I-PGD kunye ne-PGS: I-Genetic Screening Ngaphambi kwe-IVF

Ukucwangcisa i-Genetic Screening Ukukhusela izifo nokuphucula impumelelo ye-IVF

Ubuchwepheshe bokuhlola i-Genetic njengo-PGD kunye ne-PGS, xa kuhlanganiswe ne- IVF unyango , kwenze ukuba kunokwenzeka ukunciphisa umngcipheko wokudlula izifo ezonakalisa i-genetic, mhlawumbi ukunciphisa umngcipheko wokuphuphuma kwesisu, kwaye mhlawumbi ukuphucula ingxaki yokuphumelela kokukhulelwa .

Njengoko konke kuncedisa ubuchwepheshe bokuzala, kubalulekile ukuba uqonde ukuba zeziphi iimeko zobuchwephesha ezisetyenziselwa ukusetyenziswa kuzo, ingozi ekhoyo, iindleko kunye noko ukulindela ngexesha lotyando.

Uyakubona ama-acronyms ePGD kunye ne-PGS esetyenziswa ngokungafaniyo. Zizo zombini zobuchwepheshe bokuhlola i-genetic kwaye zombini zifuna i-IVF, kodwa zihluke kakhulu kwizinto zokuba zisetyenziselwa njani kwaye zisetyenziswa njani.

Ithini i-PGD?

I-PGD ibhekisele "ukuxilongwa kwe-genetic diagnosis." Igama eliphambili apha "ukuxilongwa."

I-PGS isetyenziswe xa isifo esithile esithile (okanye isethi sithile) sesifo sofuzo sifanele sithathwe kwi -embryo . Oku kunokwenzelwa ukuba ungaphepheli ukudlula kwisifo somfuzo okanye usetyenziswe ukukhetha ukutyekela komzimba. Ngamanye amaxesha, zombini ziyimfuneko-umzekelo, xa isibini sifuna ukukhulelwa umntwana onokuba ngumdlalo we-stem cell transplant for siblings kodwa ufuna nokugwema ukudlulela kwi-geni ebangela isifo esifuna ukutshintshwa kwe-cell stem.

I-PGD ayiyivivinye enye imbungu yesifo sofuzo. Oku kubalulekile ukuqonda. Ngoko, umzekelo, ukuba umbungu awubonakali unomdla we-cystic fibrosis (CF), akutshiyo nantoni nayiphi na isifo esithile esingaba khona.

Ikunika kuphela isiqinisekiso sokuba iCF ayinakwenzeka.

Ithini i-PGS?

I-PGS imele "ukuhlolwa kwe-genetic pre-plantation". I-PGS ayibukeli izakhi zofuzo ezithile kodwa ibheka i-chromosomal jikelele eyenziwe yimbungu.

Iimbrusi ziqheleke ngokuqhelekileyo zibe zi-euploidy okanye ezine- aneuploidy . Kwiimeko eziqhelekileyo, iqanda ligalela ama-chromosomes angama-23 kunye ne-sperm enye.

Bonke, bakha imbryo enempilo ngama-chromosomes angama-46. Oku kubizwa ngokuthi i-embroyo euploid.

Nangona kunjalo, ukuba i-embryo ine-chromosome eyongezelelweyo-okanye ilahlekile i-chromosome-ibizwa ngokuthi aneuploidy. Iimbrusi ezinama-Aneuploidy ziyakwazi ukuhluleka ukufaka okanye ukuphela ekuphumuleni komzimba. Ukuba ukufakelwa, ukukhulelwa, nokuzalwa kuza kwenzeka, ama-embryid aneuploidy angabangela umntwana onokukhubazeka kwengqondo okanye ngokomzimba.

Umzekelo, i-Down Syndrome inokwenzeka xa kukho ikhophi eyongezelelweyo ye-chromosome 18 okanye 21. I-PGS inokukuchonga oku ngaphambi kokuba umbungu udluliselwe kwisibeleko. Kwezinye iimeko, i-PGS iyakwazi ukuchonga ubulili obuyimfuza yombungu.

I-Chromosome Screening epheleleyo (CCS) yindlela eyodwa ye-PGS ekwazi ukuchonga ukuba i-embryo i-XX (ibhinqa) okanye i-XY (yindoda.) Oku kungasetyenziselwa ukuphepha ingxaki yesifo somzimba okanye (ngokungaqhelekanga) ukulinganisa intsapho.

I-PGD / PGS kunye noVavanyo lwangaphambi kokubeleka luhluke njani?

Zombini i-PGD kunye ne-PGS zenzeka ngexesha lokuphambi kokuqala . Oku akufani nokuvavanywa kwangaphambi kokubeletha, apho ukufakelwa kwendawo sele kwenzeke khona. Ukuvavanywa kwangaphambi kokubeletha kunokukwenziwa kuphela ukuba ukhulelwe ukukhulelwa.

Isampuli ye-Chorionic villus (CVS) kunye ne- amniocentesis inokuchonga i- chromosomal engafanelekanga kumntwana ongakazalwa. Xa ukungaqhelekanga kukhankanywa ngexesha lokuvavanywa kokubeleka, okukhethwa kukho kukuvumela ukuba ukukhulelwa kuqhubeke okanye kupheliswe.

Oku kungenza isigqibo esinzima sokwenza.

Abo bakhetha ukuqhubeka nokukhulelwa bajamelana nokungaqiniseki kunye nokwesaba oko kuza kuzala. Ngaphandle kokukhathazeka ngokuba nomntwana onokukhubazeka okuze kube nzima, banokujamelana nobungozi bokungabikho komntwana. Abo banquma ukuphelisa ukukhulelwa babhekane nentlungu, mhlawumbi batyala, kunye nentlungu yomzimba kunye nokubuyiselwa kokukhipha isisu.

Kwakhona, abanye abantu baneenkcaso zonqulo okanye zokuziphatha ukuyeka ukukhulelwa, kodwa banelungelo lokuvavanya i-genetic ngaphambi kokutshatyalaliswa kombungu. Oko kwathiwa, i-PGD ne-PGS ayiqinisekanga. Uninzi oogqirha bancomela ukuvavanywa kwangaphambi kokubeleka ngokungezelela kwi-PGD / PGS, nje xa ukuxilongwa kwemfuyo kuphosakele okanye kungaphuthelwa.

Izizathu ezinokuthi zivivinywe kwi-diagnosis ye-Genetic Diagnosis ne-IVF

Nazi izizathu ezinokwenzeka ukuba ugqirha unokucebisa iPGD (okanye izizathu ongazicela.)

Ukuze ugweme ukudlulisa kwisifo esithile esithile esisebenza kwiintsapho : Esi sizathu esiqhelekileyo sePGD. Ngokuxhomekeke ekubeni ingaba isifo somfuzo siyi-autosomal esiphezulu okanye esiphezulu, umngcipheko wokudlulela isifo somzimba kumntwana unokuba phakathi kwama-25 ukuya kuma-50 ekhulwini.

Kwezinye iimeko, isibini esithile singasidingi i-IVF ukuba sikhulelwe, kwaye ingenakujongana nokungabikho komntwana. Isizathu sabo sokuphela kwe-IVF sinokuhlolwa kwe-PGD.

Njengoko kuchaziwe ngasentla, ukuvavanywa kwangaphambi kokubeleka kunokuvavanya izifo zofuzo, ngaphandle kweendleko ezongeziweyo, ingozi kunye neendleko zonyango lwe-IVF. Kodwa ekubeni ukhetho olulodwa lokuphela kokukhulelwa (okanye ukuqhubeka nokukhulelwa) emva kokuvavanywa kokubeleka, oku akuvunyelwanga kwezinye izibini.

Kukho izikhulu zezifo zofuzo ezingahlolwayo, kodwa ezinye zezona ziqhelekileyo zizo:

• Icystic fibrosis
• Tay-Sachs
• Fragile-X
• I-muscular dystrophy
• I-anemia yesifo
• Hemophilia
• I-spinal muscular atrophy (i-SMA)
• IAncia yeFanconi

Ukukhusela i-translocation okanye i-chromosomal rearrangements : Abanye abantu bazalwa ngama-chromosomes angama-46, kodwa enye okanye ngaphezulu ayikho kwindawo ekulindelekileyo. Aba bantu bangaba nempilo enomnye, kodwa umngcipheko wokufumana ukungabikho komntwana, ukukhulelwa kubangelwa ukukhulelwa kwesisu okanye ukuzalwa, okanye ukuba nomntwana onokungaqhelekanga kwe-chromosomal kuphakamileyo kunomlinganiselo.

Kwiibini ezithandanayo kunye ne-translocation , i-PGD ingasetyenziselwa ukunceda ukufumana ama-embrys ukuba abe nempilo.

I-anti-leukocyte antigen (HLA) yomntu ohambelana nayo, ukwenzela ukutshintshwa kwe-cell-cell : Ukutshintshwa kwe- stem-cell ukuphela kwezilwanyana zegazi. Ukufumana umdlalo phakathi kwentsapho akusoloko kulula. Nangona kunjalo, i-PGD ingasetyenziselwa ukukhetha imbungu yokuba zombini iya kuba ngumdlalo wesistim (umdlalo we-HLA) kunye nokuba unokuphepha ukugqithisa kwisifo esifanayo esifana nomntakwabo.

Ukuba i-embryo ingabonwa ukuba yinto efana nomdlalo we-HLA, kwaye ukukhulelwa kunye nokuzalwa okunempilo kwenzeka, ama-stem amaseli afunekayo ukugcina ubomi bomntakwabo angakuqokelelwa kwintambo yegazi ekuzalweni.

Ukuze ugweme ukudluliselwa kwisifo somntu omdala : Ukusetyenziswa kancinci kwePGD kukugwema ukudlulisa ukuthambekela kofuzo okungabangela izifo emva koko.

Umzekelo, i-BRCA-1 yesifo somhlaza wesifuba. Ukuba le geni ayithethi ukuba ngokuqinisekileyo umntu uya kuvelisa umdlavuza webele, kodwa umngcipheko wabo uphezulu. I-PGD ingasetyenziselwa ukukhenkca ama-embroshiya kwi-BRCA-1. Eminye imizekelo ibandakanya isifo seHuntington kunye nesifo sokuqala se-Alzheimer.

Izizathu ezinokwenzeka zokuhlolwa kweGenesis Genetic Screening (PGS / CCS) kunye ne-IVF

Nazi ezinye zezizathu eziqhelekileyo zePGS ezinokusetyenziswa ngonyango lwe-IVF.

Ukuphucula imingcipheko yokuphumelela ngokuchithwa kwe-embryo eyodwa : Iiphando ezininzi ziye zafumanisa ukuba i-PGS inokukunceda ukuphucula iimeko zokukhulelwa nokunciphisa umngcipheko wokukhulelwa kwesisu, xa ukhetha ukutshintshwa kwe-embryo.

Ngokudluliselwa komntwana oyedwa okanye u-eSET , ugqirha wakho udlulisela umlwelwe owodwa onempilo ngexesha le-IVF. Oku kunokuba kudluliselwe ama-embryo amabini ngexesha elilodwa, inzululwazi eyenza ukuba iphumelele kwimpumelelo kodwa ihamba nayo ingozi yokukhulelwa iindidi. Ukukhulelwa okuninzi kuzisa ingozi kumama nakwimpilo yabantwana .

Ngaphandle kwe-PGS, i-embryo ikhethwe ngokuqhelekileyo ngokusekelwe kwindlela ebonakala ngayo. Kufunyenwe, nangona kunjalo, ukuba iimbumba ezingabonakali ziphantsi phantsi kwe-microscope zinokwenene ziphilile. Iimbrusi ezibukeka ziyimpilo zingahle zibe njengechromosomally eziqhelekileyo njengoko zivela. I-PGS ithatha enye yokuqikelela.

Ukuchonga ubulili bofuzo : Ngokuqhelekileyo kusetyenziswe xa isifo somfuzo sisisiseko esisekelwe ngokwesini, i-PGS inokukunceda ukuba uqaphele ukuba i-embryo yindoda okanye indoda. Le ndlela ingaba yindleko ephantsi kakhulu yokuphepha isifo somfuzo kunePGD.

Nangona kunjalo, i-PGS ingasetyenziselwa ukunceda isibini sinomntwana wesini esithile xa bethemba "ukulinganisela" intsapho yabo. Ngamanye amazwi, sele sele benenkwenkwe kwaye ngoku bafuna intombazana, okanye ngokufanayo. Oku kwakunqabile ukuba kwenzeke ukuba eso sibini sasingafune i-IVF ngesinye isizathu.

Enyanisweni, i-ASRM kunye ne-American College yezilwanyana zezilwanyana kunye ne-Gynecologists (ACOG) ngokusemthethweni ngokuchasene nokusebenzisa i-PGS yokukhetha ngokwesini ngaphandle kwesizathu sonyango.

Ukunciphisa umngcipheko wokuphulukana nokuphuphuma komzimba kwabasetyhini abanembali yokulahleka kokukhulelwa okuphindaphindiweyo : Ukutshatyalaliswa kwempahla kuqhelekileyo, kwenzeka kwi-25 yeepesenti zokukhulelwa. Ukuphuphuma kwesisu ngokuphindaphindiweyo-ukuchitha ilahleko ezintathu okanye ngaphezulu ngokulandelana-akunjalo. I-PGS ingasetyenziselwa ukunciphisa iimeko ezibangelwa ukukhulelwa komzimba.

Uphando malunga nokuba ngaba i-PGS ingakwazi ukuphucula ngokwenene ukukhulelwa kwabafazi abanembali yokulahlekelwa ngokuphindaphindiweyo kokukhulelwa kungabonakali. Kwiibini ezithandana kunye ne-chromosomal translocation, okanye isifo esithile somzimba esenza umngcipheko wokulahleka okanye ukuzala, i-PGD (ayiyi PGS) ingaba nengqiqo.

Nangona kunjalo, iibini ezilahlekileyo ezingaxhunyekanga kwisimo esithile sokuzalwa kwegazi, nokuba i-IVF kunye ne-PGS inokwandisa amathuba okuzalwa ngokuphilileyo ngaphandle kokuzama ukuzimela ngokwemvelo. Kukho umngcipheko omncinci wokufumana ukukhulelwa komzimba, kodwa ukukhulelwa okusemgangathweni kunye nokuzalwa akunakufika kungekudala.

Okwangoku, i-American Society of Medicine Reproductive does not recommend IVF kunye ne-PGS ukunyanga ukuphuphuma kwesisu.

Ukuphucula impembelelo yokuphumelela ukukhulelwa kwezigulane ze-IVF : Abanye oogqirha abanokwenza i-PGS kunye ne-IVF banokukhuthaza ukwanda kweengxaki zokuphulukisa unyango kwiimeko ezinobunzima bokungabikho komntwana , izibini eziye zahlangabezana nokuphumelela kokuphindaphindiweyo kwe-IVF, okanye abafazi abaneminyaka engama-12 . Ezinye iikliniki zinika iPGS nge-IVF kubo bonke abagulayo.

Okwangoku uphando oluncinane lubonisa ukuba i-PGS iya kuphucula impumelelo yonyango lwe-IVF xa ingaboniswa ngokuthe ngqo. Izifundo ezininzi ezifumene imilinganiselo ephezulu yeempumelelo zijonge amazinga okuzalwa ngokuhamba ngokutshatyalaliswa kwembungu- kungekhona ngomjikelezo ngamnye. Oku kuya kuhlala kuphakamileyo kunamazinga omjikelezo, kuba akusiyo yonke imjikelezo ye-IVF eyafumana ama-embrosi. Kunzima ukuqonda ukuba kukho inzuzo ngokwenene. Izifundo ezininzi kufuneka zenziwe.

Iimbusi zenziwe njani?

Ukuze wenze naluphi na uvavanyo lwezofuzo, iiseli ezisuka kumbindi kufuneka zifakwe kwi-biopsied. I-zona pellucida iyigobolondo elikhuselekileyo elivulela imbungu. Uluhlu olukhuselekileyo lufanele luphulwe ukwenzela ukuba i-biopsy ezinye iiseli. Ukugqithisa, i-embrologist ingasebenzisa i-laser, i-asidi, okanye inaliti yesaliti.

Emva kokuba kufakwe umnyango omncinci, iiseli eziza kuvavanywa zisuswe okanye zitshatywe nge-pipette, okanye i-embryo ityunyiwe kuze kube yilapho iiseli ezimbalwa ziphuma ngokuvulwa.

I-Biopsy ye-embryo ingenziwa iintsuku ezintathu emva kokuqumba okanye iintsuku ezintlanu. Kukho ubuchule kunye nokuqhelana ngamnye.

Usuku 3 I-Bibrsy Embryo : Umbungu ngomhla we-3 ubizwa ngokuba yi-blastomere. Unamaseli ayisithandathu ukuya kwesithoba kuphela. Kunokwenzeka ukwenza ukuhlolwa kwesimo somzimba kwisisele esisodwa nje, kodwa ukuthatha ezimbini kubhetele.

Enye yeenzuzo ezininzi zokwenza i-biopsy ye-Day 3 kuhlolwa kungenziwa ngexesha lokutshintshwa kwe-embrasi entsha ngomhla we-5 emva kokufunyanwa kweqanda. Oku kuthetha ixesha lokulinda elingaphantsi kunye neendleko eziphantsi (ekubeni unokuba ungadingi ukuhlawulela ukutshintshwa kwebraza.

Nangona kunjalo, uphando oluthile lufumene ukuba i-biopsy yesisitye esinye kwisigaba sandisa ingozi yokubanjwa kombindi. Umbungu ungayi kuphuhlisa kwaye awukwazi ukutshintshwa. Oku kunqabile, kodwa kusenomngcipheko wokuqwalasela. Kwakhona, umngcipheko weempembelelo zobuxoki kunye neziphumo ezibandakanya zikhulu kunye ne-Day 3 biopsy.

Usuku 5 I-Biopsy Embryo : Usuku lwe-5 Umbungu ubizwa ngokuba yi-blastocyst. Kule nqanaba, umbungu unamakhulu eeseli. Ezinye zala maseli ziya kuba ngumntwana, ezinye zi-placenta. I-embryologist ingathatha ezinye iiseli ukuvavanya-ngokuqhelekileyo kuthatha phakathi kwe-5 no-8-ezinokuvumela ukuxilongwa okungcono kunye neziphumo ezingaphantsi kweziphumo. Iiseli ezithathiweyo zijoliswe ukuba zibe yi-placenta; iiseli ze-fetal zishiywe zingakhange zihlolwe.

Ukungahambi kakuhle kwe-Day 5 biopsy kukuba akuyiyo yonke imibusi ehlala kwindawo yebhanki iintsuku ezininzi, nangona kunjalo i-embroyo enempilo.

Kwakhona, usuku lwe-5 lwe-biopsy ludinga ukuba i-embryos ichithwe kuze kube yilapho iziphumo zibuyela. Oku kuthetha ukuba ibhinqa liya kufuna ukulinda de ubuncinane inyanga ezayo ukwenza ukutshatyalaliswa kwembungu. Kuya kuba ngumjikelo wokutshintshwa kwebraza. Oku kuthetha ixesha lokulinda elongezelelweyo kunye neendleko ezongezelelweyo. Kukho umngcipheko wokuba ama-embryo awanakuphila kwi-frozen and frow.

Nangona kunjalo, iimbumba ezinamandla kuphela zihlala zihlala emva kwenkqubo. Abo baphila kwaye baneziphumo ezilungileyo zePGS ziyakwazi ukukhokelela kwimiphumo enempilo.

Iyintoni Inkqubo ye-IVF kunye ne-PGD kunye ne-PGS?

Kukho ukungafani kwindlela umjikelezo wonyango lwe-IVF ohamba ngayo uvavanyo lwe-PGD okanye iPGS.

Okokuqala, nge-PGD, inqubo ingaqalisa inyanga ngaphambi kokuba unyango lwe-IVF. Kuxhomekeke kwi-diagnostic ethile ye-genetic efunekayo, ukuhlolwa kofuzo lwamalungu entsapho kunokufuneka. Oku kuyadingeka ukudala iprobhethi yomzimba, efana nemephu echanekileyo ukuchaneka ngqo apho ukungaqhelekanga kofuzo okanye umakishi.

I-PGS ayifuni ukuhlolwa kofuzo lwamalungu entsapho kwaye ibandakanya ukuhlola ii-embrosi. Ngexesha lomjikelezo we-IVF, i-patient experience ye-PGS ne-PGD iyafana, nangona ubuchwepheshe bezakhi zobugcisa behlela kwilebhu. Ukuba awuqhelanga unyango oluqhelekileyo lwe-IVF, funda le nkcazo ngenyathelo lokuqala.

Lapho i-IVF yokuhlola i-genetic ihluke kwiinkqubo eziqhelekileyo kunyango. Ngokuqhelekileyo, emva kokuchumisa, nayiphi na imibusi ephilileyo iyaqwalaselwa ngokutshintshwa kweentsuku ezintathu okanye ezintlanu emva kokufunyanwa kweqanda. Nge-PGS okanye i-PGD, iibrashi zixutywa ngomhla we-3 (emva kokufunyanwa kweqanda) okanye uSuku 5. Iiseli zithunyelwa ukuvavanya. Ukuba ama-embrasi ahlolwayo ngomhla we-3, iziphumo zingabuya ngaphambi koSuku 5. Ukuba kunjalo, nayiphi na imibusi eneziphumo ezinokuthi ziqwalaselwe ukutshintshwa kwaloo mjikelo. Iimbrusi ezingaphezulu ziyakunqunyulwa ngomnye umjikelo.

Nangona kunjalo, njengoko kuchazwe ngasentla (kwicandelo le-biopsy embryo), umhla we-5 we-biopsy unokucetyiswa okanye ukhethwa. Kule meko, iibrashi zixutywa kwaye zikhawuleza zitshintshwe. Akukho mibusi iza kutshintshwa ngexesha lomjikelezo we-IVF kulo mzekelo. Esikhundleni saloo nto, baya kuhlala "kwiqhwa" kude kube neziphumo ezivela kwiimvavanyo zofuzo.

Emva kokuba iziphumo zikhoyo, ukucinga ukuba nayiphi na imibusi ithathwa njengokutshintshwa, loo mfazi uya kuthatha imishanguzo yokunciphisa i-ovulation kwaye ilungiselele isibeleko sokufakelwa. Ngexesha elifanelekileyo, enye okanye imibhobho embalwa iya kugqitywa kwaye ilungiswe ukuthunyelwa.

Xa kukhethwa usuku lwe-biopsy ne-frozen embryo yokudlulisa umjikelezo, ixesha lokunyanga linokuthi lithatha ezimbini ukuya kweenyanga ezine (ngexesha lokuphumla kwenyanga / ixesha lokulinda.)

Iingozi zePGD / PGS

I-IVF ne-PGS kunye ne-PGD iza nazo zonke iingozi zonyango lwe-IVF.

Ukongezelela kuloo mngcipheko, nabani na abaqwalasela i-PGD / PGS kufuneka baqonde le mingcipheko eyongezelelweyo:

• Amazinga okuzalwa aphilayo angaphantsi kuneentanga ezifanayo. Oku kungenxa yokuba ezinye iibrabhu aziyi kuphila kwinkqubo kwaye ezinye (okanye zonke) zingabuya neziphumo ezibi.
• Ngosuku lwe-5 ye-biopsy, kukho ingozi encinane yokwahlula okufanayo.
• Iimpawu ezingamanga kunye nokunyaniseka kwamanga kunokwenzeka. Ngamanye amazwi, imibungu engaqhelekanga ingavavanya "iqhelekileyo," kunye nama-embryo aphilileyo angabonwa ngephutha ngokungaqhelekanga kwaye alahlwe. Ngenxa yokukhathazeka ngokweqile, kukho umngcipheko wepesenti we-2 we-embrasi ekufumaneni umphumo oqhelekileyo xa ungaqhelekanga, kunye nengozi ye-11 yeengxaki ze-genetic eziphambili.
• Ukuba zonke iimbumba zibuya neziphumo ezibi, akukho nto ingayifaka.
• Iziphumo ezingabonakaliyo zenzeka. Eyaziwa nangokuthi iibrashi ze-mosaic, yilapho ezinye iiseli zibonakala ziqhelekileyo ngokuqhelekileyo kwaye ezinye azizi. Ezinye iziphumo ziye zafumanisa ukuba iibrashi ze-mosaic ziyakwazi ukuzilungisa kwaye zingakhokelela ekukhulelweni okunempilo nangomntwana.
• I-cryopreservation kunye nokuthabatha okulandelayo kunokukhokelela ekulahlekeni kwamanye ama-embrosi enempilo.
• Ezinye iimbrusi ezinempilo zingenakuhlala zize zifike kwiSuku 5 emva kokufunyanwa kweqanda.
• I-Biopsy ye-Day 3 i-embrasi ingakhokelela ekubanjweni kombungu, apho i-embryo iyeka ukukhula.
• I-PGD / PGS ayikho into engathembekanga, kwaye umntwana ophethe isifo somzimba okanye isifo angasenza. Ukuvavanywa kwangaphambi kokubeleka ngaphezu kwePGD / PGS Kunconywa ngesiqinisekiso esongezelelweyo.
• I-PGD / I-PGS emihle kunye nokuvavanywa kwangaphambi kokubeletha akuqinisekisi ukuba umntwana akayi kuphazamiseka ngumzimba okanye ukukhubazeka kwengqondo kwezinye iintlobo.
• Umngcipheko wokukhulelwa kwesisu ungaphantsi kunye nemibungu eqhelekileyo ye-PGS, kodwa kusekho umngcipheko wokulahleka kokukhulelwa.
• Ukulindela iziphumo kunye nokufuna ukwenza izigqibo malunga nama-embrasi kunye neziphumo ezingenakulinganiswa zinokuba nzima ngokomoya.
• I-teknoloji intsha kangangokuba asiyazi ngokuqinisekileyo ukuba yintoni umphumo wesikhathi eside ungaba kubantwana abazalwa emva kwe-IVF-PGD / PGS. Nangona kunjalo, iziphumo zakuqala zikhangeleka kakuhle. Izifundo ezimbini ezincinci zifumene ukuba aba bantwana abasengozini yokwanda kokuphuculwa. Baye baba nezisindo zokuzalwa eziqhelekileyo.

Ingakanani i-PGS / PGD Indleko?

I-IVF sele ibiza. Ukongeza ngeendleko zePGS okanye i-PGD iphakamisa ukuba itekisi yentengo iphezulu. Ngokomyinge, i-PGD / i-PGD yongeza phakathi kwe-$ 3,000 kunye ne-7,000 ukuya kwi-IVF. Iindleko zakho malunga nomjikelezo owodwa we-IVF kunye ne-PGS / PGD ingaba phakathi kwe-$ 17,000 kunye nama-25,000.

Ngaphezulu, ungadinga ukuhlawula umjikelezo we-embraced transfer (FET) umjikelezo. Oku kuya kuba ngu-3,000 ukuya kwi-5,000. Ngamanye amaxesha, izigulana zifuna ukucwangcisa umjikelo weFET ngokukhawuleza emva komjikelezo we-IVF. Ngale ndlela, ngokukhawuleza ukuba iziphumo zokuhlolwa kweemfuyo zibuyele, ziyakwazi ukudlulisela nayiphi na imibusi eqhelekileyo ngaphandle kokulinda inyanga eyongezelelweyo.

Nangona kunjalo, ingxaki enokwenzeka ngale ndlela kukuba ukuba akukho iibrasi eziqhelekileyo zokudlulisa, ezinye zeendleko ze-FET ziya kuchitha. Naliphi na izidakamizwa zokuzala ezithathwe ekunqandeni i-ovulation kwaye zilungiselele isibeleko sokufakela i-intlantation ziya kuthathwa ngaphandle kwesizathu.

Ukulinda inyanga eyongezelelweyo kunokunzima ngokomzwelo, kodwa ingenza imali ibe nengqiqo. Nge-PGD, unokuba neendleko ezingaphezu kweyonyango ngokwayo. I-PGD ngezinye ixesha ifuna ukuhlolwa kofuzo lwamalungu entsapho, kwaye ezo ndleko aziyi kufakwa kwixabiso lakho leklinikhi yokuzala kwaye mayinakugqutywa yi-inshurensi.

Igama elivela kwi-Verywell

Ukuhlolwa kwe-Genetic kuye kwabanceda iintsapho ngezifo zofuzo okanye i-chromosomal translocations zinethuba elingcono lokuba nomntwana onempilo kwaye kugweme ukudlula izifo eziphazamisayo. Ukuhlolwa kwe-Genetic kuye kwabanceda oogqirha ukuba baphucule ukhetho lwamaqanda ekukhethweni kwe -embryo .

Ingaba i-PGD / i-PGS inokuphucula imilinganiselo yokuzalwa ephilayo ngaphaya kwezi meko ayicacanga. I-teknoloji isele ibe yintsha yaye ihlala ishintsha. Ukusebenzisa i-PGS ukuphucula izinga lokuzalwa lokuzalwa kwi-IVF xa iteknoloji ingaboniswa ngokucacileyo ingquzulwano.

Abanye oogqirha bathi babona impumelelo ephuculweyo, ngelixa abanye bebuza ukuba ngaba kuyafaneleka ukuba iindleko ezongezelelweyo nezingozi. Abanye bacinga ukuba kufuneka unikezwe kwisigulane ngasinye se-IVF; abanye bakholelwa ukuba kufuneka banikwe ngokungaqhelekanga, kwiimeko ezithile.

Kungenzeka ukuba i-PGS inokukunceda ukuphepha ukutshintshwa kwama-embrosi okuza kupheliswa ngokungahambi kakuhle. Nangona kunjalo, oku akuthethi ukuba esi sibini asiyi kuba nomphumo wokukhulelwa okusemgangathweni kunye nokutshintshwa kwe-embryo eqhotyoshelweyo (FET) ukusuka kumjikelezo ofanayo.

Ngokomzekelo, masithi isibini sithatha ama-embryo amathathu. Masibe besenza i-PGS kwaye bafumana ezimbini zeembrusi ziqhelekileyo. Enye okanye ezimbini zithunyelwa, kwaye masithi ukukhulelwa kwenzeka kumjikelezo omnye okanye ezimbini. Ngoku, masithi loo mbhangqwana inqume ukuba ingenzi iPGS, kwaye yenzeke ekudluliseni kuqala umbungu nge-chromosomal engavamile. Lo mjikelo uya kugqiba ekuphumuleni. Kodwa banesibindi esisodwa okanye ezimbini ezilindele ukuba zitshintshwe kwaye zitshintshwe, kwaye ziyakwazi ukufumana umntwana onempilo kwenye yale mibungu. (Kwiimeko ezintle kakhulu, ngokuqinisekileyo.)

Okwangoku, uphando lubonisa ukuba iingxaki zokuzalwa eziphilayo zifanayo kwimeko nganye-kunye ngaphandle kwe-PGS. Kodwa kukho iindleko zomzwelo zokufumana ukuphuma kwesisu. I-PGS ayinakususa iimeko zokulahleka-nakuba kubonakala ngathi ukunciphisa umngcipheko.

Nguwe kuphela ugqirha wakho onokugqiba ukuba i-IVF ne-PGD / PGS ilungele intsapho yakho. Ngaphambi kokuba uthathe isigqibo, qiniseka ukuba uyazi ukuba kutheni ugqirha wakho uncoma le teknoloji yokuzalisa inzala kuwe, iindleko ezipheleleyo (kubandakanya i-cryopreservation kunye ne-FET imijikelezo), kunye nemingcipheko engozi.

> Imithombo:

> Umntu we-EJ1, uTao X, u-Ferry KM, u-Taylor D, u-Treff uNR, i-Scott RT Jr. "Ukudluliselwa komzimba ongaphantsi kwe-chromosome ekuboniseni ukukhulelwa kwezinga lokukhulelwa okuqhubekayo kunye nokwehla kwamanani omzimba. "Uhlambalaza. 2012 kuMatshi; 27 (4): 1217-22. i-doi: 10.1093 / i-humrep / des020. Epub 2012 Feb 16.

> IKomiti yokuSebenza koMbutho weTeknoloji yokuThuthukiswa koNcedo; IKomidi yokuSebenza ye-American Society kwiMithi yokuzala. "Ukuhlolwa kokuvelisa izifo zofuzo: imbono yecomputer yekomiti." Fertil Steril. 2008 Nov; 90 (5 Suppl): S136-43. i-doi: 10.1016 / j.fertnstert.2008.08.062.

> Schattman, Glenn L; Xu, Kangpu. Ukucwangciswa kwe-genetic preplantation. UpToDate.com.

> Schattman, Glenn L. Ukuxilongwa kwe-genetic diagnosis. UpToDate.com.

> INtshumayeli K1, Capalbo A2, Cohen J3, Coonen E4, De Rycke M5, De Vos A6, Delhanty J7, Fiorentino F8, Gleicher N9, Griesinger G10, Grifo J11, I-Handyside A12, iHarper J7, iKokkali G13, iMastenbroek S14, i-Meldrum D15 , Meseguer M16, Montag M17, Munne S18, Rienzi L19, Rubio C20, Scott K21, Scott R22, Simon C23, Swain J24, Treff N22, Ubaldi F19, Vassena R25, Vermeesch JR26, Verpoest W6, Wells D27, Geraedts J4. "Kutheni, indlela kunye nexesha lika-PGS 2.0: iinkqubo zangoku kunye neengcamango zengcali zengcali, i-molecular biologists kunye ne-embrologists. "I-Hum Hum ihlaziyekile. 2016 Aug; 22 (8): 845-57. i-doi: 10.1093 / molehr / gaw034. Epub 2016 Juni 2.