Iingcamango Zasemva Ukuxhaswa kunye nokuba Kukulungele
Ukuncedwa ukukhwabanisa ngutyekhnoloji wokuncedisa oluthile olusetyenziswe ngokubambisana ne- IVF yonyango . Ukuncedwa ukuxhaswa kucingelwa ukuba kunokunceda ngoncedo lwe-embryo ukunyuswa kwaye kunokwenzeka ukuba kunconywe xa kukho ukungaphumeleli kwe-IVF okungachazwanga okanye kwizigulane ezinokuhlaselwa.
Nangona ezinye iiklinikhi zisebenzisa ukusikhupha rhoqo, i-American Society of Medicine Reproductive (ASRM) ayicebisi oku. Oku kungenxa yokuba ukuncedwa kokuncediswa akuzange kubonakaliswe ukuphucula amaxabiso okuzalwa aphile. Ngaphezu koko, njengawo uphuhliso lwezobuchwepheshe, kukho iindleko ezongezelelweyo kunye nobungozi bokusebenzisa ukukhutshwa okuncedisayo.
Ingaba ugqirha wakho wakhuthaza ukuncedisa ukunqanda? Nakhu okufuneka ukwazi.
Iimbusi ZamaHatch?
Ukuqonda ukuncedwa ukuxothwa, okokuqala, kuya kunceda ukuqonda ukutshatyalaliswa kwemvelo kwembungu.
Ngaphambi kokuba ufumane umbungu, uqala nge -oocyte , okanye iqanda. I-oocyte ineprotheni-igobolondo ejikelezile iyaziwa njengezona pellucida. I-zona pellucida inendima emininzi yokuphuhliswa kwembungu, kwaye le mi sebenzi iyashintsha njengoko i-embryo ikhula.
Ngaphambi kokuba iqanda liba ngumbungu, i-zona pellucida idibanisa ngamaseli esilisa. Oku kukuqala kwenkqubo yokuchumisa. Emva kokuba enye iselwane yesinambu ingena kwiigobolondo kwaye ikhupha iqanda, i-zona pellucida iyanzima. Oku kuvimbela iindidi zamabhinqa ukungena kwi-zygote esele ikhutshwe ngoku.
Igobolondo elomeleleyo linceda ukunqanda umbungu ukususela ngaphambi kwexesha elingaphambili kwiibhulo zokulala (okuza kubangela ukukhulelwa kwe- ectopic ). Igcina kunye neeseli ezininzi ze-blastocyst kunye.
Njengoko i-zygote ihamba nge-tube ye-fallopian kwaye ikhula kwisigaba se-blastocysts, i-zona pellucida iyanda kwaye iqala ukuthoba kwaye ihlahloke. Kwimihla emine yentuthuko, i-zona pellucida idilika ivulekile kwaye i-blastocyst / imbryo ivela, ishiya igobolondo elincinci. Le yenkqubo yokuhlenga embryo.
Kwiintsuku ezimbalwa zokugxotha, i-blastocyst iyazifaka kwi-endometrium . Ngaphandle kokuqhawula, i-blastocyst ayikwazi ukuzifaka kwisalathisi se-uterine. Oku kuthetha ukuba ukukhulelwa kuya kuphumelela.
Yintoni encediswayo ukuxhonywa?
Ngonyango lwe-IVF , ukuchumisa kwenzeka kwibhuyibhile. Kodwa njengokuba nayiphi na isibini esinesibini esiye safumana unyango lwe-IVF uyazi, ukuba nombungu okhulelweyo awuqinisekisi ukukhulelwa. I-embryo idluliselwe kufuneka ifake ngokwayo kwi-endometrium kwaye "inamathele" ukuba ukhulelwe.
Ukufika kuma-85 ekhulwini ama-embrosiweyo ahanjiswe "azinamathele." Kukho iingcamango malunga nokuba kutheni oku kwenzeka, kwaye enye yezo ngcamango kukuba i-embryo ayichithi ngokufanelekileyo. Oku kwenzeka ngenxa yokuba i-embryo ingenawo igobolondo elukhuni ngokuqhelekileyo, okanye ngenxa yento ethile kwindawo yebhanti (iinkcubeko ezisetyenziselwa ukugcina i-embryo iphila, iikhemikhali zokunyusa i-cryopreservation, njl. Njl.) Sele iphazamise inkqubo yokuqhawula.
Ukunqanda ukuxhaswa kukunceda ukugqithisa nayiphi na imiqobo ekuthintela ukukhupha kunye nokuphucula iziphumo zokufakelwa (nokukhulelwa) impumelelo.
Ukuncedisa iindlela zokuHamba: Indlela eyenziwe ngayo
Unokucinga ukuba ukuncedisa ukuhlaselwa rhoqo kubandakanya ukwenza "encinci" encinci okanye ukukrazula kwi-zona pellucida. Kodwa oko akunjalo. Kukho iindlela ezimbalwa ezikhoyo, kunye nelebhu nganye yebridi iya kufana nale ndlela. Kukho ubuqili kunye noqhawulo kuyo yonke indlela, kwaye ubuchule bezinto zobuchwepheshe:
- Ukukhutshwa kwezixhobo : Ngale ndlela, i-embrologist igcina imbryo igxininiswe ngoncedo lwe-pipette, ngelixa isebenzisa inaliti encinci ukugquma ngokusebenzisa i-zona pellucida, hamba ngaphantsi kwegobolk for a bit, kwaye emva koko uphume kwesinye siphelo. (Cinga udwebe umgca omncinci kakhulu eceleni kwesibindi.) Emva koko, ummandla phakathi kweeplctures ezimbini uhlanjululwa ngenyameko de ivele. Kunzima ukulawula ubungakanani bokuvula ngale ndlela.
- Ukwandiswa kwamatshini kwegobolondo : Ngalolu cwangciso, i-zona pellucida ayiphukile evulekile. Kunoko, uxinzelelo lwe-hydrostatic luvele nje phantsi kwegobolondo, ukuze lubandise. Ingcamango yale ndlela ivela kukunyuka kwendalo kwegobolondo yangaphandle ngexesha lokuchithwa.
- Ukuchithwa kweMichiza : Le nkqubo iquka ukusebenzisa i-chemicals ebizwa ngokuba yi-Tyrode's acid. Inani elincinci le-asidi lisetyenziselwa i-zona pellucida de igobolondo iphulwe. Emva koko, i-embryo ihlanjululwa ngokukhawuleza ukuze igweme ukungafuneki.
- Ukuqhuba : Ngokufakela, ukunyakaza okunyanzelisayo kusetyenziswa ukudala ukuvulwa komzimba. Le ndlela isebenzisa into eyaziwa ngokuba yi-Piezo.
- I-Laser-help-hatching : Ukusebenzisa i-laser ekhethekileyo yokuphula i-zona pellucida enye inokwenzeka. Ukuncedwa kwe-laser-assisted hatching kuvumela ukulawula okungakumbi ubukhulu bomda owadalwa, ngaphezulu kunokuba ukuchithwa kwemishini kunye nenaliti (njengoko kuchazwe ngasentla).
Kuzo zonke iindlela, ukunqandwa kwe-laser-assisted hatching inokuba yinqaba kwaye iyasebenza kakhulu. Nangona kunjalo, akuyiyo yonke ibhodi ye-embryology exhotywe ukwenza le teknoloji ethile. Ukuchithwa kweMichiza kusetyenziswa ngokuqhelekileyo. Ngazo zonke ezi ndlela, ubuchule kunye namava e-embrologist angenza umehluko omkhulu.
Iingozi Zobuncitshiswe
Naluphi ukuphathwa okanye ukuphazamiseka nombungu kuya kubandakanya umngcipheko othile. Enye ingozi yokuncedisa ukukhupha i-embryo iya kuba yonakaliswe kakubi. Oku kuya kwenzeka phambi kokutshatyalaliswa kwembungu okanye emva koko. Kwimeko apho, ukukhulelwa kwakungeke kubangele.
Ngenye into emangalisa, enye ingozi yokuncedisa i-hatching inkqubo iya kukhishwa kwaye i-embryo izakuhluleka ukukhupha ngokupheleleyo kwi-zona pellucida.
Omnye umngcipheko wokuncedisa ukukhwabanisa ukuguqa, ngokukodwa i-twinning monozygotic. Amawele e-Monozygotic afana namawele, aphuma kwiqanda elinye kunye nesidoda esisodwa. Ukucwiliswa sekuye kwanda ngexesha lonyango lwe-IVF, kwaye uphando lufumene ukuba uncedise ukunqanda ukunyuka kwam kwingozi. Nangona zonke izikhulo ezininzi zithatha ingozi, ukukhulelwa kwe-twin monozygotic kuza nemingcipheko ephezulu kumama neentsana. Sekunjalo, umngcipheko wokuguqa uphantsi, ufike ngaphantsi kweepesenti ezili-1 zexesha.
Unokuzibuza ukuba ukuncedwa ukuxothwa kwandisa ingozi yeziphene zokuzalwa. Uphando oluthile lokuphindaphinda malunga nama-35,000 imijikelezo lufumene ukuba umngcipheko wokungabikho komntwana ongaphantsi komntwana awukhulanga ngokunyuka ngeembrusi ezazisetyenziswa ngokuncedisa ukuxhatshazwa, xa kuthelekiswa nemijikelezo ye-IVF apho kuncedwa ukuxothwa.
Ingaba Uncedisa Ukugxotha Ukuphucula Iifom zeNtsebenzo ze-IVF?
Umbuzo omkhulu, ewe, ngaba ufanelekile? Ingaba uncedwa ukukhangela uncedo ukuza ekhaya usana? Impendulo iyinkimbinkimbi.
Ukuhlaziywa kweCochrane ekuncediseni ukukhangela-okuye kwaqwalasela izifundo ezingama-31, ukukhulelwa kwe-1,992 kunye nabesifazane aba-5 728-bafumene ukuba bancedise ukugxothwa kwezinga eliphezulu lokukhulelwa kweeklinikhi. Nangona kunjalo, izinga lokuzalwa lokuzalwa alizange liphucule.
Ukuphila kwamazinga okuzalwa kubaluleke kakhulu ukuqwalasela kunokuba isantya sokukhulelwa kwekliniki ukususela ekujoliswe kuyo nayiphi na inyango yokunyanga ukuzala ekhaya-kungekhona nje ukufumana ukuhlolwa kokukhulelwa okulungileyo.
Ngelishwa, ininzi yophando ekuncediseni ukukhutshwa kwee-hatching iye yabonisa ukukhula kweekliniki kuphela, kwaye ayihlali kumazinga okuzalwa. Abo babebukele kwizinga lokuzalwa eliphilayo abazange bafumane inzuzo. Uphando olungakumbi kufuneka lwenziwe.
Olunye uphando lufumanise ukuba xa kuncedwa ukuhlanjwa kwenzelwe "emgangathweni omhle" ama-embro, ukukhulelwa kwexabiso kuyehla. Iziphumo zihluka ngoxhomekeke kwiqela elidala xa kuncedwa ukuxothwa kwenzelwe ukulungelelanisa kwiimbrusi eziphezulu. Oku kuya kuthetha ukuba ukuncedwa ukugxothwa kungekuphela nje kuya kubanceda abo banesiphelo esihle, kodwa kungalimaza amathuba abo okuphumelela.
Ngubani onokufumana inzuzo ekuxothweni okuxhaswayo?
Kukho ubungqina obunceda ukukhwabanisa kunokuphucula izinga lokukhulelwa klinikhi kunye nezigulane ezi:
- Uye wafumana amavili amabini okanye ngaphezulu ahluleka kweVF
- Unobulunga obumpofu obumpofu
- Uneminyaka engama-38 ubudala
Kwakucatshangelwa ukuba ukuncedisa ukugxothwa kunokuba kulungele ukuzama ukujikeleza kwe-embraza ye-embryo, kodwa oku kungenjalo. Enyanisweni, uphando oluthile olufumene ukuba luncedwa ukugxothwa kumjikelezo weqanda lombindi kunganciphisa ubunzima bokuzalwa okuphilayo.
Iindleko zoNyaka oNcedisiweyo
Nangona iziphakamiso ze-ASRM, ngubani ocebisa ukusetyenziswa ngokuqhelekileyo kokuncedisa ukukhutshwa, ezinye iiklinikhi ziyazinika zonke izigulane. Kule kliniki, iindleko zokuncedisa ukukhutshwa zingase zibe "zifakiwe" kwimali yonke ye-IVF .
Kwiiklinikhi ezongezelelekileyo zokuncedisa ukunqanda, iindleko zingabuka kwi-200 ukuya kwii-700 zama-700, ngokulinganayo. Kukho neekliniki ezimbalwa ezinika iteknoloji "inkululeko," ukuba bacinga ukuba kunokuba luncedo.
Igama elivela kwi-Verywell
Xa kuxoxwa ngonyango lwe-IVF, kunokuzama ukumkela okanye ukufuna ukusebenzisa yonke into enokwenziwa kwezobuchwepheshe "eyongeziweyo". Kungabonakala ngathi uncedo olungakumbi luhlala lukhokelela kwithuba elihle lokuphumelela. Kodwa ezinye azibhekiseli zibhetele.
Ngenxa yokuba kungabikho ubungqina obaneleyo bokubonisa ukuncedwa kwe-hatching kuphucula amazinga okuzalwa aphilayo, i- ASRM icebisa ngokusetyenziswa kweteknoloji rhoqo. Ukuba iklinikhi yakho isebenzisa ukusigxothwa ngoncedo ngamnye kwisigulane, xela ugqirha wakho malunga nokuba kungani bacinga ukuba oku kulungile kuwe. Unokuguqula iteknoloji.
Nangona kunjalo, kuba ngamaqela athile abagulane, ukuncedwa ukuhlanjwa kungenceda. Njengamaxesha onke, xela ugqirha wakho malunga nemeko yakho.
> Imithombo:
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> Hammadeh ME1, Fischer-Hammadeh C, Ali KR. "Ukuncedisa ukuhlengahlengiswa ekuveliseni ukukhutshwa: umgangatho wobugcisa. "Ndimncedise i-Reprod Genet. 2011 Feb; 28 (2): 119-28. i-doi: 10.1007 / s10815-010-9495-3. Epub ngo-2010 Nov 2.
> Jwa J1, Jwa SC2, Kuwahara A3, Yoshida A4, Saito H5. "Ingozi enkulu yokungabikho kokuzalwa komntwana emva kokuncedisa ukuchithwa: uhlalutyo lweminyaka emithathu yedatha evela kwi-registry yobhaliso yokuvelisa iJapan. "Fertil Steril. 2015 Jul; 104 (1): 71-8. i-doi: 10.1016 / j.fertnstert.2015.03.029. Epub 2015 Apr 29.
> Knudtson JF1, Failor CM2, Gelfond JA3, Goros MW3, Chang TA2, Schenken RS2, uRobinson RD2. "Ukuncedisa ukugxotha nokuhlala ngokuzalwa ekuhambeni kokutshintshwa kwembumbulu egciniweyo. "Fertil Steril. 2017 Oct; 108 (4): 628-634. i-doi: 10.1016 / j.fertnstert.2017.07.011. Epub 2017 Aug 30.
> TA Chang, JF Knudtson, YT Su, ES Jacoby, RD Robinson, RS Schenken. "Ukusebenza kokuncedisa ukuchithwa ngokusekelwe kumgangatho we-embryo kwiimjikelezo ze-IVF kunye nokutshintshwa okutsha. " Ukhuseleko kunye nobutyebi . NgoSeptemba 2016., uMqulu 106, iNqaku 3, iSongezelelo, Ikhasi e314.