Ukuqonda iinkqubo ze-IVF, iingozi, iiNdleko kunye neNtlawulo zeNtuthuko
I-IVF imele i- vitro fertilization, okuthetha ngokuthethileyo "kubunzana bokubumba." Ngonyango lwe-IVF, iqanda lixutywa ngedoda kwisitya se-petri. Ngokuqhelekileyo, amaqanda amaninzi athatyathwa kumama wezinto eziphilayo (onokuthi mhlawumbi angaba ngumzali ohlosiweyo), kungekhona yonke iqanda eliza kuzalisa, kwaye akuyiyo yonke iqanda ekhulelweyo iya kuba ngumbungu onobomi.
Kwiintsuku ezimbalwa emva kokuchumisa, i- embrayo okanye iimbungu ezinqamlekileyo zihanjiswe kumama okanye kwisibeletho sokuxhamla kwi-catheter ngomlomo wesibeleko.
Nayiphi na i-embrasi eyongezelelweyo ingasetyenziselwa i- cryopreserved kwixesha elizayo.
I-IVF isetyenziswa nini?
Ngenxa yokuba amaqanda athatyathwa ngokuthe ngqo ukusuka kumaqanda, kwaye i-embryo idluliselwa kwisibeletho nge-cervix, i-IVF ayifuni iifayili ezivulekileyo ezicacileyo. Abasetyhini abaneengqungquthela ezivaliweyo ze-fallopian bangasebenzisa ii-IVF ukuze bafumane ukukhulelwa.
I-IVF isetyenziselwa iimeko zokungabikho komntu ongenakunqotshwa ngonyango lwe-IUI okanye ezinye izibonelelo. Kwezinye iimeko, amadoda angenawo umduna kwisityalo sawo angaba nesidoda esilungiswa ngokuthe ngqo ukusuka kwamathambo okanye kwi-deferens. Amadoda anesibalo sembewu esezantsi maninzi amathuba okufumana impumelelo yonyango nge-IVF.
I-IVF ingasetyenziselwa kunye ne- ICSI , ebandakanya ukuthatha isidoda esisodwa kunye nokuyifaka ngqo kwiqanda. Nangona i-sperm ngokuthe ngqo ijojowe kwiqanda, ukuchumisa akukaqinisekanga, kodwa ithuba lokukhulelwa impumelelo liphezulu kakhulu kunye ne-ICSI ngaphandle kwalabo bafuna le nkqubo.
I-IVF ingasetyenziselwa nakwiimeko zokungabikho kwengqondo engabonakaliyo, abafazi abafuna ukusebenzisa iqanda okanye abaxhasi bombindi, abo basebenzelana nokuqhelana nomdabu okanye umntu ophethe isithwathwa, okanye emva kokunyanga okungekho ukuzala .
Inkqubo
Inkqubo ye-IVF ingaba yinto eyahlukileyo kubantu abahlukeneyo, kuxhomekeke kulokho ubuchwepheshe bokuzala bokuncedisa basetyenziselwa nokuba ngaba amaqanda , i-sperm, okanye ama-embro ayenayo okanye angabanikeli.
Kukho ezinye iimeko ezikhokelela kumjikelezo okhutshisiwe phakathi, mhlawumbi ngenxa yokuba iifollicle ezinganeleyo zikhula okanye ngenxa yengozi ephezulu ye- ovarian hyperstimulation syndrome (OHSS) .
Oko kwathiwa, oku kuyisicatshulwa esisiseko senkqubo.
Ngokuqhelekileyo, lo mfazi uya kuqalisa ukuthatha iipilisi zolawulo lokuzalwa okanye iyeza elinojojozo elivimbela ukuvuthwa komjikelezo ngaphambi kokunyanga , ukuvala umjikelo oqhelekileyo wokujikeleza. Oku kunjalo ugqirha unako ukulawula i-ovulation kwaye ungalahlekelwa amaqanda phambi kokufunyanwa. Emva komsebenzi wegazi osezantsi kunye ne-ultrasound, lo mfazi uya kuqala ukufumana imithi yokuvuselela i-ovulation, ngokuqhelekileyo i- gonadotropins .
Kwi- IVF , Clomid okanye akukho mayeza avuselela ama-ovulation asetyenziswa, kodwa oku akuqhelekanga. Ikliniki iya kujonga ukukhula komntu kunye namazinga e-hormone nge-ultrasound kunye negazi ngeentsuku ezininzi.
Xa iifollicle zikhangelekile zilungele, le ntokazi iya kufumana ijokeji yeHCG ukuvuthisa amaqanda. Ukufunyanwa kweqanda kuya kulungiswa kwinani elikhethekileyo leeyure emva kwesojojo, ngexesha apho lona wesifazane uya kufumana i-IV sedation kunye namaqanda aya kufunyanwa ngokusebenzisa inaliti ekhokelwa yi-ultrasound ngokusebenzisa udonga lwesisu.
Ngelixa umfazi sele efumana iqanda lokubuyiswa kweqanda, le ndoda iya kunika isampuli yesazi.
Ngamanye amaxesha oku kwenziwa kanye ngexesha lokubuyiselwa kunye nakwexesha elide ngaphambi kokuba kulandelwe imini (kunye neqhwa), xa kukho iingxaki okanye ukuxhalabisa ukudala isampuli.
I-semen iya kuhamba ngendlela ekhethekileyo yokuhlamba, kwaye amaqanda aya kufakwa kwiinkcubeko ezikhethekileyo. Idiza iya kufakwa ngamaqanda, ngethemba lokuba ukuchumisa kuya kwenzeka.
Kwiintsuku ezimbalwa emva koko, i-embrologist izokukunceda ukhethe i-embrosi ekhulile, enoba yintoni na, kunye nogqirha wakho wokuzala uza kunceda ukuba unqume ukuba uninzi lweembryo ukutshintshwa. Iimbrusi ze-Leftover zinokuthi zikhishwe i-cryopreserved umjikelezo kamva, zinikezelwa kwesinye isibini, okanye ziphonswe.
Imali yoPhumelelo
Ilungelo lakho lokuphumelela kwe- IVF liya kuxhomekeka kwimibandela eyahlukeneyo, kubandakanywa nobudala bakho, kubangele (okanye) ubunzima bakho, nokuba ngaba amaqanda anikezelayo ayasetyenziswa, iziphumo zonyango zangaphambili, kunye nolwazi lwekliniki kwiimfuno zakho ezithile.
Oku kuthetha, ngokubanzi, unyango lwe-IVF lunempumelelo yezinga eliphezulu. Ngokwezibalo zonyaka ka-2009 eziqokelelwe nguMbutho wezoNxibelelwano zoBuncwane obuncedisayo (SART), kubafazi abangaphantsi kwama-35, ipesenteji yokuzalwa ngokuzalwa kwimijikelezo ye-IVF yayingama-41 ekhulwini.
Amanani okuphumelela ayancipha kunye nobudala, ngezinga leepesenti ezili-12 leempumelelo kubasetyhini abaneminyaka engama-41 ukuya ku-42.
Khu seleko
I-IVF ikhuselekile ngokubanzi, kodwa njengoko kukho nayiphi na inkqubo yonyango, kukho iingozi. Ugqirha wakho kufuneka ahlale phantsi kwaye achaze zonke iziphumo ezichaphazelekayo kunye nemingcipheko yenkqubo nganye.
I-Ovarian hyperstimulation syndrome (OHSS) ivela kwi-10 ekhulwini yabasetyhini abahamba nge-IVF. Kwabafazi abaninzi, iimpawu ziya kuba mnene kwaye ziya kulula ngokulula. Kwipesenti encinci, i-OHSS ingaba yingozi kakhulu kwaye ingafuna ukulaliswa esibhedlele. Ngaphantsi kwama-1 ekhulwini kwabasetyhini abahamba ngokusebenzisa i-egg retrieval baya kuba namava egazi okanye ukungaphumeleli kwezintso ngenxa ye-OHSS.
Ukufunyanwa kweqanda kunokubangela ukuphazamiseka nokuphazamiseka ngexesha okanye emva kwenkqubo, kodwa abaninzi abafazi baya kuziva bephucukileyo ngosuku okanye njalo. Iingxaki ezinzima zibandakanya ukugqitywa ngokukhawuleza kwe-bladder, ubilwane, okanye imilambo yegazi; ukusuleleka kwe-pelvic; okanye ukuphuma kwiimpahla ze-ovary okanye ze-pelvic.
Ukuba ukusuleleka kwe-pelvic kwenzeka, uya kunyangwa ngamayeza omzimba. Kwiimeko ezinqabileyo zentsholongwane ekhuselekileyo, isisu, amaqanda okanye ama-tubespian tubes zingadinga ukucinywa.
Ukutshintshwa kwembungu kungabangela ukunyanzeliswa kancinci ngexesha le nkqubo. Ngokuqhelekileyo, abasetyhini baya kuba namava, ukuphuma, okanye ukuphawula emva kokutshintshwa. Kwiimeko ezininzi ezingaqhelekanga, usulelo luya kwenzeka. Usuleleko uphethwe ngokusasazwa ngamayeza.
Kukho umngcipheko wokuphindaphinda, oquka amawele, ama-triplets, okanye ngaphezulu. Ukukhulelwa okuninzi kunokuba yingozi kubantwana kunye nonina. Kubalulekile ukuxoxa kunye nodokotela wakho ukuba uninzi lweembryu zokudlulisa, njengoko ukudluliselwa ngaphezu kokuyimfuneko kuza kwandisa umngcipheko wakho wokukhulelwa amawele okanye ngaphezulu.
Olunye uphando lufumene ukuba i-IVF inokuphakamisa umngcipheko wezinye iingxaki ezingabonakaliyo zokuzala, kodwa ingozi ihlala iphantsi. Uphando lufumene nokuba ukusetyenziswa kwe-ICSI kunye ne-IVF, kwiimeko ezithile zokungabikho komntwana , kunokunyusa umngcipheko wokungabikho komntwana kunye nokukhubazeka kokuzalwa kwesini kubantwana besilisa. Lo mngcipheko, nangona kunjalo, usezantsi (ngaphantsi kweepesenti ezi-1 ezikhulelwe nge-IVF-ICSI).
Ukukhulelwa kwe-IVF
I-IVF inomngcipheko ophezulu wokukhulelwa ngokuphindaphindiweyo, kwaye ukukhulelwa okuphindaphindiweyo kuthwala ingozi kumama kunye neentsana. Ubungozi bokukhulelwa okuqela kubandakanya abasebenzi bexesha elide kunye nokuhanjiswa kwegazi, ukukhulelwa komama, ukuhanjiswa kwecandelo leC , ukukhulelwa kubangela uxinzelelo lwegazi oluphezulu kunye nesifo sikashukela .
Uphando lufumene ukuba abafazi abakhulelweyo abane-IVF banokufumana ithuba labasebenzi bexesha elide , nangona usana olungabantwana.
Abafazi abakhulelwa nge-IVF banokuthi bafumane ukuphazamiseka ekukhulelweni kokuqala , nangona kunokwenzeka ukuba bayakwazi ukulungisa ngaphandle kokulimaza ukukhulelwa.
Umngcipheko wokuphuphuma kwesisu ufana nawabasetyhini abakhulelwe ngokwemvelo, benomngcipheko okhuphuka kunye nobudala. Kubafazi abaselula kuma-20 abo, isantya sokuphuphuma kwesisu sezantsi ukuya kuma-15 ekhulwini, ngelixa kubasetyhini abangaphezu kwama-40, izinga lokukhulelwa kwesisu lingaphezulu kwama-50 ekhulwini.
Kukho umngcipheko we-2 ukuya kwe-4 weengcipheko zokukhulelwa kwe- ectopic ne- IVF design .
Iindleko
Iindleko eziqhelekileyo ze-IVF yi-$ 12,000, kodwa oku kuyahluka ngohlobo lwezobuchwepheshe ezisetyenziswayo. I-IVF kunye ne-egg donation iyona nto ixabisa kakhulu, kunye nomjikelezo omnye uvela kwi $ 25,000 ukuya kwii-30,000 zamawaka.
> Imithombo:
> Ukuncedisa ubuchwepheshe bokuzala: Isikhokelo sabathinteli. Umbutho waseMelika weMithi yokuzala. http://www.asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/ART.pdf
> IiNgxelo zeSkritish Summary. Umbutho wezobuNtu boLwazi lobuNzala. https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=0
> Izingozi ze-Vitro Fertilization (IVF). Umbutho waseMelika weMithi yokuzala. http://www.asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/risksofivf.pdf