Abaphenduli abampofu, Ukubuyiswa kwe-Egg, kunye noTshintsho lwe-Embryo elidlulileyo
Ukukhishwa komjikelezo we-IVF ngokubhekiselele kubhekiselwa xa inani elincinci lezintluli zikhula kwiiyunithi ngexesha lokuvuselela unyango, kwaye ukufunyanwa kweqanda kukhanseliwe. Abasetyhini abanamaqanda awavelanga amaqanda aneleyo (okanye i-follicles) ngexesha lonyango kuthiwa "abaphenduli abasweleyo." Phakathi kwama-5 no-35 ekhulwini kwabasetyhini abaphenduli abasweleyo .
Nangona ukuhluleka ukuvelisa iifollic ezaneleyo zokufumana iqanda yisinye sezizathu zokujikeleza kwe-IVF, umjikelo wakho unqunyulwa, ulibazisekile, okanye awuyi kuzaliswa kwezinye izizathu.
Eminye imizekelo ibandakanya ukuba ambalwa amaqanda angaboniswa, ukungaphumeleli kwamaqanda ukutshala, ukungaphumeleli kweembryu ukuphucula ngokuqhelekileyo, okanye ingozi yokuphuhlisa i-ovarian hyperstimulation syndrome . (Izizathu ezongezelelweyo zokuphelisa umjikelezo we-IVF okanye ukulibaziseka zidweliswe ngezantsi.)
Ukuba umjikelezo wakho we-IVF ukhansekile okanye ulibazisekile unokuxhalabisa. Ngalolu nqanaba, utyalombile ixesha, amandla omzwelo kunye nemali ebalulekileyo. Ukungena kwisigaba sokutshintshwa kwembungu kunokuba buhlungu.
Oko kwathiwa, ukujikeleza okanye ukulibazisa umjikelo akuthethi ukuba umjikelezo wakho olandelayo ulungele ukuphela kwesigwebo esibi. Kwaye, ngamanye amaxesha, unokukwazi ukuhamba nomjikelezo naphezu kweencomo zokurhoxisa okanye izibonakaliso zokusasazeka.
Nakhu okufuneka ukwazi ukuqonda ukujikelezwa kwe-IVF yokukhansela kunye nokwenza izigqibo ezinolwazi.
Isizathu sokuba i-IVF Cycle yakho ihlawulwe, idibene okanye ayikwazi ukugqiba
Kuphela malunga nomntu oqala umjikelezo we-IVF uyazi ukuba ukukhulelwa nokuzalwa okungaqinisekanga.
Kodwa abaninzi bayamangalisa ukuba abayifaki ekudlulisweni kwembungu.
Nazi ezinye izizathu ezinokuthi umjikelezo wakho we-IVF ungabambezeleka, ukhansele, okanye ungaphumeleli ukufikelela ekudlulisweni kwembungu.
Isiseko se-ultrasound okanye ingxaki yomsebenzi wegazi : Ekuqaleni komjikelezo we-IVF (okanye nayiphi na umjikelo wonyango wenzalo ), umsebenzi ogqityiweyo we-ultrasound kunye nomsebenzi wegazi uyalelwa.
Oku kwenziwa ngokukodwa ukuqinisekisa ukuba akukho i-cysts kuma-ovari. Ukuba i-cyst ifunyenwe, unyango lungadinga ukulibaziseka.
Ezi i-cysts ziqhelekile kwaye ziya kuhamba ngaphandle kwongenelelo olongezelelweyo. Emva kokuba isisombululo, unokukwazi ukuqala umjikelezo we-IVF emva kokulibaziseka okufutshane, okanye unokususwa kwenye inyanga.
Akukho follicle ezaneleyo eziphuhlisayo : Okukhankanywe kwangaphambili, yilo xesha i-ovaries ingaphenduli kunye nokulindeleke kwiziyobisi zokuzala . Zingaphi iintlobo "ezinganeleyo"? Incazelo "ephantsi kakhulu" iyahluka phakathi koogqirha, kodwa ngokuqhelekileyo, iintlobo ezintathu okanye ezimbalwa ziza kuhoxiswa. Abanye oogqirha baya kuhoxisa umjikelo ukuba kukho iintlobo ezingaphantsi kwamahlanu.
Ukuba awunayo i-follicles eyaneleyo, ukubuyiswa kweqanda kunokukhanselwa kwikliniki yakho, okanye ugqirha wakho unokuncoma ukukhansela kodwa akuvumele ukuba wenze ucingo lokugqibela malunga nendlela yokuqhuba. Ugqirha wakho uya kuncomeka ukuba uhlele iseshoni yokubonisana ngokulandelelana malunga nokokuqwalasela umjikelezo wonyango ozayo.
(Oko konke, ngendlela, kuthatha ukuba unokwelashwa kwe-IVF yonyango. Ukuba unomjikelezo "wezemvelo" we-IVF, okanye umjikelezo "we-mini-IVF" , ukufumana enye okanye iifollic ezimbalwa kulindeleke kwaye nenjongo.)
Amanqanaba e-estrojeni aphantsi : Ukuba ama-estrogen aphantsi kunokuba kulindeleke ngexesha le-ovulatory stimulation inxalenye yomjikelezo wakho, oku kungabonisa iingxaki ngokuphuhliswa komthetho.
Umjikelezo awunqabile ukukhanselwa kuphela ngenxa yamanqanaba e-estrojeni angaphantsi-anqwenelekayo-ngokuqhelekileyo, isigqibo esenziwe ngokusekelwe kule nto kunye nokuba zininzi zemibuzo.
Amanqanaba e-Estrogen aphakamileyo kakhulu : Njengokuba kunokwenzeka ukuba angaphumelelanga kwiziyobisi zonyango, kunokwenzeka kwakhona ukuba uphazamise. Oku kunokukhokelela kwi- ovarian hyperstimulation syndrome (OHSS) , imeko yokuba ukuba ishiywe ingakhange iphendulwe ingaba yingozi. Kwiimeko ezinzima, iimeko ezinqabileyo, kunokubangelwa ukulahleka kokuzala kunye nokufa.
Ukuba amanqanaba e-estrogen aphezulu kakhulu, umjikelo wakho unokukhanselwa. Oku kungenzeka ngaphambi kokuba inkunzi ibambe iqhosha, ngaphambi kokufunyanwa kweqanda, okanye emva kokufunyanwa kweqanda. Ukuba ukukhansela kwenzeka emva kokufunyanwa kweqanda, kwaye ezinye iimbumba ezinempilo zikhula kwibhulebhu, loo maqebunga angase aqhutywe. Baya kukhangela emva koko batyelelwe kwaye badluliselwe ngumbuthano wokutshintshwa kwebraza, okanye kwi-FET.
Kungaba yingozi ukudlulisa ama-embrosi ukuba uhlakulela iimeko ezimbi ze-OHSS. Ukukhulelwa kunokukwenza kube nzima ukubuyisela kwi-OHSS. Kungcono ukulinda omnye umjikelo kwaye wenze iFET.
Kwixesha elizayo, ugqirha wakho unokukwazi ukusebenzisa izilwanyana ezincinci zezilwanyana zokuzala okanye umgaqo-nkqubo ohlukile ukukhusela enye impendulo ye-ovarian hyperstimulation response.
Amanqanaba e-estrojeni angalindelekanga : Iimpawu ezithile ze-IVF zinokwehla kwe-estrogen ngaphambi kwesigaba sokufunyanwa kweqanda. Oku akuyona ingxaki, ngokutsho kophando.
Nangona kunjalo, ukuba amanqanaba e-estrogen ahlasele ngokungalindelekanga ngaphambi kokufunyanwa kweqanda, oku kungabonakalisa uphawu olubi. Ugqirha wakho unokucetyiswa ukuba ukhansele ukufunyanwa kweqanda, ukugcina imali kunye nomoya wamandla ekuqhubekeni komjikelezo ongenakwenzeka ukuphumelela.
Ukungathathi i-hCG / trigger ipopu ngexesha elifanelekileyo : I-hCG yonyango inokuthathwa ngejoyi malunga nama-36 iiyure ngaphambi kokufunyanwa kweqanda. Ixesha le-injection ibalulekile. Ukuba kuthathwa ngexesha elingafanelekanga, amaqanda angabhaqa phambi kwenkqubo yakho. Emva kokuba amaqanda akhululwe kwisigxina se-pelvic, azikwazi ukufunyanwa kwi-IVF.
Ugqirha wakho uza kukunika ixesha elichanekileyo lokuzinika le injection. (Ezinye iikliniki ziza kuba nezigulane zabo zifike kwiklinikhi ukuze zithathe ihlwele ngenxa yokuba ixesha libaluleke kakhulu.) Ukuba uyithatha ngexesha elingalunganga, ke, umjikelo wakho ungadinga ukukhanselwa.
Akukho maqanda athatyathwa : Iingqungquthela, zonke iifolli kufuneka zibe neqanda. Kodwa ayisebenzi njengaleyo. Ngamanye amaxesha, iifollicle ayinalutho. Unokuba nenani elincinci lentlobo, kodwa ungafumani nayiphi na amaqanda kuwo.
Ukuba akukho maqanda, ukuchumisa akunakwenzeka. Umjikelo uya kuphela apha.
Amanqanaba eprogesterone aphakamileyo kakhulu : Iprogesterone yi-hormone ephakanyiswayo emva kwe-ovulation. Inceda ukulungiselela i-endometrial lining , apho i-embryu iya kubeka khona ithemba, kwaye inceda ukugcina ukukhulelwa. Iprogesterone ayifanele iqale ukuphakama de emva kokufunyanwa kweqanda (okanye i-ovulation).
Nangona kunjalo, abanye abafazi baya kuba namazinga anokwandisa ama-progesterone ngosuku lokufumana iqanda. Ezinye izifundo ziye zafumanisa ukuba ukudluliselwa kwembungu ngexesha lemijikelezo akunakwenzeka ukuba kukhokelela ekuphumeleleni ukukhulelwa.
Ukuba oku kwenzeka kuwe, ugqirha wakho unokuncoma ukunyuka kwe-cryopreservation kwanoma yiyiphi imibusi kunye nokucwangcisa emva komhla wokutshintshwa kwebraza. Ukulinda kunokuba nzima, kodwa kunokuphucula impembelelo yempatho yempatho.
Ayikho imbrusi yokudlulisa : Ngamanye amaxesha, nangona emva kwenani elithile lamaqanda lifunyanwa, ukuchumisa akunakwenzeka. Oku kuthetha ukuba akukho mibusi eya kuhanjiswa.
Kwakhona, maxa wambi, amaqanda azalisa kodwa ama-embrasi anesiphumo kwimpilo okanye "ukubanjwa" ekuphuhliseni ngaphambi kokuba adluliswe. Esinye isizathu sokuba ungenayo iibrasi ukutshintshela ukuba i-PGS / PGD i-genetic resultsing screening ibonisa ukuba ama-embrosi aneengxaki zobomi okanye i-chromosomal.
Ukubonakalisa iimpawu zeengozi ze-OHSS : Njengoko kuchazwe ngasentla, i-ovarian hyperstimulation syndrome inokuba yinto enzulu xa ingashiywanga. Ukuba iimpawu zakho, i-ultrasound, okanye umsebenzi wegazi ubonisa umngcipheko omkhulu we-OHSS, umjikelo wakho unokukhanselwa okanye uhlehliswe.
Oku kungenzeka ngaphambi kokufunyanwa kweqanda okanye emva kokubuyiselwa kodwa ngaphambi kokudluliswa kombungu.
Ukugula okungahambelani ne-IVF : Ukuba iqabane liza kunye nesifo esibi phakathi kwonyango, umjikelo unokucinywa okanye ukulibaziseka. Umkhuhlane ophezulu unokuchaphazela kakubi izilwanyana zesininzi.
Unyanisekile ugqirha wakho ukuba unomkhuhlane ophezulu okanye uhla kunye nento ngexesha lonyango lwenyanga. Kungadakalisa ukufuna ukucima okanye ukulibaziseka unyango, kodwa ezinye izifo zinganciphisa imiphumo yakho yempumelelo kwaye inokubeka impilo yakho yonke engozini xa idibene nokuxinzezeleka kwengqondo kwonyango.
Ngaba Unokuhamba Nge-Egg Retrieval Ngaphandle Kwee-Egg / Iifolumu ezimbalwa?
Umntwana wokuqala we-IVF wakhulelwa ngeqanda elilodwa elifunayo. Kwizonyango zendalo kunye ne-mini-IVF, enye okanye iifollic ezimbalwa ezifunwayo. Ngoko, kutheni ungaqhubeki phambili nokufunyanwa kweqanda ngexesha le-IVF eqhelekileyo nangona unemivuzo embalwa nje?
Lo mbandela ophikisanayo. Kukho oogqirha abakulungele kwaye banokukukhuthaza ukuba uqhubeke nokufumana iqanda. Kwezinye iimeko, le yimeko engcono kakhulu yowesifazane othile. Ukuba uye wanciphisa i-ovarian reserves kwaye akafuni ukusebenzisa umxhasi weqanda , ukuhamba nomjikelezo nokuba neengxaki eziphantsi zokuphumelela zisenokuba yithuba elihle lokukhulelwa.
Nangona kunjalo, kubalulekile ukwazi ukuba impendulo engalunganga kwimichiza yokuzala ayikho imeko efanayo nomntu okhuthazwe kuphela ekuphuculeni enye okanye amaqanda ambalwa okufumana. Inyaniso yokuba ama-hormone aphezulu ayengakwaneli ukuvuselela kakhulu ama-ovari angabonisa ukuba izinga leqanda libi.
Akunjalo bonke ugqirha baya kunika ithuba lokuhamba phambili kunye nokubuyiswa kweqanda ukuba iinombolo zakho zomnxeba ziphantsi kakhulu. Abanye baya kukunika uluvo lwabo malunga noko ukwenzayo kodwa ushiye isigqibo sokugqibela ezandleni zakho.
Nazi ezinye iinkcukacha zokukunceda wenze ukhetho:
- Ngokwezifundo ezahlukeneyo, "abaphenduli abasweleyo" abahamba ngokugqithiswa kweqanda baphakathi kwama-7.6 ukuya ku-17.5 amathuba okufumana ukukhulelwa (xa kuthelekiswa nama-25.9 ukuya kuma-36.7 ekhulwini amathuba abo abaphendula ngokuqhelekileyo).
- Xa beqwalasela idatha ngokubanzi, abaphenduli abasweleyo banesiqingatha ithuba lokukhulelwa xa behamba kunye nokufunyanwa kweqanda.
- Imicimbi yobudala. Abaphenduli abasweleyo abaneminyaka engama-36 okanye abancinci bebanomlinganiselo wokukhulelwa phakathi kwama-13 ne-35 ekhulwini. Abaphambukeli abahluphekayo abaneminyaka engama-37 kunye naphezulu babenezinga eliphezulu lokuphumelela : phakathi kwe-1.5 ne-12.7 ekhulwini.
- Ukunyusa imiba. Abafazi abane- BMI abangaphezu kwama-30 babengenakukwazi ukukhulelwa kakhulu xa kuthelekiswa nabaphenduli abasweleyo kwisisindo esifanelekileyo.
- Abasetyhini ababephakanyisile amazinga e-FSH babengenakuncipha kakhulu ukukhulelwa emva kokuphendula okungalunganga, xa kuthelekiswa nabaphenduli abahluphekileyo abanezinga eliqhelekileyo le-FSH. (Abasetyhini abaphezulu be-FSH bane-4% yezinga lokukhulelwa, xa kuthelekiswa nama-14.8 ekhulwini kulabo abanezinga eliqhelekileyo le-FSH kodwa impendulo engalunganga.)
Inani langempela lamaqanda libuyisa izinto, kunye namaqanda ambalwa ekhokelela ekuhlaleni okuphantsi. Izifundo ezintathu zikhangele ukukhula kwezixa-mali ezixhomekeke kwinani lama-oocytes.
- Abasetyhini abafumana iqanda elilodwa bathatyathwa bafumana ukukhulelwa phakathi kwama-0 ne-2.3 ekhulwini.
- Abo bafumana amaqanda amabini afunyanwe amaxabiso aphakathi kwama-4.3 kunye ne-15.2 ekhulwini.
- Olunye uphando lwafumanisa ukuba abafazi ababenamahlanu e-oocytes bafumene iqondo lokukhulelwa kuma-22 ekhulwini.
Ukutshintshwa kwi-IVF ukuya kwi-IUI Mid-Cycle
Olunye ukhetho ugqirha wakho unokunikela ngalo ukuguqula umjikelezo wakho kwi-IVF ukuya kumjikelezo we- IUI . Oku, kuya kuba njalo ukuba ngaba amaqanda akho awaphendulanga ngokufanelekileyo njengoko ethemba. Ngeke ufune ukutshintshela kumjikelezo we-IUI ukuba ii-ovari zakho ziphenduliwe.
Ingaba oku kukhetho olufanelekileyo ukuba uya kuxhomekeka kwiindleko, izizathu zakho zokungabikho komntwana, kunye nantoni na imiba yezinto ezisemgangathweni.
Ngokomzekelo, ukuba uye wavala i-fallopian tubes , i-IUI ayiyi kukhethwa. Ukuba ubunzima bomdlelwane bakho bododa buphantsi kakhulu , okanye i- IVF ne-ICSI iyadingeka, ukuguqula umjikelezo we-IUI akunakwenzeka.
Ngamanye amaxesha, kukho iifolsi ezimbalwa ze-IVF kodwa kusezona zininzi kakhulu kwi-IUI. Ukuba ne-follicle ezintathu ukuya ezintlanu kuthetha, nge-IUI, usengozini yokukhulelwa ngamathathu, ama-quadruplets, okanye i-quintuplets . Oku kunokubeka impilo yakho kunye nawuphi na umntwana obelekileyo impilo kwimngcipheko.
Yintoni elandelayo? Ngaba kufuneka uzame kwakhona Emva kokucinywa kwe-IVF?
Emva kokulindela okukhulu kunye nokutshala imali ngokwezimali , ukuba umjikelezo wakho ukhanseke unokushiya uzibuze-ukuba uzama kwakhona?
Lo mbuzo akulula ukuphendula kwaye kuxhomekeke kwimeko ethile. Kwiimeko ezininzi, ewe, ukuba unayo indlela yezemali, kuyafaneleka ukuzama kwakhona. Ugqirha wakho unokufunda indlela yokuphucula bhetele umjikelezo wakho ozayo ngokubhekiselele kwinto engafanelekanga ngexesha lokuqala.
Umzekelo, ukuba uphendule ngokugqithiseleyo kwizidakamizwa zokuzala, ugqirha wakho unokunciphisa ama-dosages okanye usebenzise inkqubo elandelayo ngexesha elizayo. Ukuba akukho maqanda azaliswe, ugqirha wakho angazama i-IVF kunye ne-ICSI ngexesha elizayo. Nangona kwimeko yokwenza impendulo engalunganga, kunokukho umgaqo-nkqubo olwahlukileyo onokukunceda.
Olunye uphando lwafumanisa ukuba ama-54 ekhulwini kwabasetyhini ababenempendulo engalunganga kwimijikelezo eyodwa ye-IVF baqhubeka ngokuphendula ngokuqhelekileyo kwinqanaba elilandelayo. (Kubalulekile, nangona kunjalo, ukubonisa ukuba amazinga okuphumelela ekukhulelweni ayesekho kwicala eliphantsi kwesi sifundo: kuphela i-10.1 yepesenti yokukhulelwa kwisigidi esilandelayo-mpendulo.)
Kwezinye iimeko, umjikelo okhansekileyo uphepha. Ngamanye amaxesha ukuhlolwa kovalo kuqikelela ukuphendula okungalunganga . Ngamanye amaxesha zonke iimvavanyo zibukeka zilungileyo kwaye izinto azihambi nje kulindeleke.
Kule meko ngokukodwa, elinye ilinga lingaba luncedo. Uphando lufumene ukuba abaphenduli abahluphekileyo abangalindelekanga banomlinganiselo wokuphumelela ukukhulelwa kwama-25.9 ukuya kuma-47 ekhulwini xa bejonga iingxaki ezingaphezu kweemigangatho emithathu ye-IVF.
Kukho, nangona kunjalo amaxesha apho impendulo engafanelekanga, ngokubambisana nezinye izinto, uphawu olufanele uqhubeke ngalo. Ngokuxhomekeke kwingxaki, oku kungathi ukunyuka kwi- IVF kunye namaqanda abanikizi, i-IVF kunye nomnini wesibonelelo, okanye uqwalasela ukutholwa komntwana okanye ubomi obungabantwana .
Igama elivela kwi-Verywell
Akukho mntu ungena kumjikelezo we-IVF okulindele ukuba angayifaki ukudluliselwa kombindi. Kuqhelekile ukuba ube nosizi, ukudumala, kunye nomsindo. Oku kuyinyani ngokukodwa ukuba unako ukufumana imali kuphela xa uzama ukuzama.
Qiniseka ukuba umjikelezo okhansekileyo awuyiyo inkunkuma. Ugqirha wakho uya kuba nethemba lokusebenzisa idatha eqokelelwe ukunceda ukwenza umjikelezo olandelayo okanye isakhiwo sentsapho senze ngcono. Nangona umjikelezo okhansekileyo ungenzi nto ngaphandle kokuqinisekisa ukuba ufanele ucinge nge-IVF kunye nomnikezeli weqanda, okanye uqhubeke ngaphaya kwemithi yokwelapha , le ngcaciso ongenayo ngaphambili.
Khumbula ukuba umjikelezo wakho wokuqala awumqondiso wokuba uza kuhamba njani, kwaye unokuhlala ufumana umbono wesibini.
Fumana ukuxhaswa ngabahlobo kunye nosapho . Thetha ugqirha wakho malunga nomjikelezo okhansekileyo, uphulaphule iingcomo zakhe, uze wenze isigqibo-emva kokuba ube nexesha lokunyamekela amava-oko kuya kuthathwa ngamanyathelo akho alandelayo.
> Imithombo:
> Al-Azemi M1, Kyrou D, Kolibianakis EM, Humaidan P, Van Vaerenbergh I, Devroey P, Fatemi HM. "Iprogesterone ephakamileyo ngexesha lokuvuselela i-ovane ye-IVF. "Ukuhlambalaza i-Offline Biomed Online. 2012 kuMeyi; 24 (4): 381-8. i-doi: 10.1016 / j.rbmo.2012.01.010. Epub 2012 ngoJan 24.
> Fisher S1, Grin A, Paltoo A, Shapiro HM. "Amanqanaba okuwa kwe-estradiol ngenxa ye >> ngenjongo yokunciphisa i-gonadotrophin dose ayihambelani neziphumo ezimbi ze-IVF, kanti iinqununu ze-estradiol eziwela ngokukhawuleza ziphumela kwizinga eliphezulu lokukhulelwa kliniki. "Uhlambalaza. 2005 uJan; 20 (1): 84-8. Epub 2004 Oct 15.
> Oudendijk JF1, Yarde F, Eijkemans MJ, Broekmans FJ, Broer SL. "Umphenduli oyimpofu kwi-IVF: ngaba ukuhlaziywa kukusoloko kuhlwempu? "Isihlomelo sokuhlaziya. 2012 uJan-Feb; 18 (1): 1-11. i-doi: 10.1093 / i-humupd / dmr037. Epub 2011 Oktobha 10.