 一些女性可能会选择从普通妇产科医生那里进行评估, but many women will choose to start with a reproductive endocrinologist. And 一个 of the main reasons for this is that . . . 重要的是要知道，大多数35到40岁的女性都能成功怀孕, but time is more of the essence for women between 35 and 40.
It could hurt to lose time if you spend several months with your OB-GYN, then get a referral to a reproductive endocrinologist, and potentially it takes another couple of months to be seen. 所以，这个年龄段的许多女性会从生殖内分泌学家开始.
评估和测试
Those early visits will involve a very thorough evaluation. 这个评估的关键部分会问你很多关于你月经史的问题. 如果你有月经日志，那么在你来访的时候能拿出来就太好了. A very detailed look at your 病史, 你正在服用的药物, 你做过的手术, 生活习惯, 比如酒精, 烟草的使用, 锻炼, 等.
对于男性伴侣来说, we would look at the same things, 病史, 手术史, 主要生活方式因素, and factors affecting sexual function. Then as we go into evaluation, we would start with the male partner, 通常, with a semen analysis where we would ask him to give a sperm sample. Then we would look at the number of sperm, how many of those sperm are swimming forward, and how many of those sperm have normal head shapes.
Managing Stress in the Journey to Conception
Dr. 琼斯: So reproductive endocrinologists aren't completely common. 可能有很多人正在听大发娱乐的播客，他们住在不是大城市的城镇.
所以 sometimes a reproductive endocrinologist is a long way away, 有时候，人们很难收拾行李，开三四个小时的车去见一个人. 这可能会带来压力.
So does stress increase difficulties in getting pregnant? 我只是想把这个放进去因为大发娱乐有些人压力太大了.
Dr. 约翰斯通: 绝对. 有很多关于这个问题的研究，他们的发现是混合的. So I wish I could say stress has no effect at all. 我不能这么说，但我可以肯定地说，压力并不是怀孕的完全障碍.
所以我建议任何想要怀孕的人寻找方法来减少和管理他们的压力. 但这样做的首要原因是怀孕需要时间，大发娱乐永远不知道要花多长时间.
所以, for your overall health and for the health of a relationship, it makes sense to try to find ways to manage and reduce that stress. But know that it's okay that there's stress. And the fact that you're worried about this, 很难怀孕的事实并不意味着你不会怀孕.
Dr. 琼斯: 我记得几年前的一项研究，我刚预约了一位生殖内分泌学家, to a referral fertility center, increased the chances of getting pregnant in the next 六个月. 这只是那些预约的人，和那些自己尝试的人相比需要四到五个月的时间.
So sometimes doing things that will help alleviate your stress, even though you might have to travel for it, getting an appointment means that you've taken a step to move forward, and sometimes that itself makes you feel a little bit better.
Dr. 约翰斯通: 绝对. And I should mention we currently are doing a lot of telehealth visits, 这意味着当你舒适地坐在家里时，你可能有机会获得很多信息，得到很多问题的答案, even if that's several hours away.
我认为，COVID大流行带来的少数亮点之一是，远程医疗的可用性提高了. 再一次。, 我认为这对夫妻们来说是很有大发娱乐的，可以让他们更好地接触，也可以让你们有机会在舒适的家里谈论这些事情，而不是在医生的办公室里.
Age-related Concerns: Late 30s and Pregnancy
Dr. 琼斯: 大发娱乐也知道女性在快40岁的时候更有可能, 不幸的是, to miscarry if they do get pregnant. 大发娱乐知道，有时候当你在这个星球上生活了足够长的时间, you've accumulated some illnesses, 糖尿病, 高血压, and other conditions that might make pregnancy riskier.
当然，超过35岁，有些人认为你怀孕的风险更大. But if you have any kind of medical conditions that you take medicines for, 重要的是要考虑如何让自己处于最佳状态，成为你想成为的怀孕的人，为了这个你想要长大的孩子.
Dr. 约翰斯通: 绝对. I think 一个 thing I would add to that . . . So, 一个, 如果你有健康问题, 和你的医生确认一下, 但大发娱乐也可能会建议你去看母胎医学专家，为解决这些健康问题做准备. How will your pregnancy affect your 糖尿病 and your high blood pressure? How will your high blood pressure or 糖尿病 affect your pregnancy?
另一件需要考虑的事情是，一些夫妇在多年没有接受任何医疗护理的情况下开始了他们的生育之旅. 所以, 如果你开始尝试怀孕，但你已经好几年没有去看医生了，那么你可能患有未确诊的高血压或前驱糖尿病, 最好在怀孕前的某一年做一次全面的检查，这样大发娱乐就能发现这些问题，而不是等到你怀孕了才发现. 如果大发娱乐先了解他们，大发娱乐就能更好地治疗他们，让你为怀孕做好准备.
Dr. 琼斯: 完全. So we aren't so fertile as a species to start with on a month-by-month basis, and we aren't so fertile as we get older. Peak human fertility starts to decline in the late 20s. So if you're in your late 30s, 如果你没有马上怀孕，不要等太久才寻求大发娱乐，因为大发娱乐可以大发娱乐你.
感谢博士. Johnst一个 and thank you for listening on 范围.
更新日期：2023年12月14日
originally published: October 7, 2021