Ukungenzi lutho akuwona umusho. Kucatshangwa ukuthi oyedwa kwabesifazane abahlanu abahlela ukubeletha banenkinga ekuqaleni kokukhulelwa. Kodwa iningi labo ekugcineni liphumelela. Ukulungisa ukuhlonza kanye nokwelapha kwanamuhla kuyasiza ekuxazululeni inkinga enjengokuzala okungenakwenzeka nokukhulelwa.
Nini isikhathi sokuya kudokotela?
Njengomthetho, owesifazane ukhulelwa engakapheli unyaka emva kokuqala kokulala ngokocansi njalo ngaphandle kokusetshenziswa kwezizalo zokukhulelwa. Uma isikhathi singasebenzi kuwe (uneminyaka engaphezu kwengu-30 ubudala futhi awukakhulelwe, uye waba nezinkinga zobunzima noma imisebenzi esikhathini esidlule), ngemva kwalesi sikhathi, unganqikazi ukuvakashela umjozi wezifo eziphathelene nokwelashwa okungahambi kahle. Endabeni yabesifazane abancane kakhulu, ukuvakashelwa okunjalo kungahlehliselwa unyaka owodwa. Imibhangqwana eminingi iba abazali ngaphandle kokuthola usizo lwezokwelapha ngonyaka wesibili wemizamo ehlangene yokuthola ingane.
Khumbula ukuthi impilo idalwa ndawonye, ngakho udokotela kumele uhambisane nomlingani wakho. Uma umyeni wakho ekunxusa ukuba uqale uthintane nawe - umenzele ngenye indlela. Amadoda amaningi anquma ukuya kudokotela kanzima kakhulu. Bacabanga nge-diagnosis, bakholelwa ukuthi lokhu kuyisimo esibi. Ngokusho kochwepheshe, imibhangqwana eshadile engu-15% ibhekene nezinkinga ezithile zokukhulelwa. Kunezizathu eziningana zalokhu, futhi ngezinye izikhathi izizathu zomabili abalingani. Isizathu esivamile sokuhluleka kokwelashwa sigxile enkingeni eyodwa. Kodwa kudingeka uhlale ufuna izixazululo ezintsha ngaphandle kokuthola imiphumela emva kokwelashwa. Isikhathi sihamba, futhi amathuba okuphila asinakuphela.
Ukungabi namuntu okungabesilisa kuyisizathu sokuba cishe ingxenye yesibili semibhangqwana, futhi ngokusho kochwepheshe, lezi zinkomba zikhula njalo. Ukuxilongwa kwabalingani kufanele kwenziwe ngesikhathi esisodwa. Imvelo engalungile, indlela engafanele yokuphila iholela ekutheni amacala angenasifo sokungathembeki aya ngokuya kubameleli bobulili bobabili.
Ngingatholaphi usizo?
Ungaya ku-gynecologist emtholampilo, futhi uma kudingeka, kuzokuqondisa phambili. Isinqumo sokuxilonga nokuphatha ukungabi nabantwana ngokuvamile sithathwa ngumjozi wezifo zokwelapha kanye ne-endocrinologist, kanye nesazi sezinkinga ze-hormonal kumuntu we-andrologist (ochwepheshe ngezifo zesimiso sokuzala) noma urologist (ochwepheshe ngezifo zesistimu ye-genitourinary).
Uma unethuba (kufaka phakathi nezimali) - kungcono ukuthola ukwelashwa okungekho emthethweni emtholampilo. Kukhona abaxhumanisi bezobuchwepheshe, ama laboratories ochwepheshe nezokuhlaziya, bonke endaweni eyodwa. Ukuxilongwa nokwelapha kuzokwenziwa ngokucophelela futhi uzosindisa isikhathi esiningi. Uma uthola ukuthi umsebenzi wakho awuncane, cishe uzophela ngokuvakashelwa okukodwa noma kokubili ngezindleko eziphansi zamasevisi. Uma kunenkathazo enkulu, kungenzeka ukuthi udokotela othembekile uzokuqondisa kuzo zonke izigaba zokwelapha ekupheleni okujabulisayo.
Umbuzo wokuthi kungenzeka ukuxhasa ngezimali ingxenye yocwaningo kanye nokwelapha kuyacatshangelwa ukucutshungulwa ezikhungweni ezizimele ngaphansi kwezivumelwano ezifanele nesikhwama. Ulwazi oluningi oluwusizo, olufaka phakathi nezikhungo ezingcono kakhulu zokuphathwa kokwelapha endaweni yangakini kanye nemibono odokotela ongayithola eNhlanganweni Yezokwelapha Ukungafaki.
Khumbula ukuthi inkinga enjalo ebucayi njengokwelashwa kokubeletha, kubalulekile ukuthembela kuphela udokotela oqeqeshiwe kakhulu. Ngakho-ke, konke kubalulekile lapha - nempendulo yezinye iziguli, ngisho nokucabanga kwakho kokuqala. Unganqikazi ukubuza udokotela ukuqinisekiswa kweziqu zakhe - lokhu kuyilungelo lakho.
Yini ukuxilongwa owesifazane kuhlanganisa?
Ochwepheshe baveza: asikho isizathu sokuhlola ukusebenza kwakho kokuzala okuhlala isikhathi esingaphezu kwezinyanga ezintathu. Ngesikhathi esifanayo, uma usebenzisana nabachwepheshe, ungabona konke futhi unqume ukuthi yini okufanele uyenze. Odokotela abaningi abaqeqeshiwe banengxoxo enhle kakhulu nomama wabo wesikhathi esizayo ukuze babe nokusola okunengqondo ngale nkinga. Lokhu akuguquki iqiniso lokuthi intuition ayanele. Lokhu kuyadingeka ukuqedela izigaba eziyinhloko zokuxilongwa.
Kwabesifazane, ukuxilongwa kuhlanganisa ukuhlolwa kwegazi, ukuhlolwa kwe-ultrasound kwe-patency ye-tublopian tubes, ukuhlolwa kwe-laparoscopic. Okukugcina kukuvumela ukuba uhlole ukuthi imbangela yokungasebenzi yini isifo esilandelayo sokuvuvukala - i-spikes noma i-endometriosis. Uma udokotela ebona izinkinga emgodini we-uterine, njengama-polyps, angancoma ukuthi u-sonography noma i-ultrasound inike kanjani ngemuva kokujova u-saline nge-catheter. Lolu cwaningo luphansi futhi alubuhlungu.
Into ebalulekile yokuxilongwa yinkomba yesikhathi sokuvuthwa kanye nekhwalithi yayo. Lezi zifundo zokuvuthwa zithandwa kakhulu, kodwa akubalulekile nakancane ukuhlolwa kwe-mucus yomlomo wesibeletho. Kule njongo, akuyona nje kuphela i-ultrasound ejwayelekile eyenziwa, kodwa ngaphezu kwakho konke, uchungechunge lwezivivinyo ze-hormone ukuhlola umsebenzi wegciwane le-thyroid. Amazinga we-androgens, umsebenzi we-adrenal kanye nomsebenzi we-pituitary ovarian nawo ahlolwe.
Ukuhlolwa kwe-bacteriological kuyadingeka. Ukutheleleka kwebhaktheriya kuyimbangela evamile yokungabi nabantwana, kepha kusenqatshelwe ezweni lethu. Kubalulekile ukukhipha izifo ezifana ne-chlamydia. I-"smear" evamile ayanele - ukuhlolwa okukhethekile kuyadingeka, okwenza kube lula ukuhlola ukuphikiswa kwezidakamizwa zamagciwane.
Ngokuvamile kakhulu, zonke lezi zifundo aziphenduli ngezimbangela zokungazalwa. Uma wena nomlingani wakho niphilile ngaphandle, odokotela ngezinye izikhathi bancoma ukuqhubeka nokuhlola izivivinyo zezakhi zofuzo nokuzivivinya umzimba. Izinkinga ezinjalo zivela ngezikhathi ezithile, ukufinyelela emiphumeleni yocwaningo kuyinzima, futhi izindleko zabo ziphakeme kakhulu. Kodwa umphumela uwufanele.
Izimbangela ezivame kakhulu zokungabikho kwabesifazane
Ngokuvamile i-ultrasound nokuhlolwa kwegazi kungasiza ekutholeni imbangela yokungasebenzi. Ezingamaphesenti angama-30-35%, ukuhlukunyezwa kwabesifazane kuhlotshaniswa nokutholakala kwe-tubal, kanti enye i-25% ihlotshaniswa nezifo ze-hormonal. Isimbangela sokutheleleka kwe-tubal, njengomthetho, yizifo ezincane ezibangelwa izifo ezithathelwanayo, njenge-chlamydia noma i-gonorrhea. Ukuvuvukala okunamandla noma okungapheli kungaholela ekwakheni ukonakala, ukwakheka kwe-abscess kanye ne-tubal atresia.
Ukuphazamiseka kwama-Hormonal yokubeletha okuhlobene nokuntuleka kwe-ovulation noma ukuvuthwa okungalungile (i-follicle ayiqedi, iqanda alikhululwa ngesikhathi sokuvuthwa). Kukhona futhi izimpawu zesifo esizalwa njengezifuzo ezibizwa ngokuthi i-polycystic ovary syndrome. Emaqanda ama-ovari, kukhona ama-hormone abesilisa ngokweqile, okuholela ekufeni kwe-follicles nokubunjwa kwama-cysts. Enye inkinga i-hyperprolactinemia (izinga eliphakeme le-prolactin), elingabangela i-amenorrhea. Kungaphinda kuthinte ngqo izigulane zobulili, ukunciphisa ukucinwa kweprogesterone kubesifazane, ukuvimbela ukuthuthukiswa kombungu.
Ukungalingani kwe-hormonal kuholela ezintweni eziningi, ngokuvamile ezihlobene nendlela yokuphila. Ukungondleki, ukukhuluphala ngokweqile, ukucindezeleka okungapheli, ukusebenzisa kabi utshwala ngisho nemidlalo yezemidlalo kungabangela "konke" ukwenza imizamo emisha yokuba nomntwana. Imiphumela emibi nayo ibangela ukuphazamiseka ekusebenzeni kwegciwane le-thyroid, i-pituitary gland kanye nama-gland adrenal.
Isizathu sokungabikho (noma isici esengeziwe ekunciphiseni ukuzala) ngezinye izikhathi i-endometriosis. Lesi sifo sihlotshaniswa nokufakelwa kweziqephu ze-endometrium (i-membrane emangcwabeni yesibeletho) ezingxenyeni zomzimba wesisu. I-Endometrium itholakala kule ndawo futhi ngendlela efanayo nokushintsha kwe-cyclic esibelethweni. Ikhula, ibangele ukuvuvukala nokukhwabanisa. Kunzima kakhulu ukukhulelwa uma lezi zinkinga zihlobene nokusebenza kwama-ovari noma ama-tubespial tubes.
Ngezinye izikhathi imbangela yokwelapha okwesikhashana yilabo abasebenzisa izifo ezihlukahlukene zokwelashwa okusetshenziselwa ukuphatha izifo eziningi, ikakhulukazi izidakamizwa, ama-hormone, kanye nama-antibiotic kanye nama-analgesics. Phakathi kwazo yilokho okutholakala ngaphandle kwemithi (njenge-aspirin ne-ibuprofen, uma kuthathwa phakathi kwe-ovulation). Ngezinye izikhathi ukungabi namandla kubangelwa ukwelashwa kwemisebe kanye nezidakamizwa eziphikisanayo ezingalimaza izintambo.
Esinye isizathu sokungabi nabantwana kwabesifazane, njengombuso, kukhona ukungezwani ekubunjweni kwezitho zokuzala. Lokhu kufaka phakathi ukukhubazeka okubeletha kwesibeletho kanye nesiswini, kanye nazo zonke izinhlobo ze-fibroids kanye ne-postoperative adhesions emgodini nesisu. Kufanele uhlolisise umlomo wesibeletho. Okuthiwa yi-factor of infertility kwabesifazane kuvame ukuhambisana nezinguquko emzimbeni wesibeletho. Izinkinga ezijwayelekile kakhulu zihlobene nesimo somlomo wesibeletho. Ngaphansi kwezimo ezijwayelekile, ihloselwe odongeni lwangasese lwesifazane. Izinguquko endaweni zikwenza kube nzima ukuxhumana nomuthi wesilisa wesibeletho.
Isizathu sokungakhulelwa ngezinye izikhathi ukuvuvukala komlomo wesibeletho. Lithinta izakhiwo ze-mucus yomlomo wesibeletho, okwenza kube "isitha" sangempela sobudoda. Ngokuvamile kuhilela ukuguqulwa kwe-asidi kanye nokuba khona kwababulali besilisa abahlukahlukene. Ngenxa yalokho, abanalo ithuba lokufeza umgomo wabo.
Isikhathi sokwelashwa
Kuyintokwanekwane yokuthi odokotela cishe bahlinzekela njalo izingane ezivela ku-tube test. Le ndlela ibhekwa njengesilinganiso esiphezulu. Amaphilisi amaningi asetshenziselwa ukususa izifo ze-hormone, noma ukulwa nokutheleleka. Ngezinye izikhathi ukwelashwa okudingekayo kuyadingeka: ngokuvamile i-laparoscopic, evumela ngisho nokuphulukisa ama-ovarian noma ama-cysts, isifo somdlavuza we-endometrial, noma ukususa esinye isithiyo emkhakheni wokuzala.
Uma ukuxilongwa "kokukhubazeka komsebenzi wokubeletha" akukwazi ukudalula izimbangela ezibonakalayo zokungazalwa, futhi uhlobo lokusekela luyadingeka (isibonelo, uma ukuzala okuzayo kungokwemvelo ngenxa yokuguga) - ke kudingeka izinyathelo ezikhethekile. Ngokuvamile kufanele uvakashele udokotela ukuze aqaphe ukuphumelela kokwelashwa. Uma kungekho okusizayo, izindlela ezibizayo azizinamandla - ungakhuluma ngesidingo se-IVF.
Ngalesi sigaba, odokotela abathile basikisela indlela yokuqothulwa kwamakhemikhali. Injola yesibindi yomlingani yenziwa ngokusebenzisa i-catheter ekhethekile, ngqo ngaphakathi kwesibeletho. Kuyabiza kakhulu kune-in vitro, futhi kulungile uma kwenzeka izinkinga zomlomo wesibeletho kanye nesidoda somlingani. Ngesikhathi esifanayo, kufanele kukhunjulwe ukuthi ukusebenza kwayo, ngisho nasezifundweni ezinhle kakhulu, akudluli ku-15%.
Indlela ye-IVF
Isinqumo sokusebenzisa umanyolo we-in vitro kufanele sisekelwe ekuxilongweni okuqondile. Uma isikhathi sokwelashwa sendabuko sesidlulile umkhawulo owamukelekayo wabalingani, kanye nakwamacala nabesifazane abangaphezu kweminyaka engu-35, esongela ukulahlekelwa okuphelele kokuzala. Ngokuvamile, indlela ye-IVF ayinconywa kwabesifazane abangaphansi kweminyaka engama-35 abanomzimba ongakhulelwe nokukhulelwa.
Le ndlela isekelwe ekukhethweni kwilabhuthrikhi yama-ovules akhishwe ngamakhemikhali kanye nesingeniso esibelethweni. Ngakho-ke umbungu owenziwe ngomumo ufakwa esibelethweni, ugoqa zonke izigaba zokukhulelwa komvelo. Ukusebenza kwalendlela kulinganiselwa ku-30% uma kuqhathaniswa nendlela yendabuko yokukhulelwa.