Yintoni omele uyiqwalasele
Ukuchithwa kwe-embryo enye (eSET) xa ukhe unomzimba owodwa ophezulu kwi-IVF unyango kodwa ukhethe ukutshintshela enye kuphela kwisibeleko. Nayiphi na iibrasi ezisele ziyakunqandwa , zigqitywe emva koko, zitshintshwe kwiimjikelezo zokulandelelana. Kwizigulane ezilungileyo zokugulisa, iSET inokunciphisa umngcipheko wokukhulelwa okungafaniyo ngelixa kungabi nciphisa kakhulu imiphumo yonyango oluphumelelayo.
Nangona kunjalo, ukwenza isigqibo malunga nokudluliselwa komzimba omnye akulula. I-IVF unyango ibiza . Ukutshintshwa kweembumba ezincinci kunokukhokelela kwiinkxalabo zokuthi umjikelezo awunakusebenza, oko kunokuthetha ukujikeleza, ityala elingakumbi kunye nokwesaba ngakumbi ukungaphumeleli. Kwakhona kungalinga ukuba nethemba lokukhulelwa amawele , mhlawumbi "ukugqiba" intsapho yakho kumjikelezo omnye.
Ukudluliselwa komzimba ongatshatanga kumzimba akufanelekanga zonke izigulane. Kwabo abaviwa, zizathu ezifanelekileyo zokuziqwalasela ngokucokisekileyo. I-CDC kunye ne-American Society ye-Medicine Reproductive (ASRM) ithemba. Nasi isizathu.
Umbuzo weMibhide emininzi yokuTshintshela
Injongo yokunyanga ukondla ngumntwana onompilo, omnye ngexesha. Esi siyisiphumo esihle kunazo zonke kumama nomntwana. Unokucinga ukuba uthetha enye imbryo kufuneka idluliselwe yonke imijikelezo, kungakhathaliseki ukuba yintoni imeko, kodwa ayilula. Ngenxa yokuba unesibindi, oko akuthethi uya kufumana ukukhulelwa.
Oku kuyinyani xa i-embrasi "ingeyona mgangatho ophezulu" kunye nabasetyhini abaneminyaka engama-37 okanye ngaphezulu .
I- IVF yokuqala eyayikhulelwa umntwana yayingumntwana omnye. Kodwa oku kwakungekho umgaqo-nkqubo oqhelekileyo phakathi neminyaka yokuqala. Ukuncedisa iteknoloji yokuzala izasakhula, kwaye iziphumo zokuphumelela kokukhulelwa kunye nokutshintshwa kwebhere elilodwa liphantsi kakhulu.
Oku kuthetha ukuba oogqirha badlulisela ama-embro emithathu ngexesha. Ithemba lokuba umntu "uya kuhlala."
Nangona ukutshintshisa inani eliphakamileyo leembrusi kuye kwabangela ukukhula okungcono kweendleko, kwaqhubela phambili kwi-triplet nangaphezulu ukukhulelwa okuphindaphindiweyo xa ezinye okanye zonke ii-embrasi zihanjiswe "zithatha." Njengoko iteknoloji yaphucuka, yaba yinto enokwenzeka ukuba idlulisele "kuphela" imibungu ebini kwizigulane ezilungileyo zokugonywa kwaye zifumana amazinga okukhulelwa okufanelekileyo. Eyaziwa ngokuba yi-embryo transfer (DET), le nto yaba yinto ekhethekileyo kakhulu ekhethwe ngabagqirha kunye nezigulane.
Sekunjalo, ukutshintshela kabini kwimbungu kwakubonisa ukuba iingxaki zokukhulelwa amawele zaphakamileyo, ngakumbi kulabo babe nethuba elihle lokuphumelela. Izigulane ze-IVF ziphindwe ngamaxesha angama-20 ukuba zikhulelwe ngamawele kunabantu bonke. Kwiminyaka elishumi edlulileyo, ii-IVF ziye zaqhubeka kunye nokuphumelela kwayo kunye nokukwazi ukukhetha ama-embryos asemgangathweni. Oku kuye kwabangela ukunyusa ukukhuthaza ukutshatyalaliswa kwesisu esisodwa.
Kukho iimeko apho ukutshintshela ezimbini, ezintathu, kunye nemibusi enye yinto efanelekileyo. Kwabesetyhini abangaphezu kweminyaka engama-40 abanamaqabunga aphantsi kobuhlwempu, oku kuyinyani ngokukodwa. Kodwa esi sigqibo akufanele senziwe lula.
Ngaba Ungumviwa Olungileyo we-eSET?
Xa kufanelekile, i-American Society for Medicine Reproductive ikhuthaza oogqirha kunye nezigulana ukuba zikhethe ukudluliselwa komzimba omnye.
Baye bahlakulela izikhokelo ezijoliswe kuphando ukuze bancede iingcali zendalo zenze isigqibo xa kunokwenzeka.
Ukukhethwa kolunye uhambelwano lwebridi lungakhetha kakuhle ukuba ...
Umjikelezo wakho uvelisa ngaphezulu kweyodwa embryo esemgangathweni . Ewe, ukuba ufumana enye imbungu ekutshintshiseni, ayiyi kukhetha ukutshintshwa kwesisu esisodwa. Uza kuba neyodwa yokudlulisa.
Nangona kunjalo, kulo mzekelo, ukuba bathetha ukuthini ukuba ngaphezulu kweyodwa imbrus ephezulu yenzeke ngexesha lokuchumisa i-IVF. Ukufumana ngaphezu kweyodwa embryo esemgangathweni kukubonakalisa ukuba ukugqabhuka kwakho kukuhle.
Kwakhona kuthetha ukuba kufuneka ube neyodwa okanye ama-embrapreserve (okanye aqhwala).
Ezi zimbumba ezinobuncwane zingagqithiselwa kwaye zitshintshwe ngexesha lomjikelezo olandelayo, nokuba ngowona olandelayo (ukuba ukukhulelwa akukwenzeka ngeli xesha) okanye kwikamva (xa uzama umntwana ongezelelweyo).
Uneminyaka engama-35 ubudala okanye ubuncinci . Izinga lokuphumelela kwe-IVF liphezulu kubafazi abaneminyaka engama-35 okanye abatsha, ngokuqhelekileyo bathetha. Ngokuqinisekileyo, kuxhomekeke kwisizathu sokungabikho kwengqondo, oku akunjalo ngaso sonke isikhathi. Ugqirha wakho unokukunika isikhokelo ngakumbi malunga nokuba imeko yakho iyahluke.
Usebenzisa amaqanda abanikeli . I-eggor doner IVF inikeza iziphumo eziphambili zokuzalwa zonyango. Kungenxa yokuba abaxhasi beqanda bachongwa ngokuchanekileyo. I-egg donor IVF inethuba elingcono lokukhokelela ekukhulelweni kunokugqithiseleka kakhulu kwesigulane se-IVF usebenzisa amaqanda akhe.
Unemibusi enye okanye ngaphezulu, kungakhathaliseki ukuba uneminyaka elingakanani. I-embryo ekhuselekileyo ineenombolo eziqhelekileyo zama-chromosomes. Iqanda eliphilileyo kunye nesidlo esinempilo ngasinye sinegalelo lama-chromosomes angama-23, okubangele i-chromosomes ezingama-46 (ukuba isahlulo seeseli siyahamba ngokufanelekileyo.) Ukufakelwa kwemilinganiselo kunye namazinga okuzalwa aphezulu aphezulu kuma-embroids euploid.
Inombryo kunye nenani elingavumelekanga lama-chromosomes libizwa ngokuba ne-aneuploidy. Ukutshatyalaliswa komtshato kusenokwenzeka ukuba kwenzeke xa i-embryo i-aneuploidy. I-Downs syndrome ebangelwa inani elingaqhelekanga lama-chromosomes.
Abasetyhini abangaphezu kweminyaka engama-37 abanamathuba amaninzi okuba nempumelelo ye-IVF, kodwa oku kubangelwa ikakhulu ngenxa yezitenxo ze-chromosomal. Nangona kunjalo, ngokusebenzisa ukuhlola, ukuba umfazi oneminyaka engama-37 ufunyanwa ukuba neembryo ezinamaqabunga, ukuxelwa kwempumelelo kuphezulu. Ukutshintshwa kwebumba elilodwa kuyindlela efanelekileyo, nangona i-age yabo ingaba yinto engafanelekanga.
Ukukhetha i-Best Embryo
Ukudluliselwa komzimba kumntu oyedwa kunokukhethwa ukuba unombindi ongaphezulu kweyodwa. Kodwa ugqirha wakho ugqiba njani ukuba i-embryo "ingumgangatho ophezulu?"
Kukho iindlela ezimbini eziphambili:
- kujonga i-morphology (okanye umlo) we-embryo
- ukwenza i-Comprehensive Chromosome Screening (CCS) ye-embryo
Kwangexesha elide, ukugqiba ukuba imibusi yayinobungakanani obuphezulu yenziwa ngokujonga i-morphology ye-embriyo ekhulayo ebhodini. Le ndlela ineziphene zayo. Umbungu ungabonakala ube mkhulu ngaphantsi kwe-microscope kodwa usenokwenziwa kwechromosomally. Kwakhona kunokwenzeka ukuba umbungu ukhangele "ngaphantsi kokugqibeleleyo" kwaye ube nechromosomally fine.
Oku kuseyona ndlela eyona ndlela yokuqaphela ukuba yiyiphi imibusi enomgangatho ophezulu kwaye awunjalo. Kuqukwe neyonyango ye-IVF.
Nangona kunjalo, indlela echanekileyo yokukhetha ama-embryo asemgangathweni i-Comprehensive Chromosome Screening, okanye i-CCS. Olu lubuchwephesha bokuhlola i-genetic evumela ukuba uchwephesha ukuba abale i-chromosomes esipheleleyo (kwaye unqume ukuba i-embryo i-euploid). I-CSS inokukuxelela kwakhona ubulili obuyimfuza yombungu. I-CSS ayikho epheleleyo njengoko i-preimplantation genetic diagnosis / screening (PGD / PGS), kodwa ngenxa yale njongo, akumele ibe.
I-CCS ayifumaneki kwiklinikhi yonke yokuzala. Kwakhona, ithetha iindleko ezongeziweyo kwionyango lakho lonke le-IVF. Oko kwathiwa, i-CSS ihlolwe iibrikhi ziyakwazi ukukhokelela ekukhulelweni, kuncinci ukuphela kokuphazamiseka komzimba, kwaye kunokukunceda ukhethe ukudluliselwa kwesisu esisodwa kunye nokuzithemba ngakumbi.
Uvavanyo lwe-CSS lunobungozi kwaye alulungele wonke umntu. Le nto inokuxoxa ngayo nodokotela wakho.
Ngaba Unako Okuncinane Ukuba Ukhulelwe neSET?
Lo ngumbuzo wezigidigidi. Impendulo kukuba, kunzima ... kodwa uthembisa.
Ukuba uthelekisa omnye umzekelo wokukhetha umjikelezo wesibindi esisodwa kwisibindi sokudlulisa isibindi, ukukhulelwa kweeklinikhi kuphakamileyo kumjikelezo wokutshintshela kabini. Nangona kunjalo, ukuthelekiswa okungafanelekanga.
Uthelekiso olufanelekileyo ngakumbi ukuthelekisa iirhafu zokukhulelwa komjikelezo omnye wokudlulisa ummbindi ukuya kwiisondo ezimbini zokudlulisa embryo. Ngamanye amagama, kunye nokujikeleza kwesisu esisodwa, enye iya kuba ngumjikelezo omtsha kwaye, ukuba oko akuzange kubangele ukukhulelwa, i-eSET yesibini iya kwenziwa ngokusebenzisa i-embropreserved embryo ukusuka kumjikelezo owedlule.
Xa iifom zokukhulelwa zifaniswa njengaye, iziphumo zihluke kakhulu.
Ukuphononongwa kweemitha ezili-14, ezibandakanya amabhinqa angaphezu kwama-2,000, abaphandi bafumanisa ukuba amazinga okuphumelela ekudlulisweni kwembungu awazange ahluke ngokukhethekileyo kwiirhafu zokutshintshwa kwembungu enye xa ukhangelelana ezimbini ukuya kwintathu. Uphononongo lufumene ukuba ukuba iimeko zokuzalwa eziphilayo zazingama-40 ekhulwini kunye nokutshintshwa kwembumbulu kabini, kuya kuba phakathi kwe-30 no-42 ekhulwini ngokudluliselwa komzimba omnye.
Abaphandi baye bafumanisa ukuba abo babenokugqithiswa kabini kwe-embryo babengama-15 ekhulwini abanokufumana ukukhulelwa okuphindaphindiweyo, xa kuthelekiswa nephakathi kwe-1 ne-4 ekhulwini ukuchasana nokudluliselwa komzimba omnye. Ezi zifundo, nangona kunjalo, zigwebe ii-embrology ezisemgangathweni ezisekelwe kwi-morphology. Yintoni eyenzekayo xa kuhlolwa i-CSS yokuhlola i-genetic? Iingxaki zokuphumelela zibukeka zingcono.
Kwisifundo esahlukileyo, amazinga okuzalwa ahlaselwa, ukuthelekisa ukuchithwa kwe-embryo ekhethiweyo (ehlolwayo esebenzisa i-CSS) ukufunyanwa kwimijikelezo yokudlulisa embryo kabini. Ngokungafani nokufunda oku ngasentla, imijikelezo yafaniswa enye. (Ngamanye amagama, umjikelezo omnye kunye nomjikelezo owodwa okhethiweyo womyinge oqhathaniswa nomjikelezo omnye wokudluliselwa kwembilini.)
Bafumene ukuba amazinga okuphumelela awazange ahluke kakhulu. Bakufumanisa ukuba umngcipheko wokuzalwa ngokubanzi wawuncancinci (iipesenti ezi-0 ziqhathaniswa neepesenti ezingama-48) kunye neCSS eziboniswe ukutshintshwa kwe-embryo enye, kunye neengozi zeengxaki ezinjengokunikezelwa kwangaphambili, ukuzala okuphantsi, kunye nexesha kwi-NICU behluke kakhulu.
Iintsana zokudlulisa umntwana ezinomzimba ziyingcambu ukuba zizalwe kusasa kakhulu, inxalenye yesithathu ibe yinto encinci yokuba nesisindo sokuzalwa esincinane, kunye nesigqithana esingaphezulu kwesigama sokuchitha isikhathi kwiyunithi yokunyamekela kakhulu ekuzalweni.
Kodwa Ngaba Amawele Ayengabi Ngcono Kulo Mntwana 1?
Xa bebuzwa oogqirha babo ukuba ngaba baya kukulungele ukutshintshela ukudluliselwa komzimba omnye, ukuze bagweme ukukhulelwa amawele, abaninzi abantu abatshatileyo bayabuza isizathu sokuba bangafuni ukuba amawele abe ngowona khetho oluphambili. Emva kweminyaka yokuzama ukukhulelwa, kunye nemithwalo yemali yokuvavanya kunye nokunyanga, enethemba lokufumana ezimbini iintsana kwelinye elilodwa kuzama izandi ezipheleleyo.
Kodwa a kunjalo. Amawele afika engozini kumama nakwiintsana ezingakazalwa .
Ukukhulelwa kunye nokuzalwa okubini kunokwenzeka ukuba:
- namava okukhulelwa
- kuzalwa ngeC-section
- kuzalwa kungekudala
- uzalelwe ngokulinganisa okuphantsi
- ukuchitha ixesha kwi-NICU, okanye i-unit care care
Ukukhulisa nokunyamekela amawele kungabi nzima. Abazali bamawele banga:
- unobunzima bokuncelisa
- babhekane nokunyamezeka ngokomzimba nangokomzwelo kwiminyaka yokuqala
- zineendleko eziphezulu zokunyamekela (akusiyo "ibini enye")
Ukuba nelinye ilanga ngexesha likhethekileyo.
Kuthiwani Ngeendleko Zonyango Zonyango?
Esinye isizathu sokuba imibhangqwana ejongene nokungabikho komntwana inganqikazi ukukhetha ukutshatyalaliswa kwesisu esisodwa kunye neendleko zokunyanga . Kwimimandla apho i-IVF ihlanganiswa yinshurensi yezempilo, izinga lokuchithwa kwebhere elilodwa elikhethiweyo liphezulu kakhulu.
Nazi ezinye izinto omele uzigcine engqondweni:
- Iindleko zokudluliselwa komzimba omnye kunye nomjikelezo wesibini kunye ne-embryprederved embryo ayifani neyesibini, ezipheleleyo ze-IVF. Umjikelezo we-embryo-ukudlulisela kuphela uhlahle kakhulu.
- Nangona ugcina imali kwiimjikelezo ze-IVF ezongezelelweyo, amawele angabiza. Awukwazi ukugcina imali kwixesha elide.
- Ezinye iikliniki zinikeza izikhuthazo zezemali ukukhuthaza izibini ezikhethiweyo ukuba zikhethe ukutshintshiselwa komzimba omnye, kuquka iinkqubo zokubuyiselwa kwembuyekezo kunye nezaphulelo. Buza iklinikhi yakho ukuba banokwenzela ntoni.
- Ukudluliswa kombindi ongabodwa kunye nokuhlolwa kwe-CSS kuxabisa, kodwa ungekho amathuba okuba ulahlekelwe yintlungu kwaye unakho amathuba okuba ukhulelwe kwaye ukhulelwe.
Igama elivela kwi-Verywell
Isigqibo sokhetho olukhethiweyo lokudluliselwa kombindi kufuneka lwenziwe kunye negalelo lonyango lakho, kwaye uqwalasele imeko ethile yempilo, yemali kunye nokuzala.
Olunye ulwazi olufunekayo ukugqiba luya kufumaneka kude kube ngumjikelezo we-IVF, emva kokulandelwa kweqanda nokucoca. Ngaphambi kokuba ikliniki yakho iqinisekise ukuba unemibroyi enempilo efanelekile yokutshatyalaliswa kwesisu esisodwa, awukwazi ngokwenene ukuba kulungile kuwe.
Akukho sigqibo "esingalunganga" apha. Amawele ayenokuba yimiphumo emihle. Nangona kukho iingozi, ingozi ayikho isiqinisekiso. Enyanisweni, i-IVF ikhulelwe amawele ayingcipheko encinci kuneengxaki ezinokuba ngamawele azalwa ngokwemvelo, mhlawumbi ngenxa yonyango olongezelelweyo olwenziwe kwi-IVF-pregnancy pregnancy.
Nangona kunjalo, ukwenza isigqibo ngokukhawuleza akucebisi. Xoxa ngethuba lokukhetha ukutshatyalaliswa kwesisu esisodwa kunye nomlingane wakho ngaphambi kokuba umjikelezo wakho we-IVF uqale. Ngaloo ndlela, awuyi kunyanzeliswa ukuba ugqibe isigxina xa uxinzelelo kwaye uphantsi kwengcinezelo yonyango lokuzala .
> Imithombo:
> Ukukhetha Ukutshintshwa komzimba omnye . IKomidi yokuSebenza yoMbutho weeNkxaso zoLwazi ekuzaliseni iNkxaso kunye neKomiti yokuSebenza ye-American Society yeMithi yoBubele.
> Forman, Eric J .; UScott Jr., uRichard T. "Utshintsho olulodwa lwe-Embryo Transfer: I-IVV Paradigm entsha?" I-OB / GYN . Julayi 1, 2014.
> Kuohung, Wendy; Ginsburg, Elizabeth S; Racowsky, Catherine. "Amacandelo okulawula ukulingana kwezinga eliphezulu lokuthotyelwa kwamanyathelo. "UptoDate.com.
> Pandian Z1, Marjoribanks J, Ozturk O, Serour G, Bhattacharya S. "Inani leembryo zokutshintshwa kwintsholongwane emva kokufakelwa kwe-vitro fertilizer okanye intra-cytoplasmic injection. "Cochrane Database Syst Rev. 2013 Jul 29; (7): CD003416. i-doi: 10.1002 / 14651858.CD003416.pub4.
> IKomiti yokuSebenza ye-American Society yoNyango lweNzala; IKomidi yokuSebenza yoMbutho weTeknoloji yokuThuthukiswa koNcedo. "Isikhokelo kumda weenambuzane ukuhambisa: umbono wekomiti." UFertil Steril. 2017 kuMatshi; 107 (4): 901-903. i-doi: 10.1016 / j.fertnstert.2017.02.107. Epub 2017 Mar 11.
> Utshintshi olulodwa lwe-Embryo. Uxhaswe ngeTheknoloji yoLwazi. Isiko soLawulo lweZifo.