Ukuqhaqhazela ngokungafihli nto engachaziyo

Ngaba kufuneka ulandele unyango lokuzala okanye uqhubeke uzama ngokwakho?

Iyiphi indlela engcono kakhulu yokukhulelwa xa ubhekane nokungabonakali kokungafumaneki ? Akukho mpendulo ecacileyo.

Ngokuqhelekileyo, xa ungeke ukhulelwe , isinyathelo sokuqala uvavanyo lokuzala . Emva koko, xa kunokufunyanwa (okanye kubangele), kukho unyango olufanelekileyo.

Ukuba awukho i- ovulating , iCommid inokuzama . Ukuba ubuncinane besilisa buphantsi , i- IUI okanye i- IVF inokucetyiswa .

Kodwa uyayiphatha nini xa ugqirha engazi into engalungile?

Ukungakwazi ukuchaswa okungachazwanga kugcinwe ngokwemigaqo. Oku kuthetha ukuba isicwangciso sonyango sisekelwe kumava okliniki kunye nokuqikelela.

Imephu yonyango eqhelekileyo yonyango engenakuchazwa ibonakala kanje:

1. Izitshintsho zendlela yokuphila zinconywe (njengokulahlekelwa kwesisindo, ukuyeka ukutshaya)
2. Qhubeka uzama ngokwakho (ukuba uselula kwaye uzimisele) kwiinyanga ezintandathu ukuya kunyaka
3. I-Clomid okanye i- gonadotropini kunye ne- IUI imijikelezo emithathu ukuya ezintandathu
4. I-IVF yokwelapha imijikelezo emithathu ukuya ezintandathu
5. (Ngokuqhelekileyo) unyango lwe-IVF yeqela lesithathu (njengokusebenzisa umxhasi weqanda okanye ukuxhaswa)

Ngamanye amaxesha, kwiziganeko ezingapheliyo ezingenakuchazwa ngaphandle kwe-IVF eyimfuneko, kukho unyango oluthile oluphikisanayo.

Ngaphantsi kuhlolisiso olusondeleyo kule nkqubo nganye kunye nemigangatho yokuphumelela kokukhulelwa.

Indlela yokuphila iinguqu kwiNyango engabonakaliyo yokungafihli

Ngokukodwa xa kubangelwa ukungazinzi, ukuphucula impilo yakho yonke kubalulekile.

Iindlela eziphambili eziphakanyisiweyo zokuphila zitshintsha ukuphucula ukuzala kwakho ngokwemvelo zi:

• Ukunciphisa umzimba ( ukuba ungaphezu komzimba ophezulu) kunye nokusebenzisa umzimba.
• Yeka ukutshaya .
• Gwema utywala obuninzi.
• Khawukhumbule iziphuzo ze-caffeinated .
• Ukunciphisa uxinzelelo jikelele .

Kukho konke okuthethiweyo, akukho uphando olubonisa ukuba ukwenza utshintsho kunokunceda kukukhulelwe.

Kubalulekile ukwazi.

Ukunikezelwa kwindlela yokutshatyalaliswa kokungabonakali, kungakhathaliseki ukuba uphila njani utshintsho lwakho kunye nomlingane wakho ukwenza ukuba uphucule impilo yakho yonke ingcono kwaye inokukunceda.

Ukuzama ukuqonda ngaphandle kweZonyango eziZodwa zoNyango

Mhlawumbi awufuni ukuva kugqirha wakho ukuba isinyathelo sokuqala 'uqhubeke uzama ngokwakho' kwezinye iinyanga ezintandathu.

Nangona kunjalo, kwezinye iimeko, kusenokuba isicwangciso esihle.

(Kodwa emva kokuvavanya kuqinisekisile ukuxilongwa kwakho ngokungacacisiwe. Akusiyo ingcamango efanelekileyo yokuqhubeka uzama phambi kokuba uvavanywe kokubili kuba ezinye izimbangela zokungabi nantoni zibuhlungu ngakumbi.)

Ulawulo olulindelekileyo xa ugqirha wakho engagqirha unyango ngokukhawuleza, kodwa uqhuba uvavanyo olusisiseko lokuhlola kwaye unokujonga imeko njengoko uzama ngokwakho ixesha elincinane.

Uvavanyo lwangonyango olulinganiselwe luqhutyelwa luqhathaniswa nolawulo olulindelekileyo (kwiibini ezithandekayo) kunye ne-IUI kunye neziyobisi zokuzala.

Isifundo senzeke kwiinyanga ezintandathu.

Kwababhinqa abafumana i-IUI kunye neziyobisi zokuzala ...

• Iipesenti ezingama-33 zabafazi bafezekisa ukukhulelwa
• Iipesenti ezingama-23 zokukhulelwa ziyaqhubeka ekupheleni kwesifundo

Kubafazi abazange bamkele unyango, baya kulawulo lokulindela ...

• Amaphesenti angama-32 awakhulelwe
• Iipesenti ezingama-27 zokukhulelwa zaziqhubeka ekupheleni kokufunda

IUI kunye neziyobisi zokuzala abantu abanokuzihlambalaza kakuhle abazange baphucule imiphumo yabo yokuphumelela ukukhulelwa. Izibini ezaqhubeka zizama ngokwawo zazingenako ukukhulelwa njengalezo zonyango.

Iindleko zonyango ezinikezelweyo, izingozi zeziyobisi ezinobungozi , kunye nobungozi obuninzi bokukhulelwa okuphindaphindiweyo , ukuzama ngokwakho ixesha elithile elichanekileyo lingaba likhethelo elihle.

Ukwakha kulolu uphando, olunye uphando lubhekisela kwinto eyenzekayo xa iibini zinikwe isicwangciso sonyango esekelwe kwi-prognosis.

(Ukugxekwa kwabo kwakunqunywe ngokujonga iminyaka yabo kwaye bade bazama ukukhulelwa njani.)

Kule sifundo, iibini zanikwa enye yeendlela ezintathu: qala ngokulawulwa okulindelekileyo, qalisa nge-IUI ngeziyobisi zokuzala, okanye uhambe ngqo kwi-IVF unyango.

Ipesenti ezingaphezu kwe-90 zebhangqa zanikezelwa kwiqela lokuqala lokulawula.

Ngophelo lwesifundo, iipesenti ezingama-81.5 zezibini ziphumelele ukukhulelwa.

Kulokhu kukhulelwa, iipesenti ezingama-73,9 zakhulelwa ngaphandle kokunyanga.

Ezi zinto zinzima kakhulu, ingakumbi xa ucinga ukuphumelela kwezinga lokungabikho kwengqondo ngokubanzi.

(Xa ukhangele zonke izizathu zokungabikho kwempilo kunye neemeko, ukuhlaliswa kwamazinga okuzalwa emva kokunyanga kungaphantsi kwama-50 ekhulwini.)

Ngaba uyaqhubeka ezama ukukhetha okulungileyo?

Njengamaxesha onke, xubusha zakho iindlela kunye nodokotela wakho. Ezi zombini zifundo zilapha kuphela zibandakanya imibhangqwana efanelekileyo. Babesecaleni elincinci kwaye bebengakhange bazama iminyaka.

Ngokuqhelekileyo, ukuphathwa okulindelekileyo kwiinyanga ezintandathu ukuya kunyaka kuphela indlela efanelekileyo ukuba ...

• I-A ngokusebenzisa impembelelo yokuzala iqhutywe, kunye nokuzaliswa kobabini kunye nabesifazane abavavanywa. (Ukuxilongwa kufanelekile "kungekho nto.")
• Uvavanyo lwe-Ovarian reserve ( FSH , AMH, kunye ne- antral follicle counts ) lubonakala luhle.
• Uzame iminyaka engaphantsi kweyodwa ukuya kweyodwa wedwa.
• Uneminyaka engama-35 ubudala okanye ubuncinci.

Ngaba i-Clomid Yodwa iyisisombululo esihle sokungenzi lutho olungenakuchazwa?

I-Clomid iyona mveliso echanekileyo yokunyanga, kwaye inokunceda abasetyhini abangenayo i-ovulating. ( Kungaphinda kukhulise umveliso wesilisa ngezizathu ezithile zokungabikho komntwana.)

Ugqirha wokuqala oya kubona xa uzama ukunyanga intsapho yakho yokungabikho kwengqondo ngumntwana wakho. Bakho banokukunika i-Clomid, nangona unako ukungachazi kakuhle, kwaye ukuthumela ngendlela yakho.

Oku kungaba yinkcitho yexesha kwaye kukubonise engozini kunye nemiphumo emibi ngaphandle kwenzuzo.

Icandelo lokulawula ngokungapheliyo eScotland lalibandakanya amabhinqa angama-580 anokungachazi kakuhle.

Abasetyhini babethathwe ngokulandelelana kwelinye lamaqela amathathu kwiinyanga ezintandathu zonyango:

• Ulawulo olulindelekileyo
• Unyango lweComid
• IUI yedwa (akukho mveliso yeziyobisi)

Inani lokuzalwa lokuzalwa kwiqela ngalinye liyi:

• Iipesenti ezili-17 zokulawula okulindelekileyo
• 13 ekhulwini kwiComomid
• Iipesenti ezingama-22 zonyango lwe-IUI

Kuyathakazelisa ukuqaphela ukuba amaxabiso okuzalwa aphantsi kancinci kunokuba ulawulo olulindelekileyo, kwaye oku kunengqiqo. Imiphumo yeComomid yenzelwe ukunciphisa ezinye iinkalo zobuncwane bakho.

Uhlalutyo lwe-meta lwezilingo ezininzi zokulawulwa kwe-Clomid ye-Clomid ye-infertility engachazwanga ziqwalaselwe iziphumo zezifundo ezisixhenxe ezahlukeneyo. Izibini ezizi-1,159 zifakwe kule sifundo.

Olu pho nonongo lufumene ukuba akukho bungqina bokuba uColomid yedwa unyango olungenakuchazwa.

Ukwelashwa kwe-Clomid akuyona nto inobungozi. Unyango lukhuthazwa kuphela ukuya kwiijikelezo ezintandathu, ngenxa yengozi enokwenzeka yokwanda komhlaza .

Ukuba ugqirha wakho ubonisa u-Clomid wedwa, xubusha ukuba kuya kuba ngcono ukuqhubeka uzama ngokwakho ixesha elide, okanye uxoxe ukuba ngaba baya kucinga ukuba baya kuhamba ngqo ku-IUI kunye noClomid.

(Oku kungadinga ukunyuka kwiklinikhi yokuzala kunye ne- endocrinologist yokuzalana .

IUI kunye neziyobisi zokuLwela ukungafihli

Kulabo abangenalwazi olungabonakaliyo, i-IUI yodwa okanye kunye neziyobisi zonyango ziye zaboniswa ukuba zandise ukwanda kweengxaki zakho zokukhulelwa.

Ubungqina abukomelele. Nangona kunjalo, ngenxa yeendleko eziphezulu kakhulu kunye nokunyuka kwe-IVF, i-IUI kunye neziyobisi zokuzala zifanelekile ukuzama.

Ngenxa yokungakwazi ukuchasana, i-Clomid ne-IUI ibonakala iyona khetho ekhethiweyo phezu kwe-IUI kunye ne-gonadotropins.

Ngophando lokulawulwa ngokungahleliwe, izibini zatshintshwe ngezigaba ezintathu ze-IUI ne-Clomid, okanye i-IUI enegonadotropin, okanye i-IVF.

Ukukhulelwa kwaba:

• 7.6 ipesenti nganye ngomjikelo weComidid nge-IUI
• 9.8 pesenti ngomjikelezo we-gonadotropins kunye ne-IUI
• Iipesenti ezingama-30.7 ngomjikelezo we-IVF

I-Gonadotropins ibiza kakhulu kwaye iyakwazi ukukhokelela kwi-ovarian hyperstimulation syndrome (OHSS) kunye nokukhulelwa okubanzi . Kodwa azinako ukuphucula izinga lokukhulelwa ngokwaneleyo ukuzithethelela ezo zingozi.

Zingaphi iisyingi ze-IUI omele uzame? Oku kuya kuxhomekeka kwiminyaka yakho kunye nomdla wakho ekuphandeleni unyango lwe-IVF ukuba i-IUI ingaphumeleli.

Kwalawo avulelekile kwi-IVF, imijikelezo emithathu ye-IUI kunye neClomid mhlawumbi ilungileyo ngaphambi kokuhamba kwi-IVF.

Ngokomxholo ofanayo ukhankanywe ngentla, izibini ezazama i-IUI kunye ne-gonadotropins ngaphambi kokufudukela kwi-IVF zithatha ixesha elide ukuba zikhulelwe kwaye zichithe imali engakumbi kunyango jikelele.

Kulabo abangenayo okanye abanako ukuphanda unyango lwe-IVF, uphando lubonisa i-IUI kunye neziyobisi zokuzala zifanele ukuzama ukufikelela kwimijikelezo engama-9.

Amathuba akho amahle kakhulu okuphumelela nge-IVF

Xa kuziwa ekuphatheni ukungabonakali kokungazalanga, IVF ineyona ndlela engcono yokukhulelwa.

Izinga lokukhulelwa kwe-IVF unyango zihlandlo ezintathu ukuba ziphi i-IUI kunye neClomid. (Oku kuya kuhluka ngokweminyaka, nangona kunjalo.)

Njengoko kuchaziwe ngasentla, izinga lokukhulelwa kweComidid ne-IUI li-7.6 ekhulwini. Izinga lokukhulelwa ngamnye ngomjikelezo we-IVF yi-30.7 ekhulwini.

Akunjalo kuphela amazinga okuphumelela aphezulu kwi-IVF, isizathu sokuba "ukungachazwanga" ukungabikho kwengqondo ngamanye amaxesha kutholakala ngexesha lotyando.

Kuphela ngexesha le-IVF lingafaka umgangatho weqanda, inkqubo yokuchumisa, kunye nokuphuhliswa kombindi kubonwa ngokukhawuleza.

Konke okutshoyo, i-IVF ingabonakali kwaye ibiza .

Unokucinga ukuhamba ngqo kwi-IVF yinto ekhethekileyo yokukhetha (enikwe amazinga aphezulu okuphumelela). Kungcono kakhulu ukuba ininzi yezibini zinike i-IUI kunye noComomid kuqala.

Uninzi lweenkampani ze-inshorensi (ezinikezela nayiphi na uhlobo lwe-IVF coverage) zifuna unyango oluncinci ukuba luzame kuqala.

Nangona kunjalo, ukuqhubela ngqo kwi-IVF kunye nokweqa i-IUI inokuba yinto ekhethekileyo xa uneminyaka yobudala engama-38 okanye ngaphezulu.

Le nto inokuxoxa ngayo nodokotela wakho.

Ngaphandle kwe-IVF ye-Unflained Infertility

Kuthekani ukuba i-IVF yodwa ayaneleyo? Okanye kuthekani ukuba i-IVF yendabuko ihluleka?

Kukho ezinye iindlela.

Ukwelashwa kwe-immunological yokuzala : Kukho inkolelo yokuba amangqamuzana obulali bendalo angadlala indima ekungabonakali kokungazalanga, ukungaphunyezwa kweVF ngokuphindaphindiweyo, okanye ukuphuphuma kwesisu ngokuphindaphindiweyo.

Naphezu kwegama labo, "amangqamuzana abulali bemvelo" awona mbi. Uyabathanda. Awufuni ukuba basebenze ngokugqithiseleyo okanye baninzi kakhulu kubo.

Ukufakelwa kwe-intravenous nge-substance eyaziwayo njenge-intralipids ngexesha lotyando lwe-IVF lunokunciphisa impembelelo yamaseli ebulali bemvelo.

Nangona kunjalo, okwangoku akukho ubungqina obuqinileyo bonyango olunokuphucula ii-IVF eziphilayo.

Ukususwa kweentlawulo ze-endometrial : Abanye bakholelwa ukuba ukungabonakali kwemvelo kungabangelwa kukuphela kwe-endometriosis .

Kule meko, idiphozithi ye-endometrial ingabangela ukubandezeleka okanye ukuphazamisa ngokukhawuleza i-ovulation okanye i-fallopian tubes, kodwa ubukho babo bunokunyusa "ukucaphuka" kwenkqubo yokuzala.

Oku kungabangela isizathu sokungaphumeleli kwe-IVF ngokuphindaphindiweyo, ngokweli ngcamango.

Abanye oogqirha baya kunika utyando lwe-laparoscopic ukuxilonga kunye nokususa i- endometriosis embi ngaphambi kokuba i-IVF ihendwe. Abanye baphakamisa kuphela emva kokuhluleka kwe-IVF.

Enoba le nyango ingathucula amaxabiso okuzalwa aphilileyo.

Iminikelo yeGamete : Ukuba iingxaki zeqanda, i-sperm okanye i-embryo zifumene ngexesha le-IVF, ugqirha wakho unokuncoma ukusebenzisa i-gamete okanye umxhasi wombindi kwixesha elilandelayo le-IVF.

Umnikelo we-egg yindlela ebiza kakhulu, elandelwa ngumnikelo wesibindi, kunye neminikelo yesisu.

Imilinganiselo yempumelelo yabanikeli beqanda ngokubanzi iphezulu, ezo ziindaba ezilungileyo.

Izinga lomnikelo we-Embryo ziyahlukahluka kuxhomekeke kwimvelaphi yombungu. Ngokomzekelo, iminikelo emininzi yembungu iphuma emibuswini eyongezelelweyo eyenzelwe enye yonyango lwe-IVF.

Ukuzixhalabisa : Ukuba unyango lwe-IVF ludlulela ngokuphindaphindiweyo emva kokutshatyalaliswa kwembungu, ukunyuka kwesisu kungabangela isinyathelo esilandelayo.

Ukuxhomekeka kwindleko kuxabisa kakhulu kwaye kungekhona (ngokulula) kufumaneka ngokusemthethweni kuzo zonke iindawo. Kwabo abanokukwazi ukufikelela kunye nokufikelela kwiinkonzo zonyango, kungaba yindlela yabo yobuzali.

> Imithombo:

> Brandes M1, Hamilton CJ, van der Steen JO, de Bruin JP, Bots RS, Nelen WL, Kremer JA. Ukungafihlanga okungacaci: Inani eliqhelekileyo lokuTyala lokuKhulelwa kunye neNdlela yokuCoca. " Uhlambalaza . 2011 Feb; 26 (2): 360-8. i-doi: 10.1093 / i-humrep / deq349. Epub ngo-Agasti wama-16.

> I-Custers IM1, Steures P, Hompe P, Flierman P, van Kasteren Y, van Dop PA, van der Veen F, Mol BW. "I-Intrauterine Insemination: Zingaphi Iiskrini Okufanele Sizenze?" U-Hum Reprod 2008, 2008 (23): 885-8: i-10.1093 / humrep / den008.

> Hughes E1, Brown J, Collins JJ, Vanderkerchove P. "I-Clomiphene Citrate ye-Unflacial Defence in Women." I-Cochrane Database Syst Rev. 2010 Jan 20; (1): CD000057. i-doi: 10.1002 / 14651858.CD000057.pub2.

> Reindollar RH1, Regan MM, Neumann PJ, Levine BS, Thornton KL, Alper MM, Goldman MB. I-Trial Clinic Trial Yokuhlola I-Optimal Treatment ye-Infertility Engachazeki: I-Track Fast and Standard Treatment (FASTT). "UFertil Steril. Ngo-Agasti ka-2010; 94 (3): 888-99. i-doi: 10.1016 / j.fertnstert.2009.04.022. Epub 2009 Juni 16.

> Wordsworth S1, Buchanan J, Mollison J, Harrild K, Robertson L, Tay C, Harrold A, McQueen D, Lyall H, Johnston L, Burrage J, Grossett S, Walton H, Lynch J, Johnstone A, Kini S, Raja A, Templeton A,