Izimbangela zokungabikho komuntu kungase kube ukwephulwa kwe-spermatogenesis, ngenxa yesifo sokuvuvukala, ukuhlukunyezwa, izifo ezithathelwanayo ebuntwaneni (izimpumputhe ikakhulukazi), izifo ezithathelwanayo nge-urogenital (gonorrhea), ukutholakala kwe-cryptorchidism, varicocele, nokudakwa nokuphuza utshwala noma ama-chemical agents. Okubaluleke kakhulu ekuthuthukiseni ukungabi nabantwana emadodeni i-herpes simplex virus kanye nokutheleleka kwe-chlamydial, lapho isilisa singathwala khona ukutheleleka emzimbeni wesifazane. Ukungabi nalutho nakho kwenzeka ngezifo ezikhungathekile zesibindi, izinso, amaphaphu, i-endocrine pathology (isifo sikashukela, isifo sika-Itenko-Cushing).
Ngesinye isikhathi ukungabi namuntu kwenzeka ngenxa yokuzwa owesifazane kumuntu othile wesilisa.
Endabeni uma kunezinguquko ku-spermogram, indoda idluliselwa ku-sexopathologist noma i-andrologist.
Uma yonke imingcele ye-spermogram ingavamile, ukuhlolwa kwesifazane kuqala.
Izimbangela eziyinhloko zokwelashwa kwabesifazane yizi:
- Ukuhlukunyezwa kwe-ovogenesis nokungabi khona kwe-ovulation - 35-40%;
- Amapayipayipi -20-30%;
- Izifo zezitho zangasese - 15-25%;
- Izimbangela ezingavamile - 2%.
Ukuzihlola kokungabikho kwamantombazane kungamanga, okokuqala, ekuqoqweni okuhambisana ne-anamnesis (yobudala, umsebenzi, ithonya lezinto ezilimazayo ekukhiqizeni, izifo ezidlulisiwe, imikhuba emibi). Tactically ukucacisa izimo zobungqingili bokuphila, umsebenzi wokubeletha, okusho ukuthi ukungabi nabantwana okuyinhloko ngokuvamile kubangelwa ukuhlolwa kwezingane, kanti eyesibili yisisusa sezinqubo ezivuthayo zokuvuvukala.
Ngokuvamile kunalokho, imbangela yabesifazane abangenayo i-infertility yizifo ze-endocrine ezihlobene ne-ovogenis ekhubazekile kanye nenqubo yokwehla. Ukungazi lutho kuyathinta abesifazane abanezinhlobo ezahlukene ze-hyperpolaktinemia, i-hyperandrogenism, nesifo se-polycystic ovary syndrome. Inani elikhulu lamacala okungazalwa yilona umphumela wokuphulwa komsebenzi we-endocrine wama-ovari, ngaphezu kwalokho, lezi zinkinga zingaba kokubili eziyisisekelo nesekondari, umphumela wokuvuvukala okudlulisiwe. Emaqanda ama-ovari, izinqubo ze-cyclic ziphazanyiswa, ukugcoba noma ukunciphisa ukuvuthwa kwe-follicle ngesigaba esingaphansi kwe-luteal kwenzeka. Ngenxa yokungabi nalutho kwe-endocrine, ukungahambi kahle komjikelezo wokuya esikhathini kuvame ukubonwa: i-amenorrhea - ukungabi khona kwesikhathi kokuya esikhathini, i-hypomenstrual syndrome - ukukhipha ngesikhathi sokuya esikhathini kuncane kakhulu futhi kuphuma igazi.
Izimbangela ze-peritoneal infertility yizinqubo zokunamathela emgodleni omncane, okubangela ukuguqulwa kwezilimo eziyizigaxa ngenkathi kugcina ubuciko bawo. Ukwelashwa kweT Tubal kungenxa yokuphazamiseka kwe-anatomical and functional kumatayipi angama-fallopian.
Ukwakhiwa kwezigubhu ze-fallopian kuvame ukuvela ngemva kwe-gonorrheal salpingitis, nakuba kungase kube nomphumela wenqubo yokuvuvukala engabonakali. Izinqubo zokuvuvukala zingabangeli nje isithiyo se-tubal, kodwa futhi nezinguquko ze-dystrophic odongeni lwayo, ukwephulwa kwe-peristalsis ye-tube. Okubaluleke kakhulu ekukhuleni kokukhulelwa kukhishwa isisu, njengoba kubangele izinqubo zokuvuvukala embranini yamangcwaba yesibeletho nezinguquko ezilandelayo ezivimbela ukufakelwa kweqanda.
Futhi, ukungabi namntwana kungabangwa ngenxa yokuvuvukala kwe-cervix uteri - endocervicitis. Ivimbela ukuthuthukiswa kwe-spermatozoa emgodini wesibeletho.
Ifomu lokungabi namuntu lokungazalwa ngenxa yokuvela kwama-antisperm antibodies kumuntu noma owesifazane, akuvamile. Ukuvama kwalo kungu-2% phakathi kwazo zonke izinhlobo zokungazalwa. Kuzo zonke izibhangqwana ezinezizathu ezingalindelekile zokungazalwa, ukuhlolwa okulandelayo ngemva kwama-20-25% kubonisa ukuthi izifo zithinta izidakamizwa. Ngokuvamile ama-antispermanye antibodies akhiwa ngamadoda kunabesifazane. Isizathu salokhu kungenzeka kube yi-vasectomy, umonakalo we-testicular kuma-orchites, ukulimala, ukutheleleka ngokocansi. Ngalolu hlobo lokungazalwa, indlela ephumelela kakhulu i-intrauterine insemination.
Abaningi besifazane abanesifo sokungakwazi ukubeletha banenkinga ehlukahlukene yesimo senhliziyo: umzwelo wokungaphansi, isizungu, ukulindela okukhulu kwesinye isikhathi sokuya esikhathini kanye nezimo ze-hysterical ekuqaleni kwawo. Inkimbinkimbi yalezi zimpawu yilokho okuthiwa "ukukhulelwa kokulindela syndrome". Ukucindezeleka okukhulu kombhangqwana oshadile kuyisidingo sokuhlola nokuqhubeka nokusetshenziswa kwezincomo zesidakamizwa kanye nesigqi sokuphila kocansi, incazelo yenkathi yokuvuthwa komuntu owesifazane onokuhlolwa okusebenzayo nokusetshenziswa kwalesi sikhathi esithile sokukhulelwa. Ngezinye izikhathi ukuphikelela okuqhubekayo kowesifazane ekusondelene ngezikhathi ezithile kungaholela ekuhlulekeni okusebenzayo kwalowo muntu kanye nokunye ukungasebenzi kwamandla. Ikhathaza ngokuphawulekayo isimo sokuxilongwa kwe-potency ye-sperm pathology. Lezi zindaba ziholela ekutheni amandla angaphezu kwesigamu samadoda, futhi imvamisa yalokho okwenzekayo incike ekuphenduleni komlingani wakho.
Kumuntu wesifazane, isidingo sokunakekela impilo yobulili emiphumeleni yokuhlolwa kokusebenza okusebenzayo kuyisimo esicindezelayo, esingagcini nje kuphela isimo se-psyche, kodwa nezitho zegciwane lesandulela ngculazi, ikakhulukazi amashubhu angama-fallopian. I-spasm yabo, i-antiperistaltic ingase ivele, ephula ngisho nokungahambi kahle kwamangqamuzana ezocansi ngisho noma bewela emathunjini. Ngakho-ke, ngezinye izikhathi isifiso esikhulu somfazi sokukhulelwa siba yisitha sakhe. Amacala amaningi ahlongozwe lapho ukukhulelwa okulinde isikhathi eside kwenzeka ngemuva kokuba owesifazane enqume ukuyeka ukwelashwa ngokuphelele, wayeke ukulinganisa ukushisa okuyisisekelo futhi aqashwe ngesikhathi sokuvuthwa okulindelekile. Lokhu kwenzeka futhi lapho umbhangqwana oshadile ulahlekelwa ithemba ngabantwana bawo futhi uthola ingane.