SART生育专家 - 夫妻共同面对试管婴儿

我叫丹尼尔·格罗，是康涅狄格大学医学院的教授，专攻生殖内分泌和不孕不育，同时也是这里的奖学金项目主任。

My name is Daniel Grow, and I'm a professor specializing in reproductive endocrinology and infertility at the University of Connecticut School of Medicine and director of the fellowship program here.

今天能向大家介绍我们的特邀嘉宾雅各布，我真的很高兴。

It is a real pleasure that I get to introduce our featured guest, Jacob, today.

多年来，我和凯西一直有幸照顾患者，帮助他们规划人生中最重要的步骤之一：组建家庭。

Casey and I for years have had the privilege of taking care of patients, planning one of the most important steps of their lives: starting a family.

我们接诊的许多夫妻，无论是现在还是过去，都是因为怀孕困难而来。

Many of the couples we see and saw because they had trouble getting pregnant.

他们本以为怀孕是件简单自然的事，毕竟身边那么多宝宝，但发现并不容易，需要治疗时，我们看到了不孕不育给他们生活带来的压力。

They thought that this would be easy and natural as there were so many babies around them and when it wasn't easy and they discovered that some treatment was required, we saw the stress that infertility can cause in their lives.

幸运的是，现在有很多治疗方法可以帮助夫妻怀孕。

Fortunately, there are many treatments available today to help couples conceive.

同样幸运的是，也有一些应对压力的方法。

Also fortunately, there are some coping mechanisms to deal with stress.

医生。

Doctor.

凯西·雅各布于1989年在北卡罗来纳大学教堂山分校获得咨询心理学博士学位。

Casey Jacob received her PhD in Counseling Psychology in 1989 from the University of North Carolina at Chapel Hill.

她在1991年加入了美国生殖医学会，并在心理健康专业组存在的大部分时间里担任成员。

She got involved with the American Society for Reproductive Medicine in 1991 and served as a member of the Mental Health Professional Group for most of its existence.

我最了解她的是作为康涅狄格大学和高级生殖服务中心试管婴儿项目的心理医生，为接受生育治疗的夫妇提供咨询。

I knew her best as a psychologist embedded in the IVF program at the University of Connecticut and the Center for Advanced Reproductive Services providing counseling for couples going through fertility treatments.

然而，她的职业生涯远不止于为不孕患者提供咨询。

However, her professional career was so much deeper than simply counseling infertility patients.

她曾担任康涅狄格大学教师事务高级副院长，并担任精神病学系教授和妇产科学系教授。

She served as a Senior Associate Dean for Faculty Affairs at UCONN and as a Professor in the Department of Psychiatry and a Professor in the Department of Obstetrics and Gynecology.

她发表了许多同行评审的论文和书籍章节，并为许多组织提供咨询服务。

She has many peer reviewed publications, book chapters, and serves as a consultant to many organizations.

凯西，你以非常积极的方式影响了成千上万对夫妇的生活，我们非常高兴今天能邀请你来谈谈如何帮助夫妇应对不孕带来的压力。

Casey, you've touched the lives of thousands of couples in a very positive way, and we're thrilled to have you with us today to talk about helping couples deal with the stress of infertility.

非常感谢你邀请我来做这件事。

I really appreciate that you've asked me to do this.

首先，我想对正在收听的朋友们说，感谢你们的加入。

And I want to say to those of you who are listening, first of all, thank you for joining us.

其次，我希望你们今天能试着从中找到一两条或三条有用的建议带回去。

And secondly, what I would encourage you to try to do is just to find one or two or three tidbits to take away today.

像这样的讲座，总会有一些建议听起来不太适合你。

In a talk like this, there will always be suggestions that don't sound right for you.

你可以放心地直接忽略它们。

And you should feel free to just reject them right off the bat.

但请尽量保持开放的心态去听，万一有些建议是你之前没想到的，而且可能对你和你的伴侣有用，如果你们是一起面对的话。

But try to listen with an open mind in case things are suggested you haven't thought about before that could work for you and your partner if you're doing this with someone.

凯西，你知道吗，我想分享一个小故事。

Know, Casey, I wanted to share a quick story.

今天早上我见的第一位病人是来做新病人咨询的。

The first patient I saw this morning was a new patient consult.

我通常会先让病人告诉我，我怎样才能最好地帮助她。

And I typically ask a patient to open by having her tell me how I can best help her.

然后眼泪就流下来了。

And tears started running.

而且

And

我们这一行真的是充满情感的工作，帮助夫妻怀孕。

you know, this is a very emotional business we're in, helping couples get pregnant.

不管他们是试了一年还是四年，不管是男方问题还是女方问题，这都是一种让人情绪波动的诊断。

You know, it doesn't matter if they've been trying for one year or four years, if it's a male factor or a female factor, it's an emotional diagnosis.

所以我们深知那种痛苦。

And so we know that suffering.

患者们

Patients

对，确实如此。

Right, they are.

所以我们之前策划的时候讨论的一个主题是，当患者因为不孕诊断而感到压力时，她或他应该告诉别人吗？

And so, you know, one of the themes we talked about when we were planning this a little bit is, you know, when a patient is having stress around her diagnosis of infertility, you know, should he or she tell?

他们的支持圈子是谁？

Who is their support circle?

有没有办法在这方面给他们一些建议？

Is there a way to counsel them on that?

我觉得我们可以引导他们思考一些问题，因为一开始他们凭直觉认为对的做法，可能到最后并不是最有帮助的。

I think there are things we can ask people to think about because what might make intuitive sense to them right off the bat may not be what turns out to be most helpful.

而且很重要的一点是，当你第一次觉得‘哎呀，这不太顺利’的时候，什么对你有帮助？相比之下，如果你已经尝试了很长时间，情况又会不一样。

And very importantly, what helped you the first time you thought, oh dear, this isn't going very well, compared to way down the road if you've been trying for quite a while?

有帮助的方法往往会随着时间改变。

What helps often changes.

所以，愿意尝试不同的策略，可能会很有帮助。

And so your willingness to try a different strategy can be helpful.

我们也知道，虽然我们总是要小心不要用刻板印象，但如果我冒险用一下的话，我可以说，在刚开始面对不孕不育问题时，女性往往会跟很多人详细地讲这件事，有时候细节多到让人受不了。

And we also know that, although we always have to be careful when we're talking stereotypes, if I may take the risk of using a stereotype, I would say commonly early on infertility challenges, women often tell many people about it in excruciating detail sometimes.

而男性则不太会这样做。

And men are less likely to do this.

而且我觉得，这种早期的做法往往跟生育问题没什么关系。

And I would argue that that early approach often has nothing to do with fertility.

这其实跟人们如何处理生活中的隐私有关。

It has to do with how people deal with privacy in their lives.

很多时候，女性觉得没什么理由不分享，所以就直接说了。

That many times women don't see any reason not to share, they go ahead and do it.

而很多时候，男性则不太愿意分享。

And many times men are not interested in sharing.

作为心理学家，我想说，如果你本身就不太喜欢分享，不管你是男性、女性，还是其他性别认同的人。

And as a psychologist, I would say if you are not very interested in sharing in general, really whether you're a male or a female or somebody who doesn't identify either way.

如果你总体上不太愿意跟别人分享私人信息，一个可能的原因是，这样做并不会让你感觉更好。

If you are someone who in general is not that interested in sharing private information with other people, one reason may be because it doesn't make you feel better to do so.

所以你选择不说。

So you decline.

这不一定是因为你觉得别人知道了会天塌下来。

It's not necessarily that you think it would be the end of the world if somebody knew the information.

但分享的过程可能让你觉得不太舒服。

But the process of sharing it may not be comfortable for you.

而如果你习惯分享信息，你可能会发现把话说出来、梳理一遍这个过程是有帮助的。

Whereas if you are somebody who commonly shares information, you may find the process of saying things out loud and talking them through is helpful.

所以在今天的讲座中，我会不时停下来给出一个非常具体的建议，你可以思考一下这对你是否有帮助。

So as we go through this talk today, I'm going to stop periodically and say, so one very specific suggestion is, and you can think about whether it would be helpful for you.

一个非常具体的建议是，练习问自己：这样做对我有帮助吗？

One very specific suggestion is that you practice asking yourself, is that helping me?

当你做某件事的时候，尤其是如果你的伴侣做法跟你大不相同，我们要意识到，每个人应对压力的方式其实都不一样。

When you do something, and especially if your partner does it very differently, we want to recognize that what helps people cope varies from individual to individual.

我们每个人 individually 需要愿意问自己一个问题：这样做对我有帮助吗？

What each of us individually need to be willing to do is to say, is this helping me?

这比问“我是不是对的”要重要得多。

And that is a more important question than, am I right?

或者问“我有没有权利这么做或这么说”。

Or do I have a right to do this or say this?

我们很容易陷入非黑即白、对与错的纠结中。

We can get very caught up in the black and white and the right and wrong of things.

但作为心理学家，我会说，什么让你感到安慰，什么让你平静下来？

But as a psychologist, I would say, what comforts you and what soothes you?

所以在生育挑战的早期，很多人，尤其是女性，会觉得告诉别人“我在努力”是一种安慰。

So early in a fertility challenge, many people, women especially, will find it comforting to tell others, I'm trying.

我很兴奋。

I'm excited.

我很担心。

I'm worried.

这是我们正在做的事情。

Here's what we're doing.

我们打算尝试一些新方法。

We're going to try something new.

希望这次能成功。

Hopefully this will work.

而且通常，男性不太愿意谈论这件事，因为这会让他们感到不适，而不是安慰。

And commonly, men are less likely to want to talk about it because it causes discomfort and not comfort.

再说一次，这没有对错之分。

Again, it's not a right or a wrong thing.

关键是哪种方式能让自己感到安慰。

It's a what soothes me thing.

我不想一直举例子，但今天又有一对夫妇，那个年轻男士30岁，患有无梗阻性无精症，没有精子，FSH水平高。

I hate to just keep bringing up examples, but I had another couple today where the young man, 30 years old, had non obstructive azoospermia, no sperm, high FSH.

他问我，我觉得他没有告诉过任何同龄人，但他问我能不能推荐一位心理咨询师，因为他想谈谈这件事，但又不方便跟同龄人聊。

And he asked, my perception is that he's not a person who has told any of his contemporaries, But he asked if I would refer him to a counselor because he wants to talk about it, you know, but he's not comfortable talking about it with his peer group.

他能主动寻求帮助，这很好。

Good for him for asking for help.

这引出了一个非常重要的问题。

This raises a really important issue.

我之前说过，有时候随着时间推移，调整策略会有所帮助。

I said earlier on, sometimes it can be helpful to change your strategy as time goes on.

而且当你预期很快就能成功的时候，确实没有必要改变策略，对吧？

And when you're expecting to have success quite soon, there's no reason to change your strategy necessarily, right?

但如果这个过程可能会持续很长时间，而且你一直没有跟别人提起过，问题就在于，如果别人不知道你在受苦，也不知道你真的很想成为父母，那当他们有了孩子时，你还得假装自己很为他们高兴。

But if it can go on for quite a while, and if you are somebody who has not been talking about it, the problem is that if other people don't know you are suffering, and if other people don't know that you really wish to become a parent, you have to pretend that you're thrilled when they have babies.

而且你还得装作一切正常地过日子。

And you have to go through life as if there's no problem.

随着时间推移，这只会越来越难。

And that just gets harder and harder as time goes on.

但你可以学会的，每个人都能学会的，就是有限度地透露一些情况。

But what you can learn to do, everybody can learn to do, is to disclose in a limited way.

比如说，很多早期就非常坦诚地谈论这件事的人，而且这通常更多是女性而不是男性。

So for example, many people who have talked very openly early on, and again this is more likely to be females than males.

那些早期就非常坦诚的人，往往事后会希望自己能保留一些隐私。

People who have talked very openly early on often wish they could take some of their privacy back.

我有一个建议，可以帮你做到这一点。

And I have a suggestion for how to do that.

但那些一开始非常保密的人，可以想想怎么告诉别人自己有些事在发生，但又不想多谈。

But people who've been super private early on can think about how can I disclose to others that something's going on, but I don't want to talk about it?

比如说，下次有人问你：你们什么时候要孩子啊？

So for example, I would say the next time somebody says to you, So when are you guys going to have kids?

而你通常只是转移话题或者不回答。

And you're used to just diverting the conversation or not answering the question.

你可以选择说：我也想知道。

You could choose to say, I wish I knew.

我们一直在努力。

We've been trying.

但进展不顺利。

It's not going well.

这也许是我做过的最难的事。

It's maybe the hardest thing I've ever done.

而且很痛苦，我不想谈这个。

And it's very painful, and I don't want to talk about it.

对方还是会问你问题。

The person's still going to ask you a question.

你刚说了你不想谈这个。

You just said you don't want to talk about it.

但那样说很有力量。

But that's powerful.

对方还是会问，你得说：不，谈这个对我没帮助。

A person is still going to ask a question, and you have to say, No, It doesn't help me to talk about it.

但如果我有时候看起来有点低落，或者我们在家庭聚会上没待多久，那是因为这对我们来说太难了。

But if I sometimes seem kind of bummed out, or the reason we didn't stay long at the family party, It's because this is so hard for us.

所以欢迎所有的祈祷和祝福，但我不想谈这个。

So all prayers and fertile thoughts are welcome, but I don't want to talk about it.

你得

You've got to

坚持住，我只是在告诉他们。

stick I'm just telling them.

就是实话实说。

Just being honest.

所以你这是，我管这叫，把猫尾巴尖儿从袋子里露出来。

So you're letting this is what I call letting the tip of the tail of the cat out of the bag.

你没有说诊断是什么，或者试了多久，或者治疗了几个周期。

You are not saying what's the diagnosis, or how long have you been trying, or how many cycles have you been treated.

你没有谈那些细节。

You're not talking about any of the gory details.

但你也没有假装一切都很好。

But you are not pretending that everything is A Okay.

如果你是一直跟所有人说的人，而且你可能马上要开始第一次试管婴儿周期，你可能会希望收回一些隐私。

Now if you're the one who's been telling everybody everything, and you're maybe approaching your first IVF cycle, you might be wishing you could take some privacy back.

我会认真跟你说，验孕那天，你想让电话树上有多少人？

I would say to you, seriously, how many people do you want to have on the telephone tree on pregnancy test day?

你真的得想想，我要让多少人知道这件事？

You've really got to think, how many people am I going to have in this loop?

如果你已经告诉了一大堆人，那要收回一些隐私，主要有两个策略。

And if you have already told a zillion people, there are two main strategies for taking some privacy back.

第一个是问问自己，我认识的人里，有没有那些真心想帮我、老是说“我能做点什么”的人？

So one is ask yourself, do I know people who seriously want to be helpful to me and who keep saying what can I do?

如果你曾经回答过他们的问题，他们很可能会听你的。

And they're likely to listen to you if you ever answered the question.

对那些人，你可以说：非常感谢你们一直陪着我，听我讲我们生育上的困难。

Those people, you say to them, thank you so much for being there for me all this time and letting me talk about our fertility struggles.

这对我来说非常重要，也帮了我很多。

It's been incredibly important and helpful.

不过我们发现，现在对我们有帮助的方式开始变了。

And yet we are finding that what's helpful is starting to change.

所以当我们开始做试管婴儿时，也许你会透露到这一步，我们决定专心处理我们自己的情况，不再讨论细节。

And so as we begin IVF, maybe you'll disclose that far, we've decided to go into our case and not talk about the details.

我们真的不想每天都被问“你的超声波检查怎么样？”

We really don't want to be asked every day, How did your ultrasound go?

你的FSH是多少？

What's your FSH?

我们就是不想被问这些细节问题。

We just don't want all these detailed questions.

你说过你想帮忙。

And you've said you want to be helpful.

所以现在你能帮我的方式，就是除了不孕不育，其他什么都可以聊。

So the way you can be helpful now is to talk to me about everything except infertility.

而且请相信我，如果我有重要的事情要分享，我会告诉你的。

And to trust that I will tell you if I have something important to share.

与此同时，你能不能夸夸我的裙子，或者问问工作怎么样，或者聊聊你的家人？

In the meantime, could you compliment my dress or ask how work is going or tell me about your family?

就把我当成一个普通人对待。

Treat me like a regular old person.

我觉得这样才是现在对我最有帮助的。

I think that would be helpful now.

所以你身边可能有些人会说，谢谢你告诉我，我可以做到。

So you might have some people in your life who would say, Thank you for telling me, I can do that.

但我们每个人身边都有一些不会听这些话的人。

But we all have people in our lives who won't listen to that.

跟他们说这些也没用，因为他们总是会问问题。

And there's no point in saying it to them because they're going to always ask questions.

我建议你想想你生活中的榜样，那些几乎从不回答问题的人。

And I would suggest you think about the role models you have in your life who really hardly ever answer questions.

我有三个兄弟和三个姐妹。

I have three brothers and I have three sisters.

我在想，当别人问我们问题时，我们之间的差异有多大。

And I think about how different we are when people ask us questions.

你问我兄弟，你今晚要做什么？

You ask my brother, What are you doing tonight?

他会说，我不知道。

And he says, I don't know.

你问我妹妹，她会说，哎呀，我巴不得赶紧下班回家把这胸罩脱了。

You ask my sister, and she says, Oh, I can't wait to get home from work and get out of this bra.

然后我要做这个，然后我要做那个……

And then I'm gonna do this, and then I'm gonna do...

你看，回答问题的方式真的各有不同。

Know, like, There's really different ways of answering questions.

所以如果你以前总是喜欢分享，现在觉得分享太多了，你可以练习说：我不知道。

And so if you have commonly been somebody who has shared, and now that feels like too much sharing, you could practice saying, I don't know.

不确定。

Not sure.

他们还没告诉我呢。

They haven't told me yet.

就含糊其辞。

And just be vague.

最经典的是他们问你：那你什么时候取卵啊？

Favorite is when they say to you, so when's your egg retrieval?

你会说，如果我的卵巢正常，我根本不会做这些。

You would say, if my ovaries were behaving, I wouldn't be doing any of this.

我不知道我的取卵时间是什么时候。

I don't know what my egg retrieval is.

就分享你的沮丧，而不是那些医学细节。

Just share the frustration instead of the medical facts.

所以你得决定，我是想学会怎么不回答那些冒犯性的问题？

So you have to decide, do I want to learn how to really not answer all those intrusive questions?

还是我可以直接告诉大家，请别再问了，因为以前有用，现在没用了？

Or can I just say to people please stop asking them because it was helpful and now it's not?

你知道吗，凯西，听你说话真有意思，因为你的建议对所有人都适用，不管我们是因为生育问题压力大，还是因为家人谈论政治而烦恼。

You know Casey, it's just so fun to listen to you because there are tips for life that all of us can use, no matter if we have stress from fertility or stress from our family talking politics.

所以谢谢你的见解。

And so thanks for the insight.

好好享受吧。

Enjoy it.

谢谢。

Thank you.

还有一件事我想说。

And there is one other thing I would say about this.

这又回到你最初问的那个问题，就是我们怎么决定该告诉谁。

It goes back to the question you asked originally, which is how do we decide who to tell stuff?

然后呢？

And

我觉得这就是你练习问自己“那感觉好不好”的时候。

I would say this is where you practice asking, did that feel good or not?

通常，如果你是一个倾向于分享的人，你会觉得有些人是应该告诉的。

Commonly, if you are somebody who tends to disclose things, commonly you think there are people you should disclose to.

比如，很多女性和妈妈关系好的话，就会告诉妈妈。

For example, many women will disclose to their mothers if they have good relationships with them.

但很多女性告诉我，跟她聊其实没什么帮助，因为她觉得我应该考虑领养，或者让我放松点，诸如此类。

And yet, so many women tell me, but it's really not helpful to talk to her because she thinks I should start looking at adoption, or she tells me to just relax, or whatever.

所以再说一次，你要问问自己：跟谁聊的时候，我才真的感到被安慰了？

So again, you should say to yourself, who really comforted me when I talked to them?

那个人未必是你的妈妈。

It might not be your mother.

也许是以前大家天天去办公室上班时，那个在饮水机旁跟你搭话、说句暖心话、鼓励你别放弃的同事。

It might be, in the old days when we all went into the office, would say it might be the lady you see at the water cooler who just has a kind word to say and encourages you to keep the faith.

所以，没人有权利知道这些。

So nobody has a right to this information.

这些都属于个人隐私。

This is private stuff.

假设你们是一对异性恋夫妻，还在用传统方式尝试怀孕，你们当中有多少人会给爸妈打电话说：我今天排卵了？

If you are a heterosexual couple, and you were still trying to get pregnant the old fashioned way, how many of you would ring up your mom or dad and say, I'm ovulating today.

就是今晚动手。

Tonight's the night.

希望没几个人会这么做，因为这种事太私密了。这种态度你可以带到生育治疗的过程中去。

Hopefully not very many of you, because it's And not private you can take that attitude with you into fertility treatment.

太好了。

Excellent.

谢谢。

Thanks.

我想换个话题。

I want to change gears.

我们很多病人最后都做了试管婴儿，对吧？

Many of our patients end up with doing IVF, right?

而试管婴儿这个过程，确实可能很辛苦。

And in vitro fertilization it is, can be an onerous process.

要打很多针，至少得打十天、十二天的针。

There are lots of injections, at least ten days, twelve days worth of injections.

有时候早上打，有时候晚上打。

They have to be given sometimes in the morning, sometimes in the evening.

还要用两三种、甚至四种不同的药。

There's two or three or four different medications.

还要抽血、做B超。

There's blood work, there's ultrasounds.

我想知道，对于一起面对这个过程的夫妻，你有什么建议吗？

And I wonder if you have advice for couples trying to negotiate this together.

丈夫或伴侣想表示支持。

You know, the husband or partner wants to be supportive.

但责任很重。

There's a lot of responsibility.

有些针剂需要注射。

There's some shots that have to be given.

还需要一些技术操作。

There's some technical skills.

还要混合药物。

There's some mixing of medicines.

你是怎么指导夫妻应对这种压力的？

How do you coach couples in dealing with that stress?

所以主要的指导原则是，别让医生办公室告诉你怎么做。

So the main coaching theme is don't let your doctor's office tell you how to do it.

你们应该一起商量什么对你们有帮助。

You should talk together about what would help you.

如果你是那位想要怀孕的女性，别以为所有事情都是你的责任，因为你的伴侣很忙或者工作很重要之类的。

And if you are the woman trying to conceive, don't assume it's all your job because your partner is so busy or has such an important job or whatever.

你们真的应该把自己当作独立的个体来考虑。

You should really be thinking about yourselves as people.

我们俩谁更控制狂一些？

Is one of us more of a control freak than the other?

是不是其中一方，也就是没有在尝试怀孕的那位，在寻找更多帮忙的方式？

Is one looking for more, you know, is the partner who's not trying to conceive looking for ways to be more helpful?

什么会更有帮助？

What would be more helpful?

你害怕打针吗？你愿意接受别人帮你打针吗？

Are you fearful of injections, and would you welcome assistance with them?

你的伴侣害怕打针吗？

Is your partner fearful of injections?

就是有这么多不同的事情需要考虑。

There's just all these different things to think about.

我意识到在我们的实践中，我们经常对病人说话，好像我们已经知道事情会怎么发展。

I was aware in our practice, we often spoke to patients as if we already knew how it was going to go.

我们会对尝试怀孕的女性说，好像她当然会自己打皮下注射。

We would talk to the woman attempting to conceive as if, of course, she would give herself subcutaneous injections.

我们会对伴侣说，好像你当然会打肌肉注射。

And we would talk to the partner as if, of course, you would give the I'm injections.

但我想对你说，别让任何人在这件事上对你指手画脚。

But I would say to you, don't let anybody boss you around about this.

你不仅要考虑谁技术上能做、谁会在城里这类事情，还要考虑什么能让你在过程中感到更自信、更舒服。

You should think about not just who's technically able and who's going to be in town and that sort of thing, but what would allow you to feel more confident and more comfortable as you go through things.

所以你可能就是尝试怀孕的女性，而且你可能完全有能力自己打针。

So you may be the woman attempting to conceive, and you may be perfectly capable of giving yourself injections.

但如果你的伴侣真的很想参与，而且你也知道他们有能力，为什么不这样安排呢？即使有时候有点不方便，或者需要更多的计划。

But if your partner has really been wanting to be involved, and you also know they're capable, why not set that up, even if it's a little bit inconvenient at times or requires more planning?

打针只是一个例子。

Injections is just one example.

我觉得另一个很好的例子是，你们打算怎么处理跟保险公司打交道的事？

I think another great example is how are you going to handle dealing with the insurance company?

是全部由一个人负责，还是另一个人全包？

Should it be all one person or all the other?

还是说你们可以共享这些信息？

Or can you share that information?

验孕那天谁来接电话？

Who's going to answer the phone on pregnancy test day?

除非你要求不同的处理方式，否则电话很可能会打给正在尝试怀孕的女性。

Unless you ask for something different to be done, the call is probably gonna be made to the woman who's attempting to conceive.

但也不一定非得这样。

But it doesn't have to be.

你可以说，我希望那个电话由我的伴侣来接。

You could say I'd really like my partner to get that call.

我会回家躲起来，等消息传来。

I'm going to go home and hide until the news comes in.

我们不知道什么对你们最好。

We don't know what's best for you all.

所以，继续想想，什么能让我感觉更舒服。

So again, keep thinking what would allow me to feel more comfortable.

另一种思考方式，或者你可以问自己的另一个问题是，哪些事情是可预测的，我能参与决定怎么做，而哪些事情是我无法控制的。

And another way of thinking about this or another question you can ask yourself is what are the things that are predictable that I can have a vote in deciding how we will do them versus what are the things I can't.

所以，我可以决定谁来给我打针。

So I can have a vote in who gives me the injections.

我可以决定谁拿到怀孕测试结果。

I can have a vote in who gets the pregnancy test results.

我可以决定我和别人分享多少信息。

I can have a vote in how much information I share with others.

这些事情都能让我们更有掌控感。

All of those things enhance our sense of feeling in control.

我觉得这很有帮助。

I think that's helpful.

我觉得很多诊所都愿意配合夫妻和患者，如果他们想稍微调整一下流程的话。

I think that many clinics are willing to accommodate a couple and a patient if you know, they want to do things slightly differently.

不幸的是，手把手教学的时代已经过去了。

You know, unfortunately the days of hands on education are gone.

我们有很多视频教学和远程沟通，但总的来说，护理团队真的很不错，也很灵活，我觉得他们会尽量配合。

You know, we have lots of video instruction and lots of telecommunication, But in general, the nursing teams are really good and flexible, I think, to help accommodate.

这确实也需要患者和夫妻之间良好的沟通。

It does require good communication from the patientcouple as well.

你不能指望别人能猜到你的想法。

So you can't expect anybody to read your mind about what you want.

你也不能在走出门时随口提一句就算了。

And you can't just say it casually in the hallway as you walk out the door.

你真的得把它写下来或者发封邮件，说，请在我的病历里记一下，我们想这样处理。

You really have to like write it down or send an email and say, please put a note in my chart that this is how we want to handle this.

这和人们能怀孕时不想知道宝宝性别的情况没什么两样。

It's not that different when people are able to be pregnant from what do you do if you don't want to know the gender of your baby?

你得告诉你的医疗团队，他们得在到处贴上大标签，因为这不是大多数人的需求。

You have to tell your team, and they have to put big notes everywhere because it's not what most people want.

他们还得提醒自己要尊重你的意愿。

And they have to remind themselves to be respectful of what you want.

所以你把需求说清楚，团队就能尽量配合。

So you communicate it clearly, and the team can try to accommodate.

对，我们之前稍微提到过这一点。

Yeah, you know we touched on this a little bit earlier.

有很多不同的应对方式，没有哪一种一定比另一种更好。

There are a lot of different coping styles and you know one is not necessarily better than the other.

但我真的很喜欢你那句话，哪种应对方式最适合你？

But you know I really like your statement, what coping style works best for you?

也许我们都需要通过一些尝试和错误来发现这一点。

And it may be that we all have to discover that through some trial and error.

我觉得确实如此。

I think that's very true.

这也是生活中常见的情况，不仅仅是在生育方面。

And this is another one of those things that's true in life, not just in fertility land.

对你有用的方法可能和我有用的方法大不相同。

What is useful to you may be very different from what's useful for me.

根据我的经验，这往往是夫妻之间差异较大的一个方面。

And in my experience, it tends to be one of the things where couples are different.

就像那些神秘的方程式一样。

One of those mysterious equations.

我们被什么吸引？

What are we attracted to?

我们往往与和自己不同的人建立联系。

We tend to be connecting to people who are different from us.

所以在很多夫妻中，有一个人是我所说的“爱聊爱哭型”，他们想和伴侣谈论这件事。

So in many couples there is what I would call a talkercrier who wants to talk about it with the partner.

而且不一定是以我所说的“解决问题”的方式。

And not necessarily in what I would call a problem solving fashion.

其实更多就是聊聊这件事。

It's really more of a talking about it.

而另一个人则不是这种“爱聊爱哭型”。

And there is somebody else who's not a talkercrier.

我在异性恋夫妻中看到这种情况，但在同性恋夫妻中也绝对能看到。

And I see this in heterosexual couples, but I absolutely see it in same sex couples as well.

通常就是一方是这种，另一方是那种。

There just tends to be one of each.

在你开始思考这个问题之前，你很容易觉得：我做得对，他们做得不对。

And until you start thinking about it, it's very common for you to think, I'm doing it right, and they're doing it wrong.

你就不愿意谈这件事。

You won't talk about it.

那肯定就是你不关心。

That must mean you don't care.

你根本没我想得那么多。

You're not thinking about it as much as I am.

你在这件事上投入的程度不如我。

You're not as involved as much in this process as I am.

你从来不为这事哭。

You never cry about it.

我们看着对方，心里想的是：就我一个人在扛着。

I'm all alone in this by myself, is what we think when we look at the other person.

如果你是比较冷静、觉得说或哭没用的那个人，看着你的伴侣在那儿又哭又说，你会想：天哪。

And if you're the more stoic person who doesn't find it useful to talk or cry, you're looking at your talkercrier partner thinking, Oh my god.

要是我那样反应，我肯定已经崩溃了。

If I were responding in that way, I would absolutely be at the end of my rope.

但我们这些爱说爱哭的人知道，我们可以一边哭一边聊，同时还能把事理清楚。

But those of us who are talkercriers know that we can do that and stir the soup at the same time.

我们不能只是说说和哭。

We can't just talk and cry.

这对我们来说很熟悉。

It's familiar to us.

我们并没有到崩溃的边缘。

We're not at the end of our rope.

我们非常难过，因为生育问题确实让人很沮丧。

We're very upset because fertility challenges are very upsetting.

但我们并不是不能做其他事情。

But we're not unable to do other things.

所以我们必须告诉别人，这就是对我有帮助的方式。

So we have to say to people, this is what helps me.

然后在一对伴侣中，如果你们一个是这样，一个是那样，我强烈建议你们试着找到一些方式，在不把对方逼疯的情况下，在这件事上建立联系。

And then in a couple, if you have one of each, what I strongly encourage you to do is to try to find some ways to connect over that without making the other one crazy.

比如，你们可以约定，如果你们一起吃晚饭，每晚在晚餐时讨论十五分钟这件事。

So for example, you might agree, we will talk about this for fifteen minutes every night at dinner if you have dinner together.

至于比较冷静的那一方，我会倾听。

And on the stoic one, I will listen.

你是那个爱说话的人。

You're the talker.

你可以说。

You can talk.

但我们不会一直聊到睡觉前。

But we will not talk until bedtime.

我们不会一大早又提起这件事。

We will not do this again first thing in the morning.

因为如果你是那个人——

Because if you are the person

所以，专门留出时间，对。

So setting aside a dedicated time Yes.

用来讨论，这样就不会渗透到你生活的方方面面。

To talk about So it doesn't spill into every aspect of your life.

没错。

Exactly.

因为这也是为什么那些比较独立的人会变得回避的原因。

Because that's part of what makes more stoked people avoidant.

他们害怕一旦我问，你今天看医生怎么样？

They're afraid if I say, how did your doctor's appointment go today?

那我们就得聊到睡觉为止。

Then that's what we're talking about until we go to bed.

得有个办法既能表达关心，又不至于让这件事占据生活的每一刻。

There has to be a way to show that interest, and yet not have it take over every moment of life.

毕竟在等待怀孕的过程中，你总得想办法过好自己的生活。

Because you have to be finding ways to have a life while you wait to see if you're going to have a baby.

这得是个并行推进的过程。

It's got to be a parallel process.

同样地，如果你是不太爱聊天的那一方，但这样会让伴侣觉得孤单、觉得你不在乎，那我建议你找些方式去回应，但别长篇大论地去讨论。

Similarly, if you are the person who prefers not to talk about things, but it leaves your partner feeling alone and as if you are uninvolved, I encourage you to find ways to report but refuse to talk about it at length.

比如说，你可以说，今天早上我有个工作上的视频会议，一开始大家都在闲聊。

So for example, you might say, I was on a Zoom call for work this morning, and we were all schmoozing at the beginning.

然后莎莉提到她刚做了三个月的产检，他们都很期待宝宝的到来。

And Sally mentioned that she just had her third month ultrasound, and they're all excited about having a baby.

亲爱的，我当时也有你常说的那种感觉。

And I had the same feeling, sweetheart, that you often talk about it.

我心里想，什么时候轮到我们呢？

I thought, when is it going to be our turn?

那真的很难受。

It was so painful.

所以我想让你知道，我也会有像你那样的反应。

So I just want you to know I have those reactions like you do.

但我不想多谈这件事。

But I don't want to talk about it.

所以你要找到一种方式，做我所说的‘汇报’。”

So you find a way to do what I call reporting.

是的，我也有过那些糟糕的经历。

Yes, I have those horrible experiences.

对，这对我来说也很痛苦。

Yes, this is painful for me too.

但谈论它并不会让痛苦减轻。

But it doesn't make it less painful to talk about.

非常好。

Very good.

所以这真的很有趣。

So this has been really fun.

你知道，我希望这个播客能有很多听众，但我们现在得收尾结束了。

And you know, I'm hoping that this podcast gets wide listening audience, but we are going to have to close it up and end this.

我在想，你有没有什么想说的，或者想给那些在生育问题上挣扎、并为此压力很大的夫妻一些临别建议？

I'm just wondering, is there anything that you think, any parting advice you'd like to give to couples struggling with fertility and working through their stress around it?

我有两条最后的建议要给大家。

There are two final pieces of advice I give.

所以第一点，就是要真正承担起思考什么对我有帮助的责任，然后第二点，找到方法把这些告诉别人。

So one is really taking responsibility for thinking about what helps me and finding ways then, item number two, to communicate that to others.

因为我们常常觉得别人应该知道怎么帮我。

Because it is so common that we think people should just know how to help me.

但我们都听过朋友或病人说，我真不敢相信某某人说了那样的话。

And yet we've all heard friends and patients say, I can't believe so and so said such and such.

他们完全不懂。

They totally don't get it.

我们必须找到方法对别人说，我知道你想帮忙。

We have to find ways to say to people, I know you want to be helpful.

这才是对我有帮助的。

This is what would help me.

但首先，你得先弄清楚那是什么。

But first, you have to figure out what that is.

这很有力量。

That's powerful.

这需要付出努力，但可能会非常有帮助。

It's work, but it can be very helpful.

而且这是一场马拉松。

And this is a marathon.

正在收听这个节目的朋友们，或者是因为家人正在经历这些而收听的朋友们，这是一场马拉松。

Those of you listening to this, or if you're listening because you have family members going through this, this is a marathon.

不是短跑。

It's not a sprint.

所以你必须想办法，比如怎么补充水分，保持状态。

So you have to find ways to how do I hydrate, keep in shape.

你永远无法控制比赛中有谁，谁会赢，或者天气如何，但你可以控制自己是否有一双好跑鞋，以及是否进行了良好的训练。

You never can control who else is in the race or who's going to win it or what the weather is, but you can control if you have good sneakers and if you did good training.

你需要用这种心态来看待不孕不育问题。

And you've to think about infertility like that.

真是引人入胜。

Fascinating.

非常感谢你参加我们的节目。

Thank you very much for joining us.

这次分享非常精彩。

This has been a wonderful session.

这是我的荣幸。

My pleasure.

希望大家都有所收获。

I hope everybody found something to take away.

祝你好运，能重新和你聊天真的很开心。

Good luck, and it's just been really fun reconnecting with you.

非常感谢。

Thank you so much.

谢谢你邀请我。

Thank you for having me.

保重。

You take care.

本播客中表达的信息和观点不一定反映ASRM及其附属机构的观点。

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

这些内容仅供一般信息参考，不能替代与医生的咨询。

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