I-Theory Behind Inxushunwe Nokuthi Yenzelwe Wena
Ukuqothulwa okusizwayo ubuchwepheshe bokuzala okusizwayo ngezinye izikhathi ezisetshenziswa ngokuhambisana nokwelapha okuvamile kwe- IVF . Ukuxoshwa okusizwayo kucatshangwa ukuthi kungasiza ngohlelo lokufakela embryo futhi cishe kunconywa uma kunqatshelwe ukuphindaphindiwe kwe- IVF okuphindaphindiwe noma iziguli ezinezifo ezimbi.
Ngenkathi amanye amitholampilo asebenzisa ukuxoshwa okusizwa njalo, i-American Society of Reproductive Medicine (ASRM) ayincoma lokhu. Lokhu kungenxa yokuthi ukususwa okusiziwe akubonwanga ukuthuthukisa amanani okuzalwa okubukhoma. Ngaphezu kwalokho, njenganoma yibuphi ubuchwepheshe bokuzala, kunezindleko ezengeziwe nezingozi zokusebenzisa ukuxoshwa okusiziwe.
Ingabe udokotela wakho wancoma ukuthi akusize ukuxosha wena? Nansi okudingeka ukwazi.
Imithi YamaHira Ihlukana Kanjani?
Ukuze uqonde ukuxoshwa okusiziwe, okokuqala, kuzosiza ukuqonda ukunqunywa kwemvelo kombungu.
Ngaphambi kokuthola umbungu, uqala nge -oocyte , noma iqanda. I-oocyte ine-protein-shell ewuzungezile eyaziwa njenge-zona pellucida. I-zona pellucida inendima eminingi yokuthuthukiswa kombungu, futhi le misebenzi iyashintsha njengoba umbungu ukhula.
Ngaphambi kokuba iqanda libe umbungu, i-zona pellucida ifaka ne-sperm cell. Lokhu kungukuqala kwenqubo yokukhulelwa. Uma isilwane esisodwa esisodwa singena egobolondo bese sifaka umquba eqanda, i-zona pellucida iyanzima. Lokhu kuvimbela amangqamuzana amaningi wesilisa ukungena ku-zygote manje ekhulelwe.
Igobolondo elinzima lisiza ukuvimbela umbungu ukuba ungafaki ngaphambi kwesikhathi emathangeni amathanga (okuzobangela ukukhulelwa kwe - ectopic ). Iphinde igcine izingqamuzana eziningi ze-blastocyst ndawonye.
Njengoba i-zygote ihamba phansi ithubhu ye-fallopian iphinda ifike esigabeni se-blastocysts, i-zona pellucida ikhula futhi iqala ukuba yincipha futhi ifinyeleleke. Ngosuku lwesine yentuthuko, i-zona pellucida iyaphuka evulekile futhi ivela i-blastocyst / embryo, ishiya igobolondo elincane leprotheni. Lena inqubo yokuhlanza embryo.
Kungakapheli izinsuku ezimbalwa zokuqothula, i-blastocyst igxila ekugcineni kwe-endometrium . Ngaphandle kokuqothula, i-blastocyst ayikwazi ukuzifaka emdongeni wesibeletho. Lokhu kusho ukuthatha ukukhulelwa kuzokwenzeka.
Kuyini Ukuxoshwa Okusizayo?
Ngesikhathi ukwelashwa kwe-IVF , ukukhulelwa kwenzeka kulobhu. Kodwa njengoba kunoma yikuphi umbhangqwana oye wadlula ukwelashwa kwe-IVF uyazi ukuthi ukuba ne-embryo ekhulelwe akuqinisekisi ukukhulelwa. I-embryo idluliselwe kufanele izinze yona ibe yi-endometrium futhi "ithambile" ukuze ukhulelwe kwenzeke.
Kufika kumaphesenti angama-85 emibungu adluliselwe "angabambeleli." Kukhona imibono yokuthi kungani lokhu kwenzeka, futhi enye yalezo zinkimbinkimbi ukuthi i-embryo ayifuni kahle. Lokhu kungenzeka ngoba i-embryo ingenawo igobolondo elinzima ngokungavamile, noma ngenxa yokuthi into ethile emkhatsini wemibandela (amasiko asetshenziselwa ukugcina umbungu uphila, amakhemikhali e-cryopreservation, njll.) Uye waphazamisa ngokuphumelelayo inqubo yokuqeda.
Ukuxoshwa okusiziwe kuhloswe ukuba kudlule noma yikuphi ukuvimbela ukuvimbela ukuhlenga futhi kuthuthukise izinkinga zokufakelwa (nokukhulelwa) impumelelo.
Izindlela Zokuxoshwa Ezixhaswe: Kwenziwe Kanjani
Ungase ucabange ukuthi ukusiza ukusiza njalo kuhilela ukwakha "ikhefu" elincanyana noma ukukhipha in zona pellucida. Kodwa lokho akunjalo ngempela. Kunezindlela ezimbalwa ezitholakalayo, futhi yonke ibhubhu ye-embryo ihamba ngalokhu ngokuhlukile. Kukhona izinzuzo nezindleko kuzo zonke izindlela, futhi ikhono lezobuchwepheshe lisebenza:
- Ukuqothula ama-mechanical : Ngalolu lwazi, umbungu we-embryologist ugcina umbungu uhlale unomsoco ngosizo lwe-pipette, ngenkathi usebenzisa inaliti encane ukugubha i-zona pellucida, hamba ngaphansi kwegobolondo kancane, bese uphuma omunye umkhawulo. (Cabanga nje udweba umugqa omncane kakhulu eceleni kombungu.) Khona-ke, indawo emkhatsini we-punctures amabili ihlanjululwa kahle kuze kube khona izinyembezi ezincane. Kunzima ukulawula ubukhulu bokuvula ngale ndlela.
- Ukwandiswa kwemishini yegobolondo : Ngalolu lwazi, i-zona pellucida ayivulekile evulekile. Esikhundleni salokho, ingcindezi ye-hydrostatic isungulwa ngaphansi kwegobolondo, ukuze ikhulise. Umbono wale ndlela uvela ekukhuleni kwemvelo kwegobolondo yangaphandle ngesikhathi senqubo yokuqothula.
- Ukuqothula ama-Chemical : Le nqubo ihilela ukusebenzisa ikhemikhali ebizwa ngokuthi iTyrode's acid. Amanani amancane ase-acid asetshenziselwa i-zona pellucida kuze kube yilapho igobolondo iphulwa. Khona-ke, i-embryo ihlanzwa ngokushesha ukuze igweme ukutholakala kwe-asidi engadingekile.
- Ukushayela : Ngokugaya, ukunyakaza okufudumayo kusetshenziselwa ukudala ukuvula okuhambisanayo. Le nqubo isebenzisa okuthiwa yi-Piezo technology.
- Ukuqashwa kwe-Laser : Ukusebenzisa i-laser ekhethekile ukuphula i-zona pellucida kungenye indlela. Ukuhlanza okusizwa nge-laser kuvumela ukulawula okungaphezulu kokulingana komgodi owakhiwe, okungaphezu kokushiya imishini ngenaliti (njengoba kuchazwe ngenhla).
Kuzo zonke izindlela, ukuchithwa kwe-laser-assisted may be ephephile futhi kuphumelele kakhulu. Noma kunjalo, akuwona wonke amarebhu e-embryology afakwe ukwenza lobu buchwepheshe obuqondile. Ukukhishwa kwama-Chemical kusetshenziswa kakhulu. Ngazo zonke lezi zindlela, ikhwalithi nesipiliyoni se-embryologist kungenza umehluko omkhulu.
Izingozi Zokuxoshwa Okusiziwe
Noma yikuphi ukuphathwa noma ukuphazanyiswa ngumbungu kuzofaka ingozi ethile. Enye ingozi ekhona yokusiza ukuxoshwa ukuthi umbungu uzolimala kakhulu. Lokhu kungenzeka ngaphambi kokudluliswa kombungu noma ngemuva. Kunoma yikuphi, ukukhulelwa ngeke kuholele.
Ngokumangazayo, enye ingozi yokusizwa okusizwayo inqubo yokuqothula yemvelo iyothunyelwa futhi umbungu uzohluleka ukukhipha ngokuphelele i-zona pellucida.
Enye ingozi yokuxoshwa okusizwa yi-twinning, ngokuqondile ngokubheka i-monozygotic. Amawele e-Monozygotic angamawele afanayo, avela eqanda elilodwa kanye nesidoda esisodwa. Ukuqothula sekuvele kwanda ngesikhathi sokwelashwa kwe-IVF okuvamile, futhi ucwaningo lithole ukuthi kusize ukuvimbela ukwandisa kwami okuqhubekayo engozini. Nakuba zonke ukukhulelwa eziningi zithwala ingozi, ukukhulelwa kwe-twin monozygotic kuza nezingozi eziphakeme nakakhulu kumama kanye nezingane. Noma kunjalo, ingozi yokugubula iphansi, ivela ngaphansi kwamaphesenti angu-1 yesikhathi.
Ungase uzibuze ukuthi ukusizwa okusizwayo kwandisa ingozi yokukhubazeka kokuzalwa. Ucwaningo olunzulu lokuphindaphindiwe lwama-cycles angaphezu kuka-35,000 lwathola ukuthi ingozi yokukhubazeka kokuzalwa engakaze ikhuphuke kakhulu ngemibungu eyayibanjwe ngokusizwa ngokusizwa, uma kuqhathaniswa nemijikelezo ye-IVF lapho kungenakwenzeka khona ukuxoshwa.
Ingabe Ukuxoshwa Kwabasiza Ukuthuthukisa Amanani Okuphumelela kwe-IVF?
Umbuzo omkhulu, yiqiniso, kuwufanele yini? Ingabe ukusizwa okusizayo kusiza ukuthi uthathe ekhaya ingane? Impendulo yinkimbinkimbi encane.
Ukubuyekezwa kwe-Cochrane ekusizeni okusizayo-okucubungula izifundo ezingu-31, ukukhulelwa okungu-1,992 nabesifazane abangu-5 728-bathola ukuthi basiza ukuhlenga izinga elincane lokukhulelwa kliniki. Noma kunjalo, amazinga okuzalwa aphilayo awazange athuthuke.
Izinga lokuzalwa lokuzalwa libaluleke kakhulu ukucabangela ukwedlula izinga lokukhulelwa komtholampilo kusukela umgomo kunoma yikuphi ukwelashwa kokuzala kuhamba ekhaya ingane-hhayi nje ukuthola ukuvivinywa kokukhulelwa okuhle.
Ngeshwa, iningi locwaningi olusizwa ngokusizwa liye labika izinga lokukhulelwa kwamaklinikhi, futhi alikho izinga lokuzalwa lokuzalwa. Labo ababuka amazinga okuzalwa abaphilayo abatholanga inzuzo. Ucwaningo olungaphezulu kufanele lwenziwe.
Olunye ucwaningo lwathola ukuthi uma ukusizwa ekusizeni kwenziwa nge-"quality quality" imibungu, ukukhulelwa kwamazinga kuyehla. Imiphumela ihlukahluka kuye ngokuthi iqembu lobudala ngenkathi ukusizwa ekusizeni kukhishwe embukisweni wezinga eliphansi. Lokhu kungafakazela ukuthi ukususwa okusizwayo ngeke nje kusize labo abanesifiso esihle, kepha kungalimaza amathuba abo okuphumelela.
Ubani Ongase Azuze Ekuqothulweni Okusekelwe?
Kunobufakazi obusiza ukuxoshwa kungase kuthuthukise izinga lokukhulelwa emitholampilo neziguli ezilandelayo:
- Uhlangabezane nemijikelezo ye-IVF emibili noma ngaphezulu
- Yiba nekhwalithi empofu empofu
- Bakhulu kuneminyaka engu-38
Kwacatshangwa ukuthi ukusiza ukuhlwitha kungase kudinge ukuzama imijikelezo yokudlulisa embryo efriziwe, kodwa lokhu kungase kungabi njalo. Eqinisweni, isifundo esisodwa sathola ukuthi ukusizwa ekusizeni umjikelezo we-embryo efriziwe kunganciphisa kancane izinkinga zokuzalwa okuphilayo.
Izindleko Zokuxoshwa Okusiziwe
Naphezu kwezincomo ze-ASRM, ngubani ocebisa ngokusetshenziswa komkhuba wokuhlanza okusizwayo, eminye imitholampilo isayinika yona yonke isiguli. Kule mitholampilo, izindleko zokusizwa okusizwayo zingase zibe "ezifakiwe" kwimali yonke ye-IVF .
Emitholampilo eyongezwayo ngokungeziwe, izindleko zingaba kusuka ku-$ 200 kuya ku-$ 700, ngokwesilinganiso. Kukhona nemitholampilo embalwa enikeza ubuchwepheshe "mahhala," uma becabanga ukuthi kungasiza.
Izwi elivela ku-Verywell
Lapho ukhuluma ngemithi yokwelashwa kwe-IVF, kungaba yindingo yokwamukela noma ukufuna ukusebenzisa zonke izinto ezengenzeka zengeze "ukwengeza" okunikezwayo. Kungase kubonakale sengathi usizo oluthe xaxa kufanele njalo luholele ithuba elingcono lokuphumelela. Kodwa okuningi akusho njalo kangcono.
Ngenxa yokuthi abukho ubufakazi obanele bokubonisa ukususwa okusizwayo okuthuthukisa amazinga okuzalwa aphilayo, i- ASRM isincoma ngokusetshenziswa kobuchwepheshe njalo. Uma imtholampilo yakho isebenzisa ukuxosha okusizwayo kuzo zonke iziguli, khuluma nodokotela wakho ngokuthi kungani bacabanga ukuthi lokhu kungcono kuwe. Ungabuyisa ubuchwepheshe phansi.
Noma kunjalo, amaqembu athile eziguli, ukusizwa okusizayo kungasiza. Njengoba njalo, khuluma nodokotela wakho ngesimo sakho.
> Imithombo:
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> Hammadeh ME1, Fischer-Hammadeh C, Ali KR. "Ukukhishwa okusiziwe ekusizeni ukukhiqizwa: isimo sobuciko. "Ngiza Uhlobo Oluhlelekile. 2011 Feb; 28 (2): 119-28. i-doi: 10.1007 / s10815-010-9495-3. Epub 2010 Nov 2.
> Jwa J1, Jwa SC2, Kuwahara A3, Yoshida A4, Saito H5. "Ingozi ye-anomalies enkulu yokubeletha emva kokusizwa ukuxoshwa: ukuhlaziywa kwedatha yeminyaka emithathu kusukela ebhalweni lokusiza ukukhiqiza ukusiza abakwa-Japan eJapane. "Fertil Steril. 2015 Jul; 104 (1): 71-8. i-doi: 10.1016 / j.fertnstert.2015.03.029. Epub 2015 Apr 29.
> Knudtson JF1, Failor CM2, Gelfond JA3, Goros MW3, Chang TA2, Schenken RS2, Robinson RD2. "Ukuxoshwa okusiziwe nokuzalwa ngokubeletha kokudluliselwa kombuthano wokuqala we-embryo. "Fertil Steril. 2017 Oct; 108 (4): 628-634. i-doi: 10.1016 / j.fertnstert.2017.07.011. I-Epub 2017 Aug 30.
> TA Chang, JF Knudtson, YT Su, ES Jacoby, RD Robinson, RS Schenken. "Ukusebenza kokususwa okusizwa ngokusekelwe kwekhwalithi ye-embryo emijikelezweni ye-IVF ngokudluliselwa okusha. " Ukuzala kanye Nokuthobeka . September 2016., Umqulu 106, Issue 3, Isengezo, Ikhasi e314.