U-Elena Kalinina, isazi sezifo zesazi zezinzwa , MD, u-RF Government Prize umsebenzi wokusebenza "Uhlelo lwe-IVF ekwelapheni umshado ongatholakali" Ekuqaleni, indlela ye-in vitro fertilization (IVF), ehlanganisa ukuxhumeka kweqanda elivuthiwe ne-spermatozoon ngaphandle komzimba wesifazane nombungu olandelayo we-embryo isisu, kwakubhekwa njengesisombululo senkinga eyodwa. Kwakuphathelene nezimo lapho, ngenxa yezizathu ezithile, umama wesikhathi esizayo wayengenawo amathole omama: ukungabi khona kwabo kwenza ukuthi ukukhulelwa kungenakwenzeka, ngoba lapho iqanda lihlangana khona nensimu, i-egg ekhushulwa iyahamba iya embelethweni ukuze ifake emdongeni wayo futhi uqale ukuthuthukisa. Imizamo yokuvimbela le nkinga ngosizo lwe-IVF yenziwa ngabacwaningi abavela emazweni ahlukene, futhi ngoNovemba 1977 imizamo yezidokotela ze-embrylogist yesiNgisi yacaca ukuthi i-ECO izosiza ukunqoba izinhlobo ezahlukene zokungakhulelwa, kanti umama wezifo ezivela emtholampilo wase Born Born wagcina esephumelele. Umzamo olandelayo, u-601-th wokudlulisela esibelethweni sombungu okhulile ngaphandle komzimba wesifazane oholele ekuzalweni kukaLouise - "umntwana wokuqala" ovela emgodini wokuhlola.
E-Russia, ukuthuthukiswa kwale ndlela kwaqala eminyakeni engu-6 kamuva: imizamo kaVladimir Ivanovich Kulakov, umqondisi we-All-Union Research Center yokuvikela impilo yomama nengane (manje i-SC ye-Obstetrics, i-Gynecology ne-Perinatology), no-Boris Vasilievich Leonov, owahola iqembu labachwepheshe, esekelwe emtholampilo kwakukhona i-laboratory yocwaningo. Lapha, phakathi nendawo, uLenochka wabonakala - naphezu kokungabikho kwama-tubes omama wakhe omama nomzamo wesibili we-IVF. Ukulandela i-Muscovite Lenochka ngoDisemba 1986 eLeningrad, e-Research Institute of Obstetrics and Gynecology D. Otto, owokuqala emlandweni wezingane zasekhaya ze-IVF wazalwa. Ochwepheshe beCent for Infertility Treatment e-1 Grad Hospital, eholwa nguProfesa VM Zdanovsky, nabo benza imiphumela emangalisayo. Ngakho-ke, ngemizamo yamaqembu ahlukene abacwaningi, indlela ye-ECO ithole ilungelo lokuphila ezweni lakithi, futhi kusukela ngaleso sikhathi intuthuko yayo iqale kancane kancane.
Abazali abajabulayo
Ngokuhamba kwesikhathi, saqaphela ukuthi i-IVF ingasiza ekunqobeni izinhlobo ezihlukahlukene zokungakhulelwa, kokubili abesifazane nabesilisa. Lolu hlu luveza manje izinkinga ezacatshangwa ukuthi zingasenakulinganiswa: ukuvinjelwa kwamatayipi angama-fallopian, angeke abuyiselwe ngokuhlinzwa; ukukhathazeka okukhulu kwe-hormonal; ukungabi namandla okubangelwa izimbangela ezingacacile. Ukwengeza, le ndlela isinike ithuba lokuthuthukisa izinhlelo zabaxhasi, lapho iziguli ezingenayo amaqanda ngenxa yazo, zizithola kwabanye besifazane. Kuyaziwa manje futhi nethuba lokusebenzisa izinsizakalo zomama ozithandayo okhuthazelayo futhi obeletha umntwana okhulelwe ngosizo lweqanda kanye nesidoda "samakhasimende".
Indlela ye-IVF iye yaba yimpumelelo yangempela ekwelapheni ukwelashwa kwamadoda . Uma isibalo se-spermatozoa ku-papa esizayo sincane noma singenaselula, asikwazi kuphela ukucacisa "ukhetho" onamandla kakhulu, kodwa futhi sisethule ngokuqondile eqenjini labesifazane, sidlulise izithiyo zemvelo futhi siqinisekise ukuphepha kwazo zonke izindawo zayo. Le nqubo, ebizwa i-ICSI, yasungulwa kamuva nje: ingane yokuqala, yakhulelwa ngosizo lwayo, yazalwa ngo-1993.
Ngokwezinto engizibonile, indlela ye-IVF manje iyaziwa kakhulu: ingxenye ngenxa yokwandiswa kwamakhono ayo, ngenxa yokuthi izimbangela zokungazalwa zikhula. Omunye wabo: abesifazane bacabanga ngokuzalwa kwengane ngaleso sikhathi, lapho izinkinga zezempilo zengeziwe.
I-Valentin Lukin, i-Ph.D. , i-RF Government Prize yomsebenzi wayo "Uhlelo lwe-IVF ekwelapheni umshado ongatholakali" I-ECO yindlela eyaba yisisekelo sokuthuthukiswa kokukhiqizwa kwabantu. Esikhathini esizayo, ngeke kuvumele kuphela ukuphatha ukungabi nabantwana kubesilisa nabesilisa, njengoba kwenza nanamuhla, kuyosinika amathuba amasha okuvimbela nokuphulukisa izifo ezinzima ezingayithola. Phela, IVF ivumela ochwepheshe ukuba basebenze ngamaseli avumela umuntu, futhi, mhlawumbe, siyoba nethuba lokuthonya la maseli. Namuhla kunzima ngathi ukucabanga - umqondo wokulondoloza impilo yomuntu ngokusiza ukumpompela igazi kubonakala sengathi uyamangalisa ekuqaleni kwekhulu lama-20 - kodwa izikhathi, njengoba kwaziwa, zishintsha.
Enye yezihloko zokuqala zinikezwe indlela entsha, eyanikeza uLenochka ukuphila. I-Journal of Health, ngo-March 1986 Ngomntwana osanda kuzalwa, u-Elena Kalinina (ngaleso sikhathi owayengumngane omusha ocwaningayo ku-All-Union Research Center for Mother and Child Health) noValentin Lukin (ngaleso sikhathi owayeyisikhulu esikhungweni), ngoFebruwari 1986 .
Kodwa sizobuya namhlanje. Ngokufika kwe-IVF, ukungabi nabantwana kwaba lula: kungakhathaliseki ukuthi idatha yokuqala, owesifazane ophendukele kithi ukuthola usizo unethuba elingama-30% lokuthola ukukhulelwa emjikelezweni wokuqala. Futhi manje iziguli azisekho iminyaka eminingi, zixhaphaza zonke izindlela ezikhona zokuxazulula izinkinga zabo, ngoba zingabachitha.
Zikhona yini izinzuzo nezingozi? Sesivele sikhulume ngezinzuzo zendlela. Noma kunjalo angizange ngikuphakamise kubo bonke abashadile abanezinkinga. Kuyafaneleka ukucela usizo lwakhe uma amanye amathuba okuxazulula inkinga, isibonelo, abahlinzayo, abasebenza. Esinye isibonelo: Abazali besikhathi esizayo baba nenqubo yokuhlola, futhi imbangela yokungazalwa kahle ayitholakali, futhi ngaphezu kwalokho, iminyaka yabo idlule ngaphesheya kweminyaka engu-40 - kulesi simo, ukuhlehlisa ukuvakashelwa komnyango we-ECO akufanelekile. Ngokuphathelene nezindlela zokugqoka, kufanele ukhumbule lokhu: kuhilela umthelela omkhulu emlandweni we-hormonal wesifazane, ongabangela izinkinga ezingathandeki. Ngaphezu kwalokho, ukwelashwa kokungabi nabantwana nge-IVF kuyinto ebiza kakhulu.
Kungani inqubo emva kwe-IVF yenza amawele nama-triple avela kaningi?
Njengoba sekushiwo kakade, kwenzeka ukuthi akuyona nje eyodwa kuphela kodwa imibungu emibili noma emithathu iyangena esibelethweni. Kodwa-ke, wonke umuntu uyazi ukuthi kunzima ukubekezelela "inkampani" enjalo kunomntwana oyedwa (ikakhulukazi uma umama ozayo engaphansi kuka-40). Yingakho izazi ze-IVF emhlabeni wonke ziqondiswa "indalo" yokukhulelwa okungondlekile - ngokuqondene nowesifazane nomntwana. Yingakho uma umbhangqwana oshadile ufuna ingane eyodwa kuphela, emnyango we-IVF bayomhlangabeza futhi bayothatha umbungu owodwa, izikhathi eziningi njengoba kudingeka. Kwenzekani kulawo maqanda athathwe owesifazane, axhunyiwe ne-spermatozoa, kodwa engadluliselwa esibelethweni? Ngemvume ye "nkosikazi" iqhwa futhi, uma umzamo wokuqala ungaphumeleli, yenza okulandelayo, ungahambisani nalabo asele. Uma isitoreji sidliwe, inqubo iqala kusukela ekuqaleni.
Ingabe ukukhulelwa kwe-ECO nokubeletha kuhluke "kokujwayelekile"?
Ngemuva kwemizamo yophiko lwentsha ye-IVF owesifazane ukhulelwe, umama olindelekile angakwazi ukuqhubeka ebhekwa kunoma iyiphi indawo ehlelekile (isibonelo, ekubonisaneni kwabesifazane). Ukukhulelwa okunjalo kudinga ukunakekelwa odokotela, kodwa hhayi ngoba into ehlukile kulokho okuye kwavela ngokwemvelo. Yilokho nje ukuthi abesifazane basebenzisa i-IVF (ngeshwa) ngenkathi benenkinga engavimbela inkambo ezolile yezenzakalo. Ayini? Okokuqala, ubudala, okwesibili, izifo ezingapheli, isisindo esiningi. Ukuzalwa okuzayo nakho akufani kakhulu nokujwayelekile. Yiqiniso, abesifazane abavela emnyangweni we-ECO banamathuba amaningi okwenza isigaba sokudla esilungiselelwe. Kule nkinga, ama-nuances afanayo njengoba kuchazwe ngenhla ahloswe: iminyaka, izinkinga zezempilo, ukukhulelwa okuningi. Ngendlela, uma kuziwa ezintathu, noma ngabe kunjalo zivela ekukhanyeni ngokuhlinzwa, futhi ubudala bomama abuhlangene nakho.
Abazali bangacela yini isazi ukuthi 'sitshale' umbungu wezocansi ezithile?
Bangakwazi, kodwa kuphela uma benamantombazane amathathu noma abafana abathathu noma emlandweni womndeni kunezifo zofuzo ezihlobene nobulili obuhlukile, isibonelo i-hemophilia. Zonke ezinye izimo zihlanganiswa yisinqumo se-World Health Organization, esingasincoma abazali ukuba bakhethe ubulili bezingane zabo ezizayo.
Kungani i-IVF ibiza kakhulu?
Ngezindlela eziningi, intengo inqunywa izidakamizwa ze-hormonal. Ngaphezu kwalokho, wonke amathuluzi odokotela abasebenzisayo ayalahlwa futhi kufanelekile kakhulu. Omunye umzamo onjalo uzodla u-$ 3.5 million. Ukuthemba ukusizwa kombuso akukadingekile: umthetho omisiwe, ngokusho ukuthi i-IVF yokuqala izobe ikhululekile, usalinde ihora lawo.