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主人和客人表达的所有想法和观点都是他们自己的，并不一定反映他们所属机构的观点.
Is 40 the Cutoff Age for Having a Baby?
面试官: When is it too late to have a baby from a woman's point of view? 我知道有很多夫妻在他们的生活中越来越晚地推迟这件事，直到他们更舒服. I've always heard 40 is the cutoff. Is that the cutoff or not?
Dr. 琼斯: Well, actually yes and no. There is a decline in fertility that begins at about age 28. 现在, 它不像28会关闭开关或者40会关闭开关, 每个女人都有差异但关键是没有测试. You can't drive in and plug your ovaries in and say, "Am I still fertile?" So, 等待太久的最大问题不是你会生一个有先天缺陷的孩子或者你会有怀孕并发症, it's that you're not going to get pregnant at all.
面试官: 真的? Because I always thought that after 40, the percentage of complications increased dramatically, is that not true?
Dr. 琼斯: 它开始... 所以，问题是“并发症”，什么是“戏剧性”，什么时候开始?
面试官: And what are the complications?
What Are the Complications of Pregnancy?
Dr. 琼斯: And what are complications? It always depends, right? So, 事实上, 我认为人们最担心的是生一个有先天缺陷的婴儿的并发症, that's not something that a doctor can actually fix, so we're talking about complications for the mom, complications for the baby, and complications genetically.
So, we know that the older the egg is, 就异常染色体而言，并发症越多. 21三体或唐氏综合症是大多数人都知道的. Well, that number actually starts going up in the 30s.
And so the chance at 35 is about 1 in 200, the chances at 40 is about 1 in maybe 100, the chances at 44 might be 1 in 20 to 30.
面试官: 好吧, so, these chances are that there could be genetic defects in the egg, not necessarily that that's going to translate into anything bad.
Dr. 琼斯: 因为卵子中的大多数遗传缺陷根本不会产生婴儿.
面试官: 好吧.
Dr. 琼斯: So, when we're talking about abnormalities in the egg, most of the eggs after women get to their late 30s are abnormal.
面试官: 好吧.
Dr. 琼斯: 所以，如果大多数卵子都是不正常的，那么大多数卵子实际上都不会生出孩子.
Miscarriage Rates
Dr. 琼斯: So, 从30岁出头开始，怀孕和保持怀孕的几率就会下降，但35岁以后，怀孕和保持怀孕的几率会急剧下降. 所以最大的问题是怀孕因为怀孕的几率下降并且保持怀孕因为这些异常导致 流产. So, 20岁出头的女性流产率可能为15%, by their 30s it might be 20 percent, 但到了40多岁，这个比例可能会达到40%，然后达到50%.
And that's the 流产 of those that are detected. 很多怀孕开始的时候甚至都没有严重到被称为流产的程度.
面试官: 哦,真的?
Male Infertility
Dr. 琼斯: 现在，大发娱乐还没有谈到精子，但请让我抓住这个机会. We know that men as they get older have abnormal sperm too. So, aging and sperm 对精子不好，而且随着男性年龄的增长，有些疾病会更常见. 因此，精子质量会随着年龄的增长而下降，但通常不会急剧下降，直到男性年龄稍大一点，接近40岁, 50s, 和60年代. So, there is that issue. That's the chromosomal issue that people are worried about.
很明显 women as they get older have an older body. They have more hypertension. They may have more diabetes. 她们的问题使她们在怀孕期间更容易出现并发症. 所有这些都随着年龄的增长而增加，但大多数情况下，你可以通过一个好医生和一家好医院来解决这些问题.
面试官: So, not too much to worry about there, generally.
Dr. 琼斯: 一般. 现在, 对于那些想要使用这项技术的人来说，好消息是大发娱乐有了一种侵入性更小的技术来检测那些随着年龄增长而增加的基因缺陷. So, women who are older, 那些成功怀孕并保持怀孕状态的人如果发现自己有遗传缺陷，可以做一些早期筛查并决定是否继续怀孕.
现在, this is taking populations. 很明显, there are some women who start to run out of eggs earlier, so they'll be less fertile in their 30s, 有些女人很幸运有一大堆多余的卵子. Those women who have 绝经后期 have babies early and often have babies without difficulty, well into their early to mid-40s, 但在你所研究的人群中，45岁以后成功怀孕的女性很少.
High-Risk Concerns for Pregnancy
面试官: 所以，对于那些可能来到你办公室的夫妇来说，这听起来像是一个个案的基础，真的.
Dr. 琼斯: 它是.
面试官: And it sounds like getting pregnant is the hardest part. The other issues are not so much.
Dr. 琼斯: Getting pregnant and staying pregnant.
面试官: Yeah, the other issue is not so much the concern.
Dr. 琼斯: 现在, these are low-risk women. 所以如果一个女性糖尿病患者或者高血压患者来就诊, or someone who's come in who's had cancer treatment. Theirs are situations that are going to be much different. 当然, 这并不是说你应该在你最适合生育的时候跑出去生孩子, 哪一个可能是你20岁出头因为你可能没有结对关系, you may not be ready for the responsibility, for the rest of your life of caring for another person that way. So, that's always a trade-off.
但我认为人们应该意识到推迟怀孕是一种生活方式问题, 意义, you've pair-bonded, you have enough time, 努力, and money to be a good parent, 然后, 如果你真的想要那个孩子，推迟事情对你并没有多大大发娱乐.
面试官: So, what's the major takeaway that you'd have?
Dr. 琼斯: 主要的结论是，作为一种生活方式，推迟怀孕是很好的，但记住，所有这些都是有代价的. 所以，如果你在事业上很忙，你在忙着找一个可以结对的人, to raise children with, the later you wait, there may be some consequences. We have all kinds of technology to help people who wait too late. So we have what we could do for 40多岁的人不能怀孕，也不能继续怀孕大发娱乐可以用别人的精子，大发娱乐可以用别人的卵子. 大发娱乐可以做很多事情，但如果你等到35岁左右再组建家庭, it may not go as easily as you hope.
面试官: So, the getting pregnant, staying pregnant aside, is 40 too late? 45岁太晚了吗？? 50岁太晚了吗？? Is there a cutoff line?
Dr. 琼斯: No, there's not a cutoff line because people... I'd love to say every pregnancy was planned. 记住，大发娱乐有一半的怀孕是计划外的，大发娱乐不会说，“哦，你来晚了。. You can't carry this pregnancy." No, 从某种意义上说，还不算太晚，我认为这只是被告知, 我想现在大多数人都知道，如果你在40多岁的时候生了孩子, if you get pregnant in your 40s, there are going to be more things to screen for, 在染色体出生缺陷方面有更多的问题需要筛查, but if you can get pregnant, 在怀孕, and have the early screening, you're probably going to be okay.
updated: October 4, 2024
originally published: August 21, 2014