Kufanele uqale ngokuhlolisisa ukuthi amathuba akho okukhulelwa angakanani. Baqala ukwehla kusukela ekuqaleni kweminyaka engaba ngu-37 ubudala. Ngemva kweminyaka engu-40 kuphela, imizamo engu-4-5% kuphela yokuzama ukukhulelwa iholela ekukhulelweni. Lokhu kungenxa yokuthi ngokuhamba kwesikhathi inani, futhi okubaluleke kakhulu - izinga leqanda liyancipha.
Noma kunjalo, odokotela bayaqiniseka ukuthi kuwufanelekile ukuzama. Kukhona amacala lapho abesifazane abaneminyaka engama-60 beba umama wezingane ezivela ku-tube test. Isibikezelo esiqondile, zingaki izingcingo ezizodingwa, akekho ozonikeza. Kodwa-ke, ukujwayela kubonisa ukuthi kuma-80% wabesifazane, ukukhulelwa kuqala kakade ngomzamo wesibili noma wesithathu ekunakekelweni kokungenwa kwabantwana nge-IVF. Nguye kuphela udokotela ongakwazi ukunquma ngokuqondile ukuthi le nqubo ephakeme yezobuchwepheshe iboniswa kuwe.
ISIQEPHU SOKUQALA
Okokuqala, udokotela uzodinga ukuhlolwa okujwayelekile: i-ECG, igazi nge-RW, i-HIV, i-hepatitis B ne-C, i-swabs kwi-flora ne-oncocytology, izitshalo (noma ezinye izivivinyo) zezifo ezithathelwana ngocansi, ukuhlolwa kwegazi eziningana ngamahomoni, usuku lomjikelezo (i-estradiol, i-prolactin, i-FSH, i-LH, i-TTG - lena yimingcele edingekayo). Kudingeka futhi ukuhambisa ukuhlaziywa kwama-antibodies kuya ku-rubella, ukutholakala kwezitshalo ezivela emgodini wesibeletho somlomo kanye ne-sperm. Zonke lezi zifundo zidinga ukucacisa izinga lokulungela umzimba wakho ngenqubo, kanye nokugwema izinkinga ezingenzeka.
Encwadini: Ukuhlaziywa kwe-IVF kunganikezwa kusengaphambili ekubonisaneni kwabesifazane besifunda (mahhala), esikhungweni sezokwelapha noma ku-laboratory yangasese. Into esemqoka yilapho uhlelo lwe-IVF luqalisiwe, kubalulekile ukugcina isazi esisodwa esizokuhola futhi siphendule ngomphumela.
UKUKHETHA INDLELA
Ngemuva kwakho nodokotela wakho qinisekisa ukuthi akukho ukuphikisana kwezizathu zezempilo, ungaxoxa ukuthi yiziphi izindlela zokwelapha ukubeletha okulungile kuwe. Azikho izinketho eziningi kakhulu, futhi kufanele kukhethwe ukukhetha kwazo, ngokusekelwe eziciweni ezithile.
Ukukhuthazwa kwe-ovulation kungukuthi lo mbhangqwana uyakwazi ukukhulelwa ngokuzimela, kodwa ngenxa yezizathu eziningana umsebenzi we-ovarian awukho emsebenzini. Ezimweni ezinjalo, gqugquzela ama-ovarie, ubale okungcono kakhulu ekukhulelweni kosuku, bese kuthi konke kwenzeka ngokwemvelo - njengokwemvelo.
Ukusabalalisa okufakelwayo ngensizwa yendoda nomnikelo wesilisa kuyisimo lapho i-spermatozoa yesilisa "ibeka icala" yokungabi namuntu. Isixazululo esithile esilungiselelwe ngokukhethekile se-spermatozoa sijova esibelethweni, sihlolwe ngaphambilini nge-spermogram.
Eqinisweni, i-IVF iyasiza ezimweni lapho kukhona ukuvinjelwa kwamatayipi angama-fallopian, ukungabi khona kwabo ngokuphelele noma ukulimala, ne-endometriosis, engachazwe odokotela abangenalutho noma ngemuva kwemizamo engaphumeleli ekuqothulweni kokufakelwa. Futhi le ndlela iboniswa endabeni yokwelashwa kwesilisa futhi uma owesifazane enezinga eliphezulu kakhulu lamagciwane okulwa nesidoda. Lapho i-spermatozoa ingenayo imisebenzi eyanele, i-ICSI izosiza - ukungeniswa kwesidoda ku-cytoplasm yeqanda ngosizo lwamakhemikhali amakhemikhali akhethekile.
Kumanothi. Ngokuphambene nenkolelo evamile, i-ICSI akuyona indlela ehlukile, kodwa isigaba esingeziwe sokwelashwa okungenasifo kwe-IVF, futhi ngeke kudingeke ngaso sonke isikhathi.
Ngakho, udokotela watusa IVF. Uhlelo lungaqaliswa masinyane emva kokuhlolwa, ngosuku lwesithathu lwe-cycle (ngesikhathi sokujikeleza kwezinsuku ezingama-28). Kusukela manje, uzothola ukwelashwa kwe-hormonal ukuvimbela i-pituitary gland. I-ultrasound - ukukhethwa komuthi - i-ultrasound - ukulungiswa kwesilinganiso. Kulo modi, izinsuku ezingu-14 zizodlula.
Kumanothi. Ngokuphambene nenkolelo evamile, ukwelapha okwe-hormone akuyingozi empilweni. Ngaphezu kwalokho, namuhla amaphilisi athathelwa umjovo futhi angabi nengozi kubo kunesidakamizwa esetshenziswa, isibonelo, ekwelapheni umkhuhlane.
Ngemuva kwamasonto amabili, izidakamizwa zisetshenziselwa ukugqugquzela ukuvuthwa kwe-follicles. Kubalulekile ukwenza ama-ovari akhiqize ama-5 kuya kwezingu-10 ngaphezu kokujwayelekile. Phakathi nezinsuku ezingu-10-12, njalo amahora angu 48-72 udokotela uzoqapha inqubo nge-ultrasound kanye nokuhlolwa kwegazi. Phakathi nalesi sikhathi kuzodingeka ukuthi uqinisekise ukuhambisana nokudla kwamaprotheni, ukuphuza ngaphezu kwamalitha amabili ketshezi ngosuku futhi, awukwazi ukuphuza utshwala nokubhema.
Lesi sigaba sokunakekelwa kokubeletha kuyingozi ngoba kunama-3% amacala a-hyperstimulation syndrome angakhula - ukwanda ngokweqile kuma-ovari. Ngenhlanhla, izinqubo zokwelapha zanamuhla kanye nokuqapha ngokucophelela izinga lama-hormone egazini kunciphisa ingozi yokuba nezinkinga ezinjalo zibe yize. Kumanothi. Uma ukugqugquzela kungenzeki ukuzwa okungajabulisi, ngaphandle kokuthi ubuhlungu obuphakathi kwama-ovari buyenzeka - ngoba manje basebenzisana ngokweqile kunokujwayelekile.
Amaqanda aphethwe akhula futhi alulame, i-spermatozoa yanikezwa. Icala lezincane: amahora angu-4-6 ukuze ubambe amaqanda esikhwameni esithile esikhethekile emadilini agcwele umsila wezakhi, emva kwalokho ukuxuba okuyingxenye ekhethekileyo ye-sperm kubo. Oxhumana naye uhlala cishe amahora angu-20. Ekupheleni kwalesi sikhathi, sekuvele kungenzeka ukuthi ukusho ukuthi ukukhulelwa kwenzeka noma cha. Uzokwaziswa ngocingo uma udinga ukuvela ngenqubo yokugcina
Kumanothi. Uma insimu yendoda enomgangatho omubi, kunengozi ukuthi ukukhulelwa ngeke kwenzeke. Kulesi simo, vele ulondoloze i-ICSI, lapho iqanda ngalinye lihlanganiswa ne-spermatozoa ekhethiwe ngokukhethekile. Inqubo ayibuhlungu futhi iyashesha. Ngosizo lomcengezi omncane, "abazobhapathizwa" bafakwa esibelethweni. Ihora lidinga ukulala emtholampilo - futhi ungaya ekhaya. Kungakhathaliseki ukuthi konke kuhamba kahle, kuzokwaziwa ngemva kwamasonto amabili.
Kuzoba namawele, ama-triple noma umntwana oyedwa, akunakwenzeka ukubikezela. Ngokwezibalo, ingane eyodwa izalwa kuphela isigamu samacala. Cishe wonke umuntu wesithathu we-IVF-isiguli uhloselwe ukuba ngumama wamawele, owodwa kwabahlanu ubeletha kathathu.
Kumanothi. Ungazami ukuthola ukukhulelwa ngokwakho ngaphambi kwezinsuku ezingu-14 usebenzisa izivivinyo: ngenxa yokwelashwa kwe-hormone, noma yikuphi impendulo izoba ne-30% kuphela.
ISIKHATHI SOKUPHEPHA KWESIKHATHI
Umjikelezo we-IVF uthatha cishe inyanga. Ngeshwa, ngemuva kokulinda isikhathi eside "yebo", abaningi baphumule: kubonakala sengathi konke kuncike emvelweni. Kodwa ezimweni eziningi, ngaphandle kokusekelwa okwelashwa okungeziwe ezinyangeni zokuqala, ukubambelela ekudleni kanye nemigomo ehambelana nodokotela, akulula ukugcina ingane ezayo. Ngokuqinisekile konke okwedlule isikhathi se-ECO kungcono ukuyeka ugwayi, ikhofi, utshwala, amaswidi ngamanani amaningi. Kodwa udinga ukuphuza amanzi amaningi (ngaphezu kwama-2 amalitha ngosuku) nokuya kudokotela oqeqeshiwe.
IMIBUZO EVELA UKUSEBENZA KONKE
1. Zingaki imizamo? Ingabe kuyingozi ukufeza ukugqugquzela ama-hormone izikhathi eziningana?
Emva kokudluliswa kwemibungu, abesifazane abangama-35-40% kuphela abakhulelwe. Kungcono ukulungele ukuthatha imizamo engu-3-4 noma ngaphezulu. Ukudla kwama-hormone isikhathi eside akuyona eyingozi - namuhla sebenzisa izidakamizwa zesizukulwane esisha futhi ucabange zonke izici zomzimba womama wesikhathi esizayo.
2. Akudingeki wenze ukuhlanza uma umbungu ungajwayele?
I-IVF engaphumeleli ayithinti umzimba nganoma iyiphi indlela: asikho isidingo sokulinda ukukhulelwa kwesisu noma izinkinga zokusongela ngokuhlanzwa kokusebenza. Kodwa futhi akudingekile ukuqala ikholi yesibili ngesikhathi esisodwa - ukuphumula kufanele kube okungenani izinyanga ezingu-3-4.
3. Angikulungele ukubeletha amawele, ngingazibali izintathu. Endabeni yokwelapha ukungabi nabantwana nge-IVF, lokhu kungenzeka kakhulu. Yini okufanele ngiyenze?
Imibungu eningi iyatshala, iphakame amathuba okukhulelwa. Kodwa ingozi yokuba umama omkhulu nayo iphezulu. Ngakho-ke, kuvame ukuba nemibungu emibili kuphela etshalwe, ezinye ziqhwa. Uma kudingeka, kungenzeka ukunciphisa - imibungu eyodwa noma ngaphezulu "engadingekile". Le ndlela iphikisana nendawo yokuziphatha, kodwa, ubuchwepheshe bukhona, futhi bungasetshenziswa uma kudingekile.
4. Ingozi enkulu kangakanani ukuthi ingane izozalwa ngezinkinga zokubeletha?
I-ECO-izingane azifani nomkhulelwe ngendlela yemvelo. Baneba nenzuzo: ubuchwepheshe besimanje kwenza kube lula ukuvimbela ukuthuthukiswa kwezifo eziningi. Ukuqiniseka ukuthi umntwana uzobe ulungile uzohlinzekwa ngaphambi kokufakelwa isifo se-genetic (PGD). Ivumela ukuveza ukwehlukana ekuthuthukiseni umbungu, ukutholakala kwezifo zofuzo. Futhi ngenxa ye-ruble eziyizinkulungwane ezingama-60 ungakhetha ubulili bezingane ezizayo.
5. Ingabe kukhona indlela yokwenza i-IVF ngokusebenzisa amahomoni amancane?
Yebo, le ndlela ibizwa nge-IVF emjikelezweni wemvelo. Izidakamizwa ezikhuthaza ukukhula kwe-follicles, kulokhu akusebenzi. Kodwa lokhu kungenzeka kuphela uma iqanda elilodwa livuthwa. Le ndlela ibuye ibe "nobungane" emzimbeni, kodwa futhi iphinde iphumelele (ukukhulelwa kwenzeka kuphela kumacala angu-16%). Phakathi kwamaminithi kanye nokubunzima okukhulu kwalolu hlelo: ngoba uma i-follicle yodwa, amaphutha (isibonelo, ekubaleni isikhathi semithi ngesikhathi sokuvuthwa) ayamukeleki.
INDLELA YOKUKHETHA I-ECO-CENTER?
1. Okokuqala, isikhungo kumele sibe nelayisensi efanele ye-IVF (ngesisekelo seSitifiketi se-Embryology noMtholampilo).
2. Qinisekisa ukuthi umtholampilo unabasebenzi abambalwa abadingekayo ngezinqubo eziphumelelayo:
isazi sezifo zesifo sezifo (isazi sokuzala);
i-embryologist;
i-andrologist (lokhu kubalulekile uma udinga ucwaningo olwengeziwe empilweni yomlingani);
i-anesthesiologist;
unesi nomhlengikazi.
3. Zama ukuhamba nge-mini-excursion bese uhlola izinga nekhwalithi yemishini: imishini yesimanje ye-ultrasound nezihlalo zemizimba, ama-thermostats, abahlaziyi be-sperm, ama-incubators ... Uma ungekho emithi, okungenani ubuze imibuzo lapho imishini igcina ibuyekeziwe, indlela yokuthuthukisa izindlela zokuxilongwa nezinqubo.
4. Chaza ukuthi ngabe kungenzeka yini kulo mtholampilo uma kunesidingo sokwenza uphenyo olwengeziwe.
5. Isikhungo kufanele sitholakale kalula - uzodinga ukuvakashela emtholampilo.
ECO FOR FREE
Bambalwa abantu abazi ukuthi kusukela maduzane, abesifazane baseRashiya banethuba lokuhamba ngenqubo ngaphandle kokukhokha ipenny, izinhlelo ze-ECO-mahhala eMoscow zisebenzisa i-CPPS. Uhlelo luhlanganisa:
imizamo emibili ye-IVF + PE;
iqhwa futhi kugcinwe imibungu phakathi nonyaka;
ukonakala kwamabungu;
imithi edingekayo.
Ukuze usebenzise ilungelo lokukhulula IVF, udinga ukuthola ukuhanjiswa kusuka ku-Federal Health Agency. Kungcono ukuhamba ngephepha elihlomekile ngokugcwele: ngezicucu, ukuhlaziya, i-spermogram nesiphetho sokuthi une-infertility futhi indlela yokuphela kwesisombululo ingaba yi-IVF kuphela. Ngaphezu kwalokho, kufanele uhlangabezane nemigomo ethile:
ubudala - iminyaka engu-22-38 ngesikhathi sokufakwa ohlelweni;
iqiniso lokuhlala unomphela eMoscow;
ukutholakala komshado obhalisiwe kanye nokungabikho kwezingane ezivamile;
ukutholakala kokungakhulelwa kweminyaka engaphezu kwengu-2 ngokungabikho kwamanye ama-treatment, noma ukuphelelwa yisifo sofuba ngokuphelele, noma izinhlobo ezihlangene zokungabikho;
ukungabi khona kwemiphumela yezindlela zokuhlinza zokwelashwa, ukufakwa kwe-classical of ovulation izinyanga ezingu-6 nokuphathwa komlingani;
ukungabi khona kwezifo ze-somatic nezengqondo.