不孕不育

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Family Portrait
::家庭轮廓

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This family portrait shows an Alaskan Inuit family in 1929. The picture was taken by a famous photographer named Edward S. Curtis. With his photographs, Curtis provided a visual record of the lives of Native American people (including the Inuit) during the late 19 ^th and early 20 ^th centuries. As you might infer from the photo, the Inuit — like people in virtually all human societies past and present — value having children. Indeed, for most people, parenthood is an important life goal. Unfortunately, some people are unable to achieve that goal because of infertility.
::这幅家庭肖像展示了1929年阿拉斯加因努伊特的一个家庭。照片是由一位著名的摄影师爱德华·柯蒂斯拍摄的。用他的照片,柯蒂斯提供了19世纪末和20世纪初美洲原住民(包括因努伊特人)生活的视觉记录。正如你从照片中可以推断的那样,因努伊特人与几乎所有人类社会过去和现在的人一样,对有孩子的价值具有价值。事实上,对大多数人来说,为人父母是一个重要的生活目标。不幸的是,有些人由于不育而无法实现这一目标。

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What Is Infertility?
::什么是不孕症?

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Infertility is the inability of a sexually mature adult to reproduce by natural means. For scientific and medical purposes, infertility is generally defined as the failure to achieve a successful after at least one year of regular, unprotected sexual intercourse. Infertility may be primary or secondary. Primary infertility applies to cases in which an individual has never achieved a successful pregnancy. Secondary infertility applies to cases in which an individual has had at least one successful pregnancy, but fails to achieve another after trying for at least a year. Infertility is a common problem. About ten percent (6.1 million) of U.S. women aged 15 to 44 have difficulty getting or staying pregnant.
::不孕症是指成年性成年人无法以自然方式生育。为科学和医学目的,不孕症一般被定义为在正常、无保护的性交至少一年后未能取得成功。不孕症可以是初级或二级的。初级不孕症适用于个人从未成功怀孕的情况。二级不孕症适用于个人至少成功怀孕一次、但至少尝试过一年后又未能实现另一个怀孕的情况。不孕症是一个常见问题。大约10%(610万)的15至44岁女性难以怀孕或继续怀孕。

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Causes of Infertility
::造成不育症的原因

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Pregnancy is the result of a multi-step process. In order for a normal pregnancy to occur, a woman must release an egg from one of her ovaries , the egg must go through a Fallopian tube , a man’s must fertilize the egg as it passes through the Fallopian tube, and then the fertilized egg must implant in the uterus . If there is a problem with any of these steps, infertility can result.
::怀孕是多步骤过程的结果。 为了正常怀孕,妇女必须释放卵子,卵子必须穿过输卵管,男人必须给通过输卵管的卵施肥,然后将受精卵植入子宫。 如果这些步骤有任何问题,不孕症就会导致不孕。

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A couple’s infertility may be due to a problem with either the male or the female partner. As shown in the circle graph , about 30 percent of infertility cases are due to female infertility, and about 30 percent are due to male infertility. Most of the remaining 40 percent of cases are due to a combination of male and female problems or unknown causes.
::一对夫妇的不孕症可能与男性或女性伴侣的问题有关。 如圆形图所示,约30%的不孕症是由于女性不孕症,约30%是由于男性不孕症。 其余40%的不孕症大部分是由于男女问题或未知原因的结合。

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Causes of Male Infertility
::男性不育的原因

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Male infertility occurs when there are no or too few sperm, or when the sperm are not healthy and motile and  cannot travel through the female reproductive tract to fertilize an egg. A common cause of inadequate numbers or motility of sperm is varicocele, which is enlargement of in the scrotum . This may raise the temperature of the testes and adversely affect sperm production. In other cases, there is no problem with the sperm, but there is a blockage in the male reproductive tract that prevents the sperm from being ejaculated.
::没有精子或精子太少时,或者精子不健康、不动、不能通过雌性生殖道施肥卵时,就会出现男性不孕症,精子数量不足或机能不足的一个常见原因是贪腐性,这就是阴囊的膨胀,这可能提高睾丸的温度,对精子的生产产生不利影响。 在其他情况下,精子没有问题,但男性生殖道存在阻塞,阻止精子射出。

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Factors that increase a man’s risk of infertility include heavy alcohol use, drug abuse , cigarette smoking, exposure to environmental toxins (such as pesticides or lead), certain medications, serious diseases (such as disease), and radiation or chemotherapy for . Another risk factor is advancing age. Male fertility normally peaks in the mid-twenties and gradually declines after about age 40, although it may never actually drop to zero.
::增加男性不育风险的因素包括酗酒、吸毒、吸烟、接触环境毒素(如杀虫剂或铅)、某些药物、严重疾病(如疾病)和放射或化疗。 另一个风险因素是年龄的增长。 男性生育率通常在20年代中期达到峰值,在40岁以后逐渐下降,尽管实际上可能永远不会下降到零。

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Causes of Female Infertility
::女性不育的原因

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Female infertility generally occurs due to one of two problems: failure to produce viable eggs by the ovaries, or structural problems in the Fallopian tubes or uterus. The most common cause of female infertility is a problem with ovulation . Without ovulation, there are no eggs to be fertilized. Anovulatory cycles (menstrual cycles in which ovulation does not occur) may be associated with no or irregular menstrual periods, but even regular menstrual periods may be anovulatory for a variety of reasons. The most common cause of anovulatory cycles is polycystic ovary syndrome (PCOS), which causes imbalances that can interfere with normal ovulation. Another relatively common cause of anovulation is primary ovarian insufficiency. In this condition, the ovaries stop working normally and producing viable eggs at a relatively early age, generally before the age of 40.
::女性不育一般是由于两个问题中的一个原因造成的:卵巢不能生产可行的卵,或者胎儿管或子宫的结构问题;女性不育的最常见原因是排卵问题;没有排卵,就无卵可施肥;革新周期(不进行排卵的月经周期)可能与没有或不正常的月经期有关,但由于多种原因,即使是正常的月经期也可能是动脉,循环的最常见原因是多细胞卵巢综合症(PCOS),它造成不平衡,可能干扰正常排卵;另一个相对常见的排卵原因是主要卵巢不健全;在这种情况下,卵巢一般在40岁之前,较早时停止正常工作并生产可行的卵蛋。

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Structural problems with the Fallopian tubes or uterus are less common causes of female infertility. The Fallopian tubes may be blocked as a result  of endometriosis. Another possible cause is pelvic inflammatory disease , which occurs when sexually transmitted infections spread to the Fallopian tubes or other female reproductive organs (see figure ). The infection may lead to scarring and blockage of the Fallopian tubes. If an egg is produced and the Fallopian tubes are functioning — and  a woman has a condition such as uterine fibroids —   implantation in the uterus may not be possible. Uterine fibroids  are non-cancerous clumps of tissue and muscle that form on the walls of the uterus.
::输卵管或子宫的结构问题不是女性不孕症的常见原因,输卵管可能由于内分泌硬化而被堵塞,另一个可能的原因是骨盆炎,这种疾病在性传染病传播到输卵管或其他女性生殖器官时发生(见图),感染可能导致输卵管的疤痕和堵塞,如果产卵和输卵管正常运转,而妇女患有子宫纤维机等疾病——在子宫内植入可能是不可能的。

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Factors that increase a woman’s risk of infertility include tobacco smoking, excessive use of alcohol, stress, poor diet, strenuous athletic training, and being overweight or underweight. Advanced age is even more problematic for females than males. Female fertility normally peaks in the mid-twenties, and continuously declines after age 30 and until menopause around the age of 52, after which the ovary no longer releases  eggs. About one-third of couples in which the woman is over age 35 have fertility problems. In older women, more cycles are likely to be anovulatory, and  the eggs may not be as healthy.
::增加妇女不育风险的因素包括吸烟、过度使用酒精、压力、饮食差、艰苦的体育训练以及超重或体重不足。女性的老年问题比男性更严重。女性的生育率通常在20年代中期达到高峰,30岁以后持续下降,直到52岁更年期开始,此后卵子不再释放卵。35岁以上女性的夫妇中约有三分之一有生育问题。在老年妇女中,更严重的周期可能是排卵性,卵子可能不健康。

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Diagnosing Causes of Infertility
::诊断不孕症的原因

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Diagnosing the cause(s) of a couple’s infertility often requires testing both the man and the woman for potential problems. In men, the semen is likely to be examined for the number, shape, and motility of sperm. If problems are found with sperm, further studies are likely to be done, such as medical imaging to look for structural problems with the testes or ducts.
::诊断一对夫妇不孕症的原因往往需要测试男女的潜在问题。 在男性中,精子的数量、形状和运动能力可能由精子来检查。 如果发现精子有问题,则有可能进行进一步的研究,比如通过医学成像来寻找睾丸或管子的结构问题。

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In women, the first step is most often determining whether ovulation is occurring. This can be done at home by carefully monitoring body temperature (it rises slightly around the time of ovulation) or using a home ovulation test kit, which is available over the counter at most drugstores. Whether or not ovulation is occurring can also be detected with tests or ultrasound imaging of the ovaries. If ovulation is occurring normally, then the next step may be an X-ray of the Fallopian tubes and uterus to see if there are any blockages or other structural problems. Another approach to examining the female reproductive tract for potential problems is laparoscopy. In this surgical procedure, a tiny camera is inserted into the woman’s abdomen through a small incision. This allows the doctor to directly inspect the reproductive organs.
::在妇女中,第一步通常是确定排卵是否正在发生。这可以通过仔细监测体温(排卵时间前后稍有上升)或者使用家庭排卵测试包(在大多数药店的柜台上都有这种工具 ) , 排卵是否正在发生也可以通过卵巢的测试或超声波成像来检测。 如果排卵正常,那么下一步可能是对Fallopian管和子宫进行X光检查,看看是否有阻塞或其他结构性问题。检查女性生殖道潜在问题的另一个方法是腹腔镜检查。在这个手术过程中,通过小切口将一台小相机插入女性腹部。这样医生就可以直接检查生殖器官。

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Treating Infertility
::治疗不育症

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Infertility often can be treated successfully. The type of treatment depends on the cause of infertility.
::不孕症往往可以成功治疗,治疗的类型取决于不孕症的原因。

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Treating Male Infertility
::治疗男性不育症

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Medical problems that interfere with sperm production may be treated with medications or other interventions that may lead to the resumption of normal sperm production. If, for example,  an infection is interfering with sperm production, then antibiotics that clear up the infection may resolve the problem. If there is a blockage in the male reproductive tract that prevents the ejaculation of sperm, surgery may be able to remove the blockage. Alternatively, the man’s sperm may be removed from his body and then used for artificial insemination of his partner. In this procedure, the sperm are injected into the woman’s reproductive tract.
::妨碍精子生产的医疗问题可以通过药物或其他干预措施进行治疗,从而恢复正常的精子生产。例如,如果感染会干扰精子生产,那么清除感染的抗生素可以解决问题。如果男性生殖器官中存在阻碍精子射精的阻塞,手术可以消除阻塞。或者,男子的精子可以从身体中取出,然后用于对其伴侣进行人工授精。在这个过程中,精子被注入女性生殖器官。

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Treating Female Infertility
::治疗女性不育症

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In females, it may be possible to correct blocked Fallopian tubes or uterine fibroids with surgery. Ovulation problems, on the other hand, are usually treated with hormones that act either on the pituitary gland or on the ovaries. Hormonal treatments that stimulate ovulation often result in more than one egg being ovulated at a time, thus increasing the chances of a woman having twins, triplets, or even higher multiple births. Multiple fetuses are at greater risk of being born too early or having health and developmental problems. The mother is also at greater risk of complications arising during pregnancy. Therefore, the possibility of multiple fetuses should be weighed in making a decision about this type of infertility treatment.
::在女性中,有可能通过手术来纠正被阻塞的Fallopian管管管或子宫纤维化器;另一方面,排卵问题通常使用在垂体腺或卵巢上作用的荷尔蒙治疗;刺激排卵的激素治疗往往导致一次排卵不止一个卵,从而增加妇女双胞胎、三胞胎或多胞胎多胞胎的可能性;多种胎儿早产或有健康和发育问题的风险更大;母亲在怀孕期间也更容易出现并发症;因此,在就这种不孕治疗作出决定时,应该权衡多种胎儿的可能性。

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Assisted Reproductive Technology
::辅助生殖技术

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Some cases of infertility are treated with assisted reproductive technology (ART) . This is a collection of medical procedures in which eggs are removed from the woman’s body and sperm are taken from the man’s body to be manipulated in ways that increase the chances of occurring. The eggs and sperm may be injected into one of the woman’s Fallopian tubes for fertilization to take place in vivo (in the body). More commonly, however, the eggs and sperm are mixed together outside the body so fertilization takes place in vitro (in a test tube or dish in a lab). The latter approach is illustrated in the figure . With in vitro fertilization, the fertilized eggs may be allowed to develop into embryos before being placed in the woman’s uterus.
::一些不孕症由辅助生殖技术治疗(ART),这是一系列医疗程序,从妇女的身体中取出卵子,从男子的身体中取出精子,以增加发生机会的方式加以操纵。卵子和精子可能会被注入该妇女的Fallopian管中,以便在体内(体内)施肥。 然而,更常见的是,卵子和精子混合在身体外,因此在体外施肥(在试验管或实验室的盘子中),因此在体外施肥(在试验管或试验盘中),后一种方法在图中说明。在体外施肥后,受精卵可以进入胚胎,然后放入妇女子宫。

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ART has about a 40 percent chance of leading to a live birth in women under the age of 35, but only about a 20 percent chance of success in women over the age of 35. Some studies have found a higher-than-average risk of birth defects in children produced by ART procedures, but this may be due to the generally higher ages of the parent — not the technologies  used.
::抗逆转录病毒疗法有大约40%的机会导致35岁以下妇女的活产,但35岁以上妇女只有大约20%的成功机会。 有些研究发现,抗逆转录病毒疗法程序造成的儿童出生缺陷的风险高于平均水平,但这可能是因为父母年龄普遍较高,而不是因为使用的技术。

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Other Approaches
::其他方法

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Other approaches for certain causes of infertility include the use of a surrogate mother, a gestational carrier, or sperm donation.
::某些不育原因的其他办法包括使用代孕母亲、妊娠载体或捐精。

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• A surrogate mother is a woman who agrees to become pregnant using the man’s sperm and her own egg. The child, who will be the biological offspring of the surrogate and the male partner, is given up at birth for adoption by the couple. Surrogacy might be selected by women with no eggs or unhealthy eggs. A  woman who carries a mutant gene for a serious might choose this option to ensure that the defective gene is not passed on to the offspring.
  ::代孕母亲是同意使用男性精子和自己的卵子怀孕的妇女。 孩子是代孕人和男性伴侣的生子,在出生时被双方放弃收养。 代孕可由没有蛋或不健康蛋的妇女选择。 携带变种基因严重性的妇女可以选择这一选择,以确保有缺陷的基因不会传给后代。
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• A gestational carrier is a woman who agrees to receive a transplanted embryo from a couple and carry it to term. The child, who will be the biological offspring of the couple, is given to the parents at birth. A gestational carrier might be used by women who have normal ovulation but no uterus, or who cannot safely carry a fetus to term because of a serious health problem (such as kidney disease or cancer).
  ::妊娠载体是指同意接受一对夫妇的移植胚胎并一直将胚胎移植到世的妇女,孩子是夫妇的生子,孩子在出生时就交给父母,怀孕载体可能由有正常排卵但没有子宫的妇女使用,或者由于严重的健康问题(如肾病或癌症)而不能安全生育胎儿的妇女使用。
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• Sperm donation is the use of sperm from a fertile man (generally through artificial insemination) for cases in which the male partner in a couple is infertile, or in which a woman seeks to become pregnant without a male partner. A  lesbian couple may use donated sperm to enable one of them to become pregnant and have a child.  Sperm can be obtained from a sperm bank, which buys and stores sperm for artificial insemination, or a male friend or other individual may donate sperm to a specific woman.
  ::Sperm捐赠是指将育种男子的精子(一般通过人工授精)用于夫妇中的男性伴侣不育或妇女试图在没有男性伴侣的情况下怀孕的情况,女同性恋夫妇可以使用捐赠的精子使其中一人怀孕并生育子女,可以从精子库获取精子,购买和储存精子用于人工授精,或者男性朋友或其他个人可以向特定妇女捐赠精子。

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Social and Ethical Issues Relating to Infertility
::与不孕症有关的社会和伦理问题

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For people who have a strong desire for children of their own, infertility may lead to deep disappointment and depression. Individuals who are infertile may even feel biologically inadequate. Partners in infertile couples may argue and feel resentment toward each other, and married couples may get divorced because of infertility. Infertility treatments — especially ART procedures — are generally time-consuming and expensive. The high cost of the treatments can put them out of financial reach of many couples.
::对于那些对自己的子女有强烈愿望的人来说,不孕症可能会导致深深的失望和抑郁;不育的人甚至可能感到生理上的不足;不育夫妇中的伙伴可能会相互争吵和感到怨恨,而已婚夫妇可能会因为不孕症而离婚;不孕症治疗,特别是抗逆转录病毒疗法,通常耗时昂贵,治疗费用高昂,许多夫妇无法负担费用。

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Ethical Concerns
::道德关注问题

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Some people question whether the allocation of medical resources to infertility treatments is justified, and whether the resources could be better used in other ways. The status of embryos that are created in vitro and then not used for a pregnancy is another source of debate. Some people oppose their destruction on religious grounds, and couples may sometimes argue about what should be done with their extra embryos. Ethical issues are also raised by procedures that increase the chances of multiple births, because of the medical and developmental risks associated with multiple births.
::一些人质疑为不孕症治疗分配医疗资源是否合理,以及资源是否可以以其他方式得到更好的利用。 胚胎在体外生成,然后不用于妊娠,这是另一个争论的源头。 有些人反对以宗教为由摧毁胚胎,夫妇有时会争论应如何处置其额外胚胎。 增加多胎生育机会的程序也提出了道德问题,因为多胎生育有医疗风险和发展风险。

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Infertility in Developing Countries
::发展中国家不育不孕不孕症

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Infertility is an under-appreciated problem in the poorer nations of the world, because of assumptions about overpopulation problems and high birth rates in developing countries. In fact, infertility is at least as great a problem in developing as in developed countries. High rates of health problems and inadequate health care in the poorer nations increase the risk of infertility. At the same time, infertility treatments are usually not available — or are far too expensive — for the vast majority of people who may need them. In addition, in many developing countries, the production of children is highly valued. Children may be needed for family income generation and economic security of the elderly. It is not uncommon for infertility to lead to social stigmatization, psychological problems, and abandonment by spouses.
::由于对人口过多问题和发展中国家出生率高的假设,不孕症在世界较贫穷国家是一个认识不足的问题,事实上,不孕症在发展中国家至少与在发达国家一样严重,较贫穷国家高的健康问题和保健不足增加了不孕症的风险,与此同时,不孕症治疗通常得不到,或者对可能需要治疗的绝大多数人来说过于昂贵,此外,在许多发展中国家,生产儿童的价值很高,为了家庭创收和老年人的经济安全,可能需要儿童,不孕症通常会导致社会耻辱、心理问题和配偶遗弃。

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Feature: Human Biology in the News
::特著:《新闻》中的人类生物学

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More than 14 million women in the United States have polycystic ovary syndrome (PCOS), an endocrine disorder with a genetic basis that is the most common cause of female infertility. Most women with PCOS grow many small cysts on their ovaries. The cysts are not usually harmful, but they lead to hormone imbalances, such as higher-than-normal levels of male sex hormones in affected women. The hormonal imbalances are the primary cause of infertility associated with PCOS. The disorder also increases the risk of a whole slew of other serious health problems, including endometrial cancer, heart disease, high , type 2 diabetes , asthma , obesity , depression, and anxiety.
::美国1 400多万妇女患有多细胞卵巢综合症(PCOS),这是一种内分泌紊乱,遗传性疾病是女性不孕的最常见原因,大多数患有PCOS的妇女在其卵巢上生长许多小细胞,这些细胞通常并不有害,但导致荷尔蒙不平衡,例如受影响妇女中男性性激素水平高于正常水平;荷尔蒙不平衡是与PCOS有关的不育的主要原因;这种紊乱还增加了其他严重健康问题的风险,包括内脏癌症、心脏病、高血压、2型糖尿病、哮喘、肥胖、抑郁和焦虑。

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Despite the prevalence of PCOS and its serious potential effects, until recently, its cause was poorly understood. There were also no effective early diagnostic or treatment strategies for it. A ll that appears to be changing now. A review of the research literature on PCOS published in 2016 provides new insights into causes, diagnosis, and treatment for the disorder.
::尽管PCOS的流行及其严重的潜在影响,但直到最近,其原因还没有得到很好地理解,也没有对其有效的早期诊断或治疗战略,所有这些现在似乎都在改变,对2016年出版的PCOS研究文献的审查提供了对病因、诊断和治疗疾病的新洞察力。

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Among the research cited in the review is promising new work on nonhuman models, including monkeys and mice. One line of research suggests that PCOS may be programmed into a fetus during the second trimester of pregnancy. Another line of research indicates that hair taken from an infant can be analyzed for early risk factors for PCOS, even though PCOS symptoms do not show up until . In addition, the research is helping scientists identify a constellation of genes that are suspected to play a role in PCOS.
::在审查中引用的研究中,有希望对包括猴子和小鼠在内的非人类模型进行新的工作。一项研究显示,在怀孕的第二个三个月期间,PCOS可能被编入胎儿体内。另一项研究显示,可以分析从婴儿身上提取的毛发对PCOS的早期风险因素,尽管PCOS症状直到......才出现。此外,研究还在帮助科学家确定涉嫌在PCOS中发挥作用的基因群。

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The new research on PCOS is important for women who suffer from the disorder and its consequences, including infertility and life-threatening chronic conditions (such as heart disease and diabetes). The hope is that such research will lead to new ways of diagnosing PCOS at an early age, when medical interventions and lifestyle choices may be used to head off the more serious complications. It is likely that the research will also eventually lead to new and more effective treatment options for the millions of women who battle PCOS.
::关于PCOS的新研究对患有不孕症及其后果,包括不孕症和危及生命的慢性病(如心脏病和糖尿病)的妇女非常重要,希望这种研究能够导致在早期诊断PCOS的新方法,届时可以采取医疗干预措施和生活方式选择来消除更为严重的并发症,最终还有可能为与PCOS作战的数百万妇女带来新的和更有效的治疗选择。

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Summary
::摘要

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• Infertility is the inability of a sexually mature adult to reproduce by natural means. It is defined scientifically and medically as the failure to achieve a successful pregnancy after at least one year of regular, unprotected sexual intercourse.
  ::不孕症是指成年性成年人无法以自然方式生育,在科学和医学上被定义为在正常、无保护的性交至少一年后未能成功怀孕。
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• About 30 percent of infertility in couples is due to female infertility, and another 30 percent is due to male infertility. In the remaining cases, a couple’s infertility is due to problems in both partners, or to unknown causes.
  ::夫妇中约30%的不孕症是女性不孕症造成的,另外30%是男性不孕症造成的。 在其余情况下,夫妇不孕症是夫妻双方的问题或原因不明造成的。
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• Male infertility occurs when there are no or too few healthy, motile sperm. This may be caused by problems with spermatogenesis, or by blockage of the male reproductive tract that prevents sperm from being ejaculated. Risk factors for male infertility include heavy alcohol use, smoking, certain medications, and advancing age, to name just a few.
  ::男性不孕症发生时,健康、运动的精子没有或太少,这可能是由精子产生问题或男性生殖道堵塞导致的,防止精子射精,男性不孕症的风险因素包括酗酒、吸烟、某些药物和年龄提高,仅举几个例子。
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• Female infertility occurs due to failure to produce viable eggs by the ovaries, or structural problems in the Fallopian tubes or uterus. Polycystic ovary syndrome is the most common cause of failure to produce viable eggs. Endometriosis and uterine fibroids are possible causes of structural problems in the Fallopian tubes and uterus. Risk factors for female infertility include smoking, stress, poor diet, and older age, among others.
  ::雌性不育是由于卵巢不生产可行的卵,或由于输卵管或子宫的结构性问题而发生。多细胞卵综合症是不能生产可行的卵的最常见原因。内分泌硬化和子宫纤维固醇可能是造成输卵管和子宫结构问题的原因。女性不育的风险因素包括吸烟、压力、饮食不良、年龄较大等等。
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• Diagnosing the cause(s) of a couple’s infertility generally requires testing both the man and the woman for potential problems. For men, semen is likely to be examined for adequate numbers of healthy, motile sperm. For women, signs of ovulation are monitored, for example, with an ovulation test kit or ultrasound of the ovaries. For both partners, the reproductive tract may be medically imaged to look for blockages or other abnormalities.
  ::诊断一对夫妇不孕症的原因通常要求男女双方对潜在的问题进行检测。对于男性来说,精液很可能被检测为足够数量的健康和运动精子。对于女性来说,排卵迹象会受到监控,比如用卵巢的卵巢测试箱或卵巢的超声波监测。对于伴侣双方来说,生殖道都可能是医学上的图像,以寻找阻塞或其他异常。
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• Treatments for infertility depend on the cause. For example, if a medical problem is interfering with sperm production, medication may resolve the underlying problem so sperm production is restored. Blockages in either the male or the female reproductive tract can often be treated surgically. If there are problems with ovulation, hormonal treatments may stimulate ovulation.
  ::不孕症的治疗取决于原因,例如,如果医学问题干扰精子生产,药物可以解决根本问题,从而恢复精子生产,对男性或女性生殖道的阻塞往往可以进行外科治疗,如果排卵有问题,荷尔蒙治疗可能会刺激排卵。
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• Some cases of infertility are treated with assisted reproductive technology (ART). This is a collection of medical procedures in which eggs and sperm are taken from the couple and manipulated in a lab to increase the chances of fertilization occurring and an embryo forming. Other approaches for certain causes of infertility include the use of a surrogate mother, gestational carrier, or sperm donation.
  ::一些不孕症得到辅助生殖技术的治疗,这是一系列医疗程序,其中从夫妇中取出卵子和精子,在实验室中操纵,以增加发生受孕和胚胎形成的机会,其他一些不孕症的原因包括使用代孕母亲、妊娠载体或精子捐赠。
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• Infertility can negatively impact a couple socially and psychologically, and it may be a major cause of marital friction or even divorce. Infertility treatments may raise ethical issues relating to the costs of the procedures and the status of embryos that are created in vitro, but not used for pregnancy. Infertility is an under-appreciated problem in developing countries, where birth rates are high and children have high economic — as well as social — value. In these countries, poor health care is likely to lead to more problems with infertility and fewer options for treatment.
  ::不孕症在社会和心理上可能对一对夫妇产生消极影响,这可能是婚姻摩擦甚至离婚的一个主要原因,不孕症治疗可能引起与手术费用有关的伦理问题和在体外产生、但不用于怀孕的胚胎的状况,不孕症在发展中国家是一个认识不足的问题,那里的出生率很高,儿童具有很高的经济价值和社会价值,在这些国家,保健不良可能导致更多的不孕症和较少的治疗选择。

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Review
::回顾

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1. What is infertility? How is infertility defined scientifically and medically?
::1. 不孕症是什么?不孕症是如何在科学和医学上界定的?

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2. What percentage of infertility in couples is due to male infertility? What percentage is due to female infertility?
::2. 男性不孕症导致夫妇不孕症的比例是多少?女性不孕症导致的比例是多少?

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3. Identify causes of and risk factors for male infertility.
::3. 查明男性不育的原因和风险因素。

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4. Identify causes of and risk factors for female infertility.
::4. 查明女性不育的原因和风险因素。

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5. How are causes of infertility in couples diagnosed?
::5. 被确诊的夫妇不育的原因如何?

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6. How is infertility treated?
::6. 不孕症如何治疗?

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7. Discuss some of the social and ethical issues associated with infertility or its treatment.
::7. 讨论与不孕症或其治疗有关的一些社会和伦理问题。

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8. Why is infertility an under-appreciated problem in developing countries?
::8. 为什么不孕症在发展中国家是一个认识不足的问题?

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9. Describe two similarities between causes of male and female infertility.
::9. 描述男女不育原因之间的两个相似之处。

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10. True or False:  A person who already has a biological child can suffer from infertility.
::10. 真实或假:已经生有生物子女的人可能患有不孕症。

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11. True or False:  ART always involves fertilization outside of the body.
::11. 真实或假:ART总是涉及身体外的施肥。

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12. Explain the difference between males and females in terms of how age affects fertility.
::12. 解释男女在年龄如何影响生育率方面的差别。

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13. If a woman has no viable eggs, which method below is the most likely to help her and her partner have a baby?
::13. 如果妇女没有可行的蛋,以下哪种方法最有可能帮助她及其伴侣生孩子?

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a. gestational carrier
::a. 妊娠载体

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b. surrogate mother
::b. 代孕母亲

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c. i n vitro fertilization
::c. 体外受孕

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d. i n vivo fertilization
::d. 活体受孕

 

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14. Do you think that taking medication to stimulate ovulation is likely to improve fertility in cases where infertility is due to endometriosis? Explain your answer.
::14. 你认为服用药物刺激排卵在不孕症因子宫内分泌硬化而导致的情况下可能提高生育率吗?解释你的答复。

 

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15. If a semen sample shows no sperm, what is a possible cause?
::15. 如果精液样本显示没有精子,什么是可能的原因?

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a. blockage in the male reproductive tract
::a. 男性生殖道的阻塞

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b. lack of spermatogenesis
::b. 缺乏精子产生

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c. PCOS
::c. PCOS

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d. A and B
::d. A和B

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Explore More
::探索更多

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A new study shows that men who smoke  marijuana more than once a week have sperm counts around 33 percent lower than men that don't. Learn more here:
::一项新的研究表明,每周不止一次吸食大麻的男子,精子比不吸大麻的男子低33%左右。

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Check out this video to watch an   embryo created with in vitro fertilization developing over five days:
::看看这段影片, 观看一个胚胎, 体外受精持续五天: