SART生育专家——子宫肌瘤与生育能力

本播客中表达的信息和观点不一定反映ASRM和SART的观点。

The information and opinions expressed in this podcast do not necessarily reflect those of ASRM and SART.

这些播客仅供一般信息参考，不能替代医生的咨询。

These podcasts are provided as a source of general information and are not a substitute for consultation with a physician.

欢迎收听SART生育专家播客，我们在这里讨论对想要组建家庭的人们来说重要的话题。

Welcome to SART Fertility Experts, a podcast that brings you discussions on important topics for people trying to build a family.

我们的专家是SART（辅助生殖技术协会）的成员，该组织致力于确保您获得优质的生育护理。

Our experts are members of SART, the Society for Assisted Reproductive Technology, an organization dedicated to ensuring you receive quality fertility care.

大家好，我叫布鲁克·罗西，是俄亥俄州哥伦布市的一名生殖内分泌科医生和不孕不育专家。

Hello, my name is Brooke Rossi and I am a practicing reproductive endocrinologist and infertility specialist in Columbus, Ohio.

今天我们将讨论子宫肌瘤与生育能力的话题。

We will be doing a podcast today, on uterine fibroids and fertility.

我们邀请到了伊丽莎白·斯图尔特医生。

We have Doctor.

她今天和我们在一起。

Elizabeth Stewart with us today.

她是明尼苏达州罗切斯特市梅奥诊所的生殖内分泌科医生和不孕不育专家。

She is a practicing reproductive endocrinologist and infertility specialist at the Mayo Clinic in Rochester, Minnesota.

她是梅奥医学院妇产科的教授。

She is a professor in the Department of Obstetrics and Gynecology at the Mayo Clinic School of Medicine.

她是子宫疾病方面的专家，特别是子宫肌瘤。

She is an expert in diseases of the uterus, specifically uterine fibroids.

她在子宫肌瘤研究方面做出了巨大贡献，涵盖了遗传、治疗、预防和费用等多个方面。

She has contributed greatly to research on uterine fibroids, addressing many aspects of the condition, including genetics, treatment, prevention, and cost.

SART播客系列非常感谢Dr.

The SART podcast series is thankful to have Dr.

Stewart今天能来和我们一起讨论子宫肌瘤与生育问题。

Stewart joining us today to discuss uterine fibroids and fertility.

那么，Doctor.

So Doctor.

Stuart，我们不妨先聊聊什么是子宫肌瘤吧。

Stuart, maybe we can just start by talking about what uterine fibroids are.

斯图尔特医生。

Dr.

好的。

Okay.

所以，子宫肌瘤是长在子宫壁里的肿块，它们可能像硬币那么小，也可能像篮球那么大，并且往往会给女性带来一些症状。

So uterine fibroids are growths inside the wall of the uterus, that they can be as small as a penny or they can be as large as a basketball and they tend to cause certain symptoms for women.

最常见的症状是月经量多或经期延长，以及因为子宫增大（就像怀孕时那样）而产生的压迫感或不适。现在越来越多的证据表明，它们还与痛经以及经间期疼痛有关。

The most common symptoms are heavy or long menstrual periods, pressure or discomfort because the uterus is enlarged like it can be when a woman is pregnant and thereis increasing data that theyire also related to painful periods and also maybe pain between periods.

好的。

Okay.

我遇到过一些患者来找我，

So I've had patients come to

说医生诊断出她们子宫里有肿块。

me and say that their doctor has diagnosed them with a mass in their uterus.

很多人一听到‘肿块’就联想到癌症，所以会非常紧张。

And a lot of people, mass equals cancer and so they get really nervous about that.

那么肌瘤和癌症是一回事吗？或者肌瘤会变成癌症吗？

So are fibroids the same thing as cancer or can fibroids become cancer?

嗯，肌瘤很少是癌症。

Well, fibroids are rarely ever cancer.

问题是，有时候当你看到子宫里有肿块时，你不知道它是典型的肌瘤还是罕见的癌症，但对于大多数育龄女性，也就是二三十岁、四十岁的女性来说，它更更更可能是肌瘤，尤其是如果你有肌瘤相关的症状。

The problem is sometimes when you do see a mass in the uterus, you don't know whether it's a typical fibroid or rare cancer, but for most reproductive age women, women in their 20s, 30s, and 40s, it's much, much, much more likely that it's going to be a fibroid, and especially if you're having fibroid related symptoms.

太好了。

Perfect.

那么大多数育龄女性，也就是大概20到50岁之间的女性，如果被告知有肿块，大多数都不会是癌症。

And so most people who are reproductive age, so women between the ages of maybe 20 and 50, most of them aren't going to have cancer if they're told

对，绝对是这样。

to Absolutely, have absolutely.

肌瘤有多常见呢？

And how common are fibroids?

嗯，这似乎非常非常常见，这也是一个大问题。

Because this Well, seems very like, extremely common and that's one of the big issues.

研究表明，白人女性一生中患子宫肌瘤的概率高达百分之七十，而黑人女性则更接近百分之八十。

The study suggests that white women have up to a seventy percent chance of having a fibroid within their lifetime and for black women it's more like eighty percent.

所以很多很多女性一生中都会长子宫肌瘤，其中相当一部分人会出现症状，但有些女性虽然有肌瘤，却从未给她们带来任何麻烦，也无需采取任何措施。

And so many, many women will have a fibroid during their life time and a pretty good percentage of those women will have fibroid symptoms, but some women have fibroids, they never cause them any problem and they never have to take any action.

好的，你刚才提到肌瘤的发病率在种族上有些差异。

Okay, and so you did mention that there's a little bit of a racial difference in maybe the rates of fibroids.

还有哪些女性更容易得子宫肌瘤呢？

Are there any other women that are more prone to have fibroids?

肌瘤会遗传吗，或者有家族倾向之类的？

Do they run-in families or anything like that?

医生。

Dr.

确实有数据表明肌瘤有家族聚集性，但非洲裔血统不仅会增加患肌瘤的风险，还会让你更可能在较早年龄就长出肌瘤，并且症状也更严重。

There is some data that fibroids do run-in families, but being of African descent really not only increases your risk of fibroids, it causes you to be more likely to develop fibroids at an earlier age, and also is associated with more severe fibroid symptoms.

所以黑人女性有多重风险因素，使得肌瘤对她们来说更成问题。

So black women have multiple risk factors that make fibroids more of a problem for this group.

至于亚裔女性和拉丁裔女性，这方面的研究还不多。

Now for Asian women, Latino women, there's not a lot of research.

目前的研究显示，这些群体中子宫肌瘤的发病率并没有更高，但这些研究实际上只基于少数女性。

The current research suggests that fibroids are not more likely in these groups, but that research is really based on a small number of women.

所以我认为我们还有更多正在进行的研究，以了解全球范围内的风险。

So I think we've got more research ongoing to understand global risk.

好的，这确实是我们需要进一步研究的领域。

Okay, so definitely an area that we need to look more into.

大多数患者是怎么知道自己有子宫肌瘤的？

How is it that most patients are told they have fibroids?

是通过某种特定的检查发现的吗，比如超声波、CT扫描之类的，医生？

Are they found with any specific type of testing like ultrasound or CT scans or anything Dr.

比如

Like

最常见的两种情况，让女性发现自己有未察觉的子宫肌瘤，要么是盆腔检查。

the two most common things that cause a woman to find out she has unsuspected fibroids are either a pelvic exam.

如果医生做盆腔检查时摸到子宫表面不平整或凹凸不平，那有时就说明可能有肌瘤，因为当肌瘤长在子宫外面时，

If your doctor's doing a pelvic exam and feels a lumpy or bumpy uterus, that sometimes indicates that there may be fibroids because when the fibroids are on the outside of the uterus,

摸起来会不规则。

it feels irregular.

有人会自己摸到吗？

Do people ever feel them themselves?

哦，当然会。

Oh, absolutely.

而且有时候她们自己都不知道那是什么。

And sometimes they don't even know what it is.

她们来就诊时会说，我右边好像有个东西，或者我感觉有点不对劲。

They come in and say, I've got something over here on my right side, or I'm feeling something funny.

但我觉得最常见的发现方式还是超声波检查。

But I would say probably the most common thing is an ultrasound.

所以你可能因为卵巢囊肿或者怀孕去做超声波，然后被告知，哎呀，你还有个肌瘤。

So you may even be getting an ultrasound for an ovarian cyst or during a pregnancy, and you may be told, Oh gee, you have a fibroid too.

再说一次，很多女性的子宫肌瘤是没有症状的，所以知道它存在并不意味着你需要做什么。

And again, many women have asymptomatic fibroid, so just knowing it's there doesn't make you need to do something.

但如果有人告诉你你有肌瘤，你就会想，哦，也许这就是为什么我每个月来月经九天，或者为什么我穿不下自己的衣服了。

But if somebody tells you you have a fibroid and you go, Oh yeah, maybe that's why I have nine days of my period every month or maybe that's why I can't fit into my clothes anymore.

我去年裤子的尺码都换了。

I've had to change the size of my pants in the last year.

这让你会想，也许这跟我遇到的一些问题有关。

It prompts you to kind of say, Gee, maybe this is related to something I'm experiencing.

好的，听起来，我们刚才聊到现在你已经提到了人们会有的一些不同症状。

Okay, and it sounds like, I mean you've mentioned over the course of our talk so far some different symptoms that people have.

他们可能出血量大，腰围可能变大，或者有些疼痛。

They may have heavy bleeding, they may have that their waist may start to increase in size, some pain.

还有其他常见的大症状吗？

Any other big common symptoms that people have?

病人来找你，最常抱怨的是什么？

What do patients come to you and complain about the most?

医生。

Dr.

我觉得当

I think by

人们来找我的时候，他们已经对自己的症状做过评估，而且这些症状很可能与肌瘤有关。

the time people come to me, they've already had an assessment of their symptoms and they're likely linked to fibroids.

但有时候，女性会被初级保健医生告知她们贫血，而贫血在老年人中又与结肠癌和其他疾病相关，可能没有人会想到，她的月经量是不是很大？

But sometimes women are told by their primary care provider that they're anemic, and again, anemia in older people is associated with colon cancers and other things, and nobody may even think, Gee, are her periods heavy?

她会不会有肌瘤？

Could she have fibroids?

对，很好。

Exactly, great.

有时候你会有肠道或膀胱问题，因为某个特定的肌瘤压迫了你的肠道或膀胱。

Sometimes you have bowel or bladder problems because there's a specific fibroid pressing on your bowel or your bladder.

我有一位患者，她本来要去接受髋部手术，后来才有人发现她有一个巨大的肌瘤压迫着她的右髋部。

I had one woman who came in who was on her way to hip surgery before someone realized she had an enormous fibroid pressing on her right hip.

所以，子宫的解剖结构确实会影响具体的症状。

So, the anatomy of the uterus really can affect specific symptoms.

所以，肌瘤可以出现在子宫的任何位置，而且可能很大，所以它们可能压迫膀胱、肠道或神经，从而引发各种不同类型的症状。

So the fibroids can be in any part of the uterus and they can be large, so they can press on either the bladder or they can press on the bowel or they can press on nerves, creating all different types of symptoms, it

对，听起来像是背痛、坐骨神经痛。

Right, sounds like back you're pain, sciatic pain.

现在，很多这样的症状，比如背痛和坐骨神经痛，都很常见，肌瘤也很常见。

Now, a lot of those symptoms like back pain and sciatic pain are common and fibroids are common.

所以你可能同时有背痛和肌瘤，但肌瘤可能并不是导致背痛的原因。

So you might have back pain and fibroids, but the fibroids may not be causing the back pain.

但我认为，特别是对于年轻女性，如果有月经过多、经期延长、贫血、特定的肠道或膀胱功能障碍，那么尝试判断肌瘤是否与这些问题有关，

But I think particularly in a young woman who has heavy menstrual bleeding, prolonged periods, anemia, specific bowel or bladder dysfunction, trying to say, Are fibroids related to this problem?

可能很重要。

Can be important.

好的，肌瘤会随着时间如何变化？

Okay, how do the fibroids change over time?

它们是不是总是会长大、变得更严重？

Do they always grow and get worse?

还是说它们会保持差不多大小？

Do they stay about the same?

对，这其实挺有意思的，因为很多妇科医生都不知道，但研究表明，大约三分之一的肌瘤会在一段时间内保持大小不变，大约三分之一会缩小，还有大约三分之一会长大。

Yeah, so that's actually interesting because many gynecologists don't even know this, but studies suggest that about a third of fibroids will stay the same size for a prolonged period of time, about a third will shrink, and about a third will grow.

而妇科医生看到的，往往是那三分之一长大的。

Now, gynecologists see the third to grow.

其他的可能根本就不会走进他们的诊室。

The others may not ever even walk into their office.

所以，这种误解其实是有现实基础的。

So, that misperception is based in reality.

但另一个重要的一点是，很多研究显示，即使女性去寻求信息，她们也可能得不到好的反馈。

But the other important thing is that many studies are showing that even when women seek information, they may not get good feedback.

比如说，因为肌瘤有家族遗传性，如果你问你妈妈，月经来九天正常吗？

For example, since fibroids run-in families, if you ask your mom, Is having nine days of your period okay?

她可能会说，当然，我和你的姐姐一直都是一样的。

She may say, Sure, that's what's always been the same for me and your sister.

所以，很多女性可能长期有肌瘤和肌瘤症状，但没有引起别人的注意。

And so, many women may have fibroids and fibroid symptoms for a prolonged period of time and not bring it to someone's attention.

好的。

Okay.

我们希望您觉得这期SART生育专家节目对您有帮助。

We hope you're finding this episode of SART Fertility Experts helpful.

请记住，想了解更多关于这个话题和相关主题的信息，请访问www.sart.org，并点击标有“患者”的标签。

Remember, for more information on this and related topics, visit www.sart.org and click on the tab labeled Patients.

现在回到生育专家节目。

And now back to start fertility experts.

我们的很多听众，可能是想怀孕的女性，也可能被告知有肌瘤。

A lot of our listeners, maybe women that are interested in getting pregnant and may also have been told that they have fibroids.

所以我想讨论的两个问题是，肌瘤如何影响怀孕，以及怀孕如何影响肌瘤？

So I think the two questions I have that I wanted to discuss are how do fibroids affect pregnancy and then also how does the pregnancy affect fibroids?

医生。

Dr.

好的，我觉得这个问题挺复杂的，而且实际上有一些新的研究可能会改变我们对怀孕期间子宫肌瘤的看法。

Okay, so I think that's a complex question and there's actually some new research that may be changing what we're thinking about fibroids in pregnancy.

很多有子宫肌瘤的女性都能顺利怀孕，整个孕期也没什么问题。

Many women with fibroids get pregnant and carry pregnancies without any trouble.

但有一些数据表明，如果子宫内部被我们称为黏膜下肌瘤的东西挤压变形，很多女性可能会难以怀孕，或者流产的风险会增加。

But there is some data to suggest that if the inside of the uterus is distorted by what we call a submucosal fibroid, many women will have trouble getting pregnant or maybe an increased risk of miscarriage.

黏膜下肌瘤就是那种稍微长到子宫腔里面的肌瘤。

And a submucosal fibroid is a fibroid that's a little bit coming into the inside of the cavity.

有时候只是稍微长进去一点，有时候它就在中间。

Sometimes it's a little bit and sometimes it's sitting in the middle

在

of the

子宫里，像个高尔夫球一样。

uterus like a golf ball.

好消息是，这些肌瘤通过微创手术切除要容易得多。

And the good news is that those fibroids are much easier to remove through minimally invasive surgery.

所以我觉得，如果一位女性正在怀孕或者怀孕困难，并且发现了这样的肌瘤，那么切除它其实是相当直接的。

So I think if a woman is getting pregnant or having trouble getting pregnant and one of those fibroids is found, then removing it is rather straightforward.

那么这些肌瘤也会影响生育能力吗？

So can those fibroids affect fertility then also?

会的，所以通常不孕评估的一部分就是检查子宫。

They can and so again, usually part of an infertility evaluation is to look at the uterus.

你不能跳过其他步骤，不去评估女性是否排卵、伴侣是否有精子，因为只关注肌瘤可能会让你完全走错方向。

You don't want to leave out the other steps and not assess is a woman ovulating and does her partner have sperm because focusing just on the fibroids prematurely can lead you in absolutely the wrong direction.

对，你的意思是很多这样的女性可能很容易怀孕，被告知有肌瘤，而她们自己都不知道。

Right, what you're saying is many of those women probably may get pregnant easily, be told that they have fibroids and they didn't even know they had them.

没错。

Exactly.

我们要小心过度诊断和过早治疗它们。

We have to be careful about over diagnosing them and treating them maybe prematurely.

这也是新研究正在探索的方向之一。

And that's one of the areas the new research is going in.

有一项大型研究专门探讨了子宫肌瘤与流产之间的关系，结果发现肌瘤的大小和位置都不会影响流产。

One big study that looked at the association between fibroids and miscarriage found that neither the size nor the position of the fibroid affected miscarriage.

真正的风险因素是年龄增长。

The real risk factor was increasing age.

我们知道年龄越大，流产的风险越高，而且肌瘤也跟年龄增长有关，直到绝经期为止。所以，在某些怀孕和流产相关的问题上，肌瘤可能只是无辜的旁观者。

We know increasing ages are associated with an increased risk of miscarriage, and we know that fibroids are associated with increasing age up until menopause, so maybe the fibroids are just innocent bystanders in some pregnancy and miscarriage related issues.

没错。

Exactly.

如果一个女性很容易就怀孕了，而且有肌瘤，那

If a woman conceived easily and had fibroid, does

这个肌瘤在怀孕期间会变化吗？

that fibroid change during pregnancy?

它会变大或者引起什么症状吗？

Does it grow or cause her any symptoms?

有时候它们会长大，但同样，有些肌瘤在怀孕期间是稳定的。

Sometimes they can grow but again, some fibroids are stable through pregnancy.

还有一些与肌瘤相关的妊娠并发症。

There's also a number of pregnancy complications complications There's that are associated with fibroids.

所以一般来说，有肌瘤的女性在怀孕期间可能会被更密切地监测。

So generally, women with fibroids may be monitored more carefully during pregnancy.

但有一个好处是，有些数据表明，怀孕后，随着子宫从能容纳八磅重的婴儿恢复到拳头大小，有时会消除小的肌瘤。

But one of the good things is there is some data to suggest that after pregnancy, as the uterus grows from being capable of carrying an eight pound baby to going back to the size of a pair, that sometimes gets rid of small fibroids.

所以女性降低未来肌瘤风险的最好方法就是成功怀孕。

So the best thing women can do to decrease their risk of future fibroids is to have a successful pregnancy.

好的，我们稍后会讨论肌瘤的治疗方法。

Okay, and we'll talk about treatments for fibroids in a minute.

但我觉得听众可能想知道的一个大问题是，他们是否需要在做不孕治疗或试管婴儿之前切除肌瘤？

But I think one of the big questions that our listeners may want to know is do their fibroids need to be removed before they do their infertility treatment or IVF?

或者更好的问题是，我们知道哪些类型的患者在做不孕治疗前切除肌瘤可能会有更好的结果？

Or maybe a better question is which types of patients do we know may have a better result by having their fibroids removed before they do their infertility treatment?

对，我觉得这个问题真的很难回答。

Yeah, so I think that's a really tough one.

我知道，这方面的数据确实不多。

I know, that there's not a lot of data.

我觉得在美国，大多数生育专家还是会建议，在进行生育治疗之前，先切除那些长在子宫内部的肌瘤。

I think in The United States, still most fertility specialists would recommend removing those fibroids that are sitting on the inside of the uterus before proceeding to fertility treatment.

但在美国，

But in The U.

我们对于在生育治疗前切除肌瘤的态度要激进得多，这可能是我们医疗体系的一种偏见。在其他国家，试管婴儿和肌瘤手术都由医疗系统支付，很多女性会直接进行生育治疗而不做肌瘤手术。

S, we're much more aggressive about removing fibroids prior to fertility treatment and that may be a bias of our funding system that in other countries where IVF and fibroid surgery are both paid for by the health system, many more women will go to fertility treatment without fibroid surgery.

在这里，很多人自费进行生育治疗，确实存在一种倾向，就是利用保险来切除肌瘤，以优化生育治疗的效果，但关于这一点，可靠的数据并不多。

Here, where many people are paying out of pocket for fertility care, there does seem to be a bias to using your insurance to remove the fibroids to optimize your fertility care, But there's not a lot of good data on that.

好的。

Okay.

所以对于某些患者来说，这确实是个很难回答的问题，她们应该和自己的生育专家讨论一下具体情况。

So that's definitely a hard question to answer for some of our patients, and they should probably speak with their fertility specialists about their specific cases.

我们来聊聊子宫肌瘤的治疗方法吧。

Let's talk a little bit about how fibroids are treated.

是不是一定要手术切除？手术有哪些选择？除了手术还有其他办法吗？

Do they always have to be surgically removed, and what are those surgical options, and are there any other options besides surgery that exist?

幸运的是，现在除了子宫切除，还有其他选择。我觉得每个人都应该有子宫切除以外的选择。

So, we're lucky that there are now more alternatives to hysterectomy, hysterectomy and I think everybody should have an alternative to hysterectomy.

没错，所以如果你被告知没有别的选择，那就是该去寻求第二意见的时候了。

Exactly, So I think if you're told there's no other option, that's the time to seek a second opinion.

对于子宫肌瘤，除了子宫切除，还有药物和手术或介入性的替代方案。

And that there are both medical and surgical or interventional alternatives to hysterectomy for fibroids.

有些女性用药物就能控制得很好，比如激素宫内节育器或者避孕药。

Some women will do fine with medications like a hormone releasing IUD or birth control pills.

还有一些药可以在月经量大的那几天服用，减少出血。

There are some medications you can take just during the heavy days of your period to decrease bleeding.

所以，对于单纯月经量大的女性，药物治疗可能就够了。至于手术，除了子宫切除，还有几种选择，比如肌瘤剔除术，有时可以通过宫腔镜或腹腔镜做，有时则需要开腹手术。

So, for the woman that has heavy bleeding alone, medical care can be an There are a couple of surgical alternatives to hysterectomy where the fibroids are removed, called a myomectomy, and that can sometimes be done with telescopes or sometimes through a bigger incision.

还有一些介入性技术，比如在腹腔镜检查时使用激光纤维，或者通过导管输送小颗粒，就像做心脏导管检查那样，这叫子宫动脉栓塞术，或者还有一些利用声波来摧毁肌瘤的技术。

There's also a couple of interventional techniques where you can use a laser fiber during laparoscopy or you can use little pellets that are delivered through a catheter, so more like you're having a cardiac catheterization called a uterine artery embolization or there are a couple of techniques that use sound waves to destroy fibroids.

所以，除了子宫切除，还有很多其他选择，有些简单到只需要休息几天就能回去上班。

So there are a number of alternatives to hysterectomy and some of them simple enough that you're only out of work for a couple of days.

那对于想要更多孩子的女性，有哪些选择呢？

And what options would be available to women who want to have more children?

是的，再说一次，大多数人发现通过肌瘤切除术手术移除肌瘤可能是最佳选择，因为我们已经用了上百年了。

Yeah, so again, most people find that removing the fibroid surgically through a myomectomy is probably the optimal option because we've used it for a hundred of years.

但话虽如此，像子宫动脉栓塞、聚焦超声和射频消融这些技术，都有女性成功怀孕并分娩的案例。

But that being said, techniques like uterine artery embolization and focused ultrasound and radiofrequency ablation all have women who have successfully gone on and had pregnancies and deliveries.

好的。

Okay.

作为在这个领域工作多年的专家，您认为肌瘤研究的未来方向是什么？

Now, as somebody who's worked in this field for many years, where do you see the field of fibroid research going?

有没有什么让您兴奋的新研究，或者即将出现的治疗方案？

Any new research you're excited about or treatment options that are on the horizon?

我觉得最令人兴奋的是，现在有一些新的治疗方案正在陆续推出。

Well, think that's what's really exciting is that there are some treatment options that are becoming available.

在美国以外，有一些药物可以阻断孕激素，看起来对治疗子宫肌瘤很有效。

There are some drugs that are available outside The US that block the hormone progesterone that appear to be effective medical therapy for fibroids.

这些药目前在美国还没有上市，但希望未来几年内能引进。

They're not available here yet, but hopefully in the next couple of years they will be.

它们叫做孕激素受体调节剂。

They're called progesterone receptor modulators.

另外还有一类叫口服拮抗剂的药物，目前正在进行多项临床试验，结果令人鼓舞。

And then there's another class of drugs called oral antagonists and there are several clinical trials ongoing that are showing exciting results for these medications.

太好了，非常感谢你。

Great, thank you so much.

再次提醒，这里是SART播客系列，我们邀请到了医生。

And again, this is the SART podcast series and we had Doctor.

来自明尼苏达州罗切斯特梅奥诊所的伊丽莎白·斯图尔特医生。

Elizabeth Stewart with us from the Mayo Clinic in Rochester, Minnesota.

非常感谢您，医生。

Thank you so much, Doctor.

斯图尔特医生今天和我们聊了关于子宫肌瘤和生育的问题。

Stewart, talking with us today about fibroids and fertility.

感谢给我这个机会来分享。

Thanks for the opportunity to speak.

感谢收听SART生育专家节目，这是您获取试管婴儿信息的资源。

Thank you for listening to SART Fertility Experts, your resource for information on IVF.

如果您觉得这期播客有用，请在您喜欢的社交媒体平台上给我们点赞，并告诉您的朋友们。

If you found this podcast useful, please like us on your favorite social media platform and tell your friends about us.

如需更多关于组建家庭的资源，请访问www.sart.org/patientinformation或www.reproductivefacts.org。

For more family building resources, visit www.sart.org/patientinformation or www.reproductivefacts.org.