I-PGD ne-PGS: I-Genetic Screening Ngaphambi kwe-IVF

Ukuhlolwa kwe-Genetic Pre-Plantation Ukuvimbela Izifo & Ukuthuthukisa Impumelelo Ye-IVF

Ubuchwepheshe bokuhlola i-Genetic njengo-PGD ne-PGS, uma kuhlanganiswe ne- IVF yokwelashwa , kwenze ukuba kwenzeke ukunciphisa ingozi yokudlulela izifo zofuzo ezibhubhisayo, mhlawumbe kuncishise ingozi yokukhulelwa kwesisu okuphindaphindiwe, futhi mhlawumbe kuthuthukise ukungafani kokuphumelela kokukhulelwa .

Njengawo wonke osiza ubuchwepheshe bokuzala, kubalulekile ukuthi uqonde ukuthi yiziphi izimo ezobuchwepheshe ezisetshenziselwa kakhulu, izingozi ezingenzeka, izindleko, nokuthi yini ongayilindela ngenkathi ukwelashwa.

Ungabona ama-acronyms PGD ne-PGS asetshenziswe ngokungafani. Zombili ubuchwepheshe bokuhlola i-genetic futhi bobabili badinga i- IVF, kodwa bahluke kakhulu ukuthi kungani basebenzisa nokuthi kanjani.

Kuyini okushoyo i-PGD?

I-PGD ihlose "ukuhlolwa kwangaphambi kokusungula izakhi zofuzo." Igama eliyinhloko lapha "ukuxilongwa."

I-PGS isetshenziswe uma isifo esithile (noma isethi esiqondile) sesifo sofuzo sifanele sibonakale embumbeni . Lokhu kungafisa ukugwema ukudlula isifo sofuzo noma esetshenziselwa ukukhetha ukuthambekela kwezakhi zofuzo. Ngesinye isikhathi, kokubili kuyadingeka-ngokwesibonelo, lapho umbhangqwana ufuna ukukhulelwa ingane engafanelana nokufakelwa kwe-stem cell kwezingane zakubo kodwa futhi ifuna ukugwema ukudlulisa isisindo esibangela isifo esidinga ukuguqulwa kwesisindo se-stem.

I-PGD ayihlolisi i-embryo eyodwa yazo zonke izifo ezenzekayo zofuzo. Lokhu kubalulekile ukuqonda. Ngakho-ke, isibonelo, uma umbungu ungabonakali unesisindo se-cystic fibrosis (CF), lokho akutsheli lutho nganoma yisiphi esinye isifo sofuzo esingase sibe khona.

Ikunikeza kuphela isiqinisekiso sokuthi i-CF ayinakwenzeka kakhulu.

Kuyini Okushiwo yi-PGS?

I-PGS imele "ukuhlolwa kwesandulela-ngculazi kwangaphambili." I-PGS ayibheki izakhi zofuzo ezithile kodwa ibheka i-chromosomal jikelele eyenziwe umbungu.

Imibungu ingasetshenziswa ngokujwayelekile njenge-euploidy noma i- aneuploidy . Esimweni esivamile, leli qanda linikeza ama-chromosomes angu-23 kanti i-sperm enye enye engama-23.

Bonke, bakha umbungu onempilo ngama-chromosomes angu-46. Lokhu kubizwa ngokuthi i-embryus euploid.

Noma kunjalo, uma umbungu une-chromosome eyengeziwe-noma ulahlekelwa i-chromosome-ibizwa ngokuthi aneuploidy. Ama-embroidy ane-aneuploidy angase ahluleke ukufaka noma ukuphela kokukhulelwa kwesisu. Uma ukufakelwa, ukukhulelwa, nokubeletha kwenzeka, imibungu ye-aneuploidy ingabangela ingane ekhubazekile ngokwengqondo noma emzimbeni.

Isibonelo, i-Down Syndrome ingenzeka uma kukhona ikhophi eyengeziwe ye-chromosome 18 noma 21. I-PGS ingazibona lokhu ngaphambi kokuba umbungu udluliselwe kwisibeletho. Kwezinye izimo, i-PGS ingabonisa ubulili obufuywayo bombungu.

I-Chromosome Screening ephelele (CCS) yindlela eyodwa ye-PGS engakwazi ukubona ukuthi i-embryo ingu-XX (owesifazane) noma i-XY (owesilisa.) Lokhu kungasetshenziswa ukugwema isifo sofuzo esihlobene nobulili noma (okungavamile kakhulu) ukulinganisela komndeni.

I-PGD / PGS kanye nokuhlolwa kokubeletha kungafani kanjani?

Zombili i-PGD ne-PGS zenzeka ngesikhathi sokuqala. Lokhu akufani nokuhlolwa kokubeletha, lapho ukufakelwa khona sekuvele khona. Ukuhlolwa kokubeletha kungenziwa kuphela uma kutholakale ukukhulelwa.

Isampuli ye-Chorionic villus (i-CVS) ne- amniocentesis ingabona okungajwayelekile kwe-chromosomal kumntwana ongakazalwa. Uma kwenzeka ukungaqondakali kahle ngesikhathi sokuhlolwa kokubeletha, okukhethwa kukho ukuvumela ukukhulelwa kuqhubeke noma kuqedwe.

Lokhu kungaba yisinqumo esinzima sokwenza.

Labo abakhetha ukuqhubeka nokukhulelwa babhekana nokungaqiniseki nokwesaba okuzofika ngesikhathi sokuzalwa. Ngaphandle kokukhathazeka ngokuthi unomntwana onokukhubazeka kwansuku zonke, bangase babhekane nobungozi bokubeletha. Labo abanquma ukuqeda ukukhulelwa babhekene nosizi, mhlawumbe benecala, futhi ubuhlungu bomzimba nokubuyiselwa kokukhipha isisu.

Futhi, abanye abantu banokuphikisa okungokwenkolo noma ukuziphatha kokuqeda ukukhulelwa, kodwa banelungelo lokuhlolwa kwezakhi zofuzo ngaphambi kokudluliswa kombungu. Lokho kusho ukuthi, i-PGD ne-PGS ayiqinisekisiwe. Odokotela abaningi batusa ukuhlolwa kokubeletha ngaphezu kwe-PGD / PGS, nje uma ukuxilongwa kwezakhi zofuzo kuphutha noma kungaphuthelwa.

Izizathu Ezingenzeka Zokuhlola Ukuthola Ukuhlolwa Kwezakhi Ezifuze Nge-IVF

Nazi izizathu ezingenzeka udokotela wakho angancoma i-PGD (noma izizathu ongazicela.)

Ukuze ugweme ukudlulisa kwesifo esithile sokuzalwa esikulo mndeni : Lesi yisizathu esivame kakhulu se-PGD. Kuncike ekutheni isifo sofuzo siyi-autosomal esiphezulu noma esiphezulu, ingozi yokudlulisela isifo sofuzo kwengane ingaba phakathi kwamaphesenti angu-25 no-50.

Kwezinye izimo, umbhangqwana ungase ungadingi i-IVF ukuze ukhulelwe, futhi kungenzeka ukuthi ubhekane nokungafaki. Isizathu sabo kuphela sokuphishekela i-IVF kungase kube ukuhlolwa kwe-PGD.

Njengoba kushiwo ngenhla, ukuhlolwa kokubeletha kungaphinda kuhlolwe izifo zofuzo, ngaphandle kwezindleko ezengeziwe, izingozi, nezindleko zokwelapha kwe-IVF. Kodwa njengoba ukhetho olulodwa kuphela ukuqeda ukukhulelwa (noma ukuqhubeka nokukhulelwa) emva kokuhlolwa kokubeletha, lokhu akumukeleki emibhangqwana ethile.

Kunezinhlobo zezifo zezakhi zofuzo ezingahlolwa, kodwa ezinye ezivame kakhulu yizo:

• I-cystic fibrosis
• Tay-Sachs
• I-Fragile-X
• I-dystrophy yama-muscular
• I-anemia ye-sick-cell
• I-Hemophilia
• I-spinal muscular atrophy (i-SMA)
• Anemia kaFanconi

Ukuhlola ukuthuthwa kwe-translocation noma i-chromosomal rearrangements : Abanye abantu bazalwa ngama-chromosomes angu-46, kepha eyodwa noma ngaphezulu ayikho esimweni esilindelekile. Laba bantu bangase babe nempilo enhle, kodwa ingozi yokuthola ukungabi nabantwana, ukukhulelwa okubangelwa ukukhulelwa kwesisu noma ukuzalwa, noma ukuba nengane engavamile kungaphezu kwesilinganiso.

Emibhangqwana enomlingani ophethe i-translocation , i-PGD ingasetshenziselwa ukusiza ukubona imibungu ukuba ibe nempilo enhle.

Ukuze i-leukocyte antigen (HLA) yomuntu ihambelane, ukufakelwa kwe-stem-cell : Ukufakelwa kwe- Stem-cell yilapho kuphela ukwelashwa kwezifo ezithile zegazi. Ukuthola umdlalo emndenini akulula ngaso sonke isikhathi. Kodwa-ke, i-PGD ingasetshenziselwa ukukhetha umbungu wokuthi kokubili kungaba ngumdlalo we-stem (umdlalo we-HLA) nokuthi kungenzeka ugweme ukudlulisa leso sifo sofuzo esithinta ingane yakini.

Uma i-embryo ingabonakala ukuthi iyinto efanayo yomdlalo we-HLA, futhi ukukhulelwa nokubeletha okunempilo kwenzeka, ama-stem amangqamuzana adingekayo ukuze asindise impilo yomntanakho angasetshenziswa egazini legazi lomzimba lapho ezalwa.

Ukuze ugweme ukudlulisa isifo se-adult-ups : Ukusetshenziswa okungenakuphikisana kwe-PGD ukugwema ukudlula ukuthambekela kwezakhi zofuzo ezingase zibe nezifo esikhathini esizayo ekuphileni.

Isibonelo, i-BRCA-1 yomdlavuza webele webele. Ukuba nalesi gciwane akusho ukuthi umuntu ngokuqinisekile uzokwakha umdlavuza webele, kodwa ingozi yabo iphakeme. I-PGD ingasetshenziselwa ukubuka imibuthano ye-BRCA-1 ehlukile. Ezinye izibonelo zifaka isifo seHuntington kanye nesifo sokuqala se-Alzheimer.

Izizathu Zingenzeka Zokuhlolwa KwamaGenesis Okujwayelekile (PGS / CCS) Nge-IVF

Nazi ezinye izizathu ezivamile ze-PGS ezingasetshenziselwa ukwelashwa kwe-IVF.

Ukuthuthukisa izinkinga zokuphumelela ngokudluliswa komuntu oyedwa oyedwa : Ucwaningo oluthile luye lwabona ukuthi i-PGS ingasiza ekuthuthukiseni izingqinamba zokukhulelwa nokunciphisa ingozi yokukhulelwa kwesisu, lapho ukhetha ukudluliselwa komzimba ongabodwa.

Ngokudluliselwa komzimba okungabodwa kwe-embryo, noma eSET , udokotela wakho udlulisela umbungu owodwa ophilayo ophilile ngesikhathi sokuphathwa kwe-IVF. Lokhu esikhundleni sokudlulisa imibungu emibili ngesikhathi esisodwa, inqubo eyandisa amathuba okuphumelela kodwa futhi ihamba nayo ingozi yokuthola izimpande. Ukukhulelwa okuphindwe kaningi kuletha izingozi kumpilo kamama nezingane .

Ngaphandle kwe-PGS, i-embryo ikhethwe ngokwesiko ngokusekelwe ukuthi ivela kanjani. Kutholakale, noma kunjalo, ukuthi imibungu engabonakali ephelele ngaphansi kwe-microscope ingaba impela ibe nempilo. Futhi imibungu ebheka impilo enhle ingase ingabi njenge-chromosomally evamile njengoba ivela. I-PGS ithatha okunye kokuqagela.

Ukuhlonza ubulili bofuzo : Ngokujwayelekile esetshenziswa uma isifo sofuzo sisekelwe ngokobulili, i-PGS ingasiza ekuboneni ukuthi umbungu ungowesifazane noma owesilisa. Lokhu kungaba indlela ephansi kakhulu yokugwema isifo sofuzo kunePGD.

Kodwa-ke, i-PGS ingasetshenziselwa ukusiza umbhangqwana ukuba nomntwana ubulili obuqondile uma bethemba "ukulinganisela" umndeni wabo. Ngamanye amazwi, kakade banomfana futhi manje bafuna intombazane, noma ngokufanayo. Lokhu kwakungeke kwenzeke uma lo mbhangqwana ungadingi i-IVF ngesinye isizathu.

Empeleni, i-ASRM kanye ne-American College of Obstetricians kanye neGynecologists (ACOG) ngokuziphatha ngokumelene nokusebenzisa i-PGS yokukhetha ngokobulili ngaphandle kwesizathu sezokwelapha.

Ukunciphisa ingozi yokukhulelwa kwesisu kwabesifazane abanomlando wokulahlekelwa kokukhulelwa okuphindaphindiwe : Ukuhlukaniswa kwemishado kuvamile, kwenzeka emaphesenti angu-25 okukhulelwa. Ukususwa kwesisu okuphindaphindiwe- okulahlekelwa kathathu noma ngaphezulu ngokulandelana-akunjalo. I-PGS ingasetshenziselwa ukusiza ukunciphisa izinkinga zesinye isisu.

Ucwaningo lokuthi noma ngabe i-PGS ingayithuthukisa ngempela imithwalo yokukhulelwa kwabesifazane abanomlando wokulahlekelwa okuphindaphindiwe kokukhulelwa akucacile. Emibhangqwana enomlingani ohamba nge-chromosomal translocation, noma isifo sofuzo esithile esibangela ingozi yokukhulelwa noma ukubeletha, i-PGD (hhayi i-PGS) ingaba nengqondo.

Kodwa-ke, emibhangqwaneni ekulahlekelwa kwayo okungaxhunyiwe ekuthambekeni kofuzo lokukhulelwa, ngabe i-IVF ne-PGS ingayandisa ngempela amathuba okubeletha okuphilayo ngaphandle kokuzama ukuzama ngokwemvelo. Kungase kube nomngcipheko ophansi wokuthola isisu, kepha ukukhulelwa okuhle nokubeletha kungase kungabi ngokushesha.

Njengamanje, i-American Society of Medicine Reproductive does not recommend IVF ne PGS ukuphatha ukukhulelwa kwesisu okuphindaphindiwe.

Ukwenza ngcono ukuhlukumezeka kokuphumelela kokukhulelwa kweziguli ze-IVF : Odokotela abathile bokuzala batusa i-PGS kanye ne-IVF ukukhulisa ngokweqile ukunganaki kokuphumelela kokwelapha lapho kwenzeka ubuhlungu besilisa obunzima, imibhangqwana eye yabhekana nokuhluleka kokuphindaphindiwe kwe-IVF, noma abesifazane abaneminyaka yobudala obudala . Ezinye imitholampilo zinikeza i-PGS nge-IVF kubo bonke abagulayo.

Kukhona okwamanje ucwaningo oluncane lokubonisa ukuthi i-PGS izokwenza ngempela ukuphumelela kwempatho ye-IVF uma ingaboniswa ngokuqondile. Ucwaningo oluningi oluthole izinga eliphezulu lokuphumelela libheke izinga lokuzalwa lokuzalwa ngokudluliswa kombungu- hhayi umjikelezo ngamunye. Lokhu kuzohlale kuphakeme kunezinga ngalinye lomjikelezo, ngoba akuwona wonke umjikelezo we-IVF othola imibungu. Kunzima ukubona ukuthi kunenzuzo yangempela. Izifundo eziningi kudingeka zenziwe.

Imibungu Yenzelwe Kanjani?

Ukuze wenze noma yikuphi ukuhlolwa kofuzo, amangqamuzana avela embungwini kumele abe ne-biopsied. I-zona pellucida igobolondo elivikelayo elivulela umbungu. Lolu ungqimba oluvikelayo kufanele luphulwe ukuze kuhlaziywe amanye amaseli. Ukuze aphule, isisu se-embryologist singasebenzisa inaliti ye-laser, i-asidi, noma ingilazi.

Uma sekuvuliwe ukuvulwa okuncane, amaseli okufanele ahlolwe asuswe noma athandwe nge-pipette, noma umbungu ubambe kahle kuze kube yilapho amaseli ambalwa ephuma ngokuvula okuvulekile.

I-biopsy ye-embryo ingenziwa izinsuku ezintathu emva kokukhulelwa noma izinsuku ezinhlanu. Kunezinzuzo nezindleko kumuntu ngamunye.

Usuku lwesithathu lwe-Bibrsy Embryo : Umbungu osukwini lwe-3 ubizwa ngokuthi i-blastomere. Unamaseli ayisithupha kuya kwesishiyagalolunye kuphela. Kungenzeka ukwenza ukuhlolwa kwezakhi zofuzo esitokisini esisodwa, kodwa ukuthatha ezimbili kungcono.

Enye yezinzuzo ezinkulu zokwenza i-biopsy ye-Day 3 ukuhlolwa kungenziwa ngesikhathi sokudluliswa okusha kwe-embryo ngosuku lwe-5 lokuthunyelwa kwamaqanda emva kokuthunyelwa kwamaqanda. Lokhu kusho isikhathi esincane sokulinda kanye nezindleko eziphansi (ngoba kungenzeka ukuthi awudingi ukukhokha ukudluliswa kwebridi efriziwe.)

Kodwa-ke, ucwaningo oluthile luye lwabona ukuthi i-biopsy yamangqamuzana angaphezu kwesisodwa kulesi sigaba yandisa ingozi yokuba "umbungu uboshwe." Umbungu ungase uyeke ukukhula futhi awukwazi ukushintshwa. Lokhu kungavamile, kepha kuyingozi engayicabangela. Futhi, ingozi yamathuba amanga kanye nemiphumela ehlanganisiwe inkulu neSuku 3 le-biopsy.

Usuku Lwesihlanu Lwe-Bibrsy Embryo : Usuku 5 Umbungu ubizwa ngokuthi i-blastocyst. Kulesi sigaba, umbungu unamakhulu amangqamuzana. Amanye alawa maseli azoba umntwana, amanye ama-placenta. I-embryologist ingathatha amangqamuzana amaningi ukuhlola-ngokuvamile ukuthatha phakathi kuka-5 no-8-okungavumela ukuxilongwa kangcono nemiphumela embalwa engavumelani. Amaseli athathwayo ahloselwe ukuba yi-placenta; amangqamuzana e-fetal ashiywanga angafundwa.

Ukungahambi kahle kwe-biopsy ye-Day 5 ukuthi akuwona wonke ama-embryo asinda emkhatsini wemibandela izinsuku eziningi kangaka, ngisho nemibungu enempilo eminye.

Futhi, i-biopsy ye-Day 5 idinga ukuthi imibungu ibhalwe phansi kuze kube yimiphumela ebuya. Lokhu kusho ukuthi owesifazane kuzodingeka alinde kuze kube yinyanga ezayo ukwenza ukudluliswa kombungu. Kuzoba umjikelezo wokudlulisa umbungu we-embryo. Lokhu kusho isikhathi esengeziwe sokulinda nezindleko ezengeziwe. Kukhona futhi ingozi ukuthi imibungu ngeke isinde emakhazeni nasezinhlanzi.

Kodwa-ke, imibungu enamandla kakhulu ijwayele ukuhlala ngemva kwalolu hlelo. Labo abasinda futhi babe nemiphumela emihle ye-PGS kungcono nakakhulu ukuholela emiphumeleni enempilo.

Iyini Inqubo Ye-IVF Ne-PGD ne-PGS?

Kunezimpikiswano ezithile endleleni umjikelezo wezokwelapha we-IVF ozohlolwa ngayo i-PGD noma i-PGS.

Okokuqala, nge-PGD, inqubo ingase iqale izinyanga ngaphambi kokwelashwa kwangempela kwe-IVF. Kuncike ekuxilongweni kofuzo oludingekayo, ukuhlolwa kofuzo kwamalungu omndeni kungadingeka. Lokhu kuyadingeka ukudala isephrothi yesigineshi, efana nebalazwe esetshenziselwa ukukhomba ngqo lapho okungajwayelekile khona noma ukuphawula kofuzo.

I-PGS ayidingi ukuhlolwa kofuzo lwamalungu omndeni futhi kuhilela kuphela ukuhlola imibungu. Phakathi nomjikelezo we-IVF wangempela, isipiliyoni sesiguli se-PGS ne-PGD sinjalo, yize ubuchwepheshe bezakhi zofuzo ezenzeka ebhodini buhlukile. Uma ungajwayele ukwelashwa okuvamile kwe-IVF, funda le ncazelo ngesinyathelo ngesinyathelo kuqala.

Lapho i-IVF yokuhlola i-genetic ihluke ekutheni ukwelashwa okuvamile kuyisiteji sombungu. Ngokuvamile, emva kokukhulelwa, imibungu enempilo ibhekwa njengokudluliselwa kwezinsuku ezintathu noma ezinhlanu emva kokubuyiswa kweqanda. Ngama-PGS noma i-PGD, imibungu iyaqhutshwa ngosuku lwesithathu (emva kokubuyiswa kwamaqanda) noma uSuku 5. Amaseli athunyelwa ukuhlolwa. Uma lemibungu ihlolwa ngosuku lwesithathu, imiphumela ingahle ibuyele ngaphambi kweSuku 5. Uma kunjalo, noma yikuphi imibungu enemiphumela emihle ingacatshangelwa ukudlulisela lowo mjikelezo. Ama-embryo angeziwe angadliwa ngenye imjikelezo.

Nokho, njengoba kushiwo ngenhla (esigabeni se-embryy biopsy), usuku lwe-biopsy lwe-Day 5 lunganconywa noma lukhethwa. Kulesi simo, imibungu iyaqhutshwa futhi ivele igubha ngokushesha. Ayikho imibungu izodluliswa phakathi nomjikelezo we-IVF kulokhu. Esikhundleni salokho, bazohlala "eqhweni" kuze kube yilapho imiphumela evela ekuhlolweni kofuzo ibuya.

Uma imiphumela isatholakala, ukucabanga ukuthi noma yikuphi imibungu kubhekwa njengokudluliswa, owesifazane uzothatha imithi yokuvimbela ukuvuthwa nokulungiselela isisu sokufakelwa. Ngesikhathi esifanele, eyodwa noma emibungu embalwa izokwenziwa futhi ilungiswe ukudluliselwa.

Uma usuku olulodwa lwe-biopsy ne-frozen embryo yokudlulisa lukhethiwe, isikhathi sokwelapha singase sisebenzise izinyanga ezimbili kuya kwezine (ngesikhatsi sokuphumula senyanga noma isikhathi sokulinda.)

Izingozi ze-PGD / PGS

I-IVF ne-PGS ne-PGD ihamba nazo zonke izingozi zemithi yokwelashwa ejwayelekile ye-IVF.

Ngaphandle kwalezi zingozi, noma ubani ocabangela i-PGD / PGS kudingeka abuye aqonde lezi zingozi ezingeziwe:

• Izinga lokubeletha livela lingase libe liphansi kunelabo ontanga abafanelwe ubudala. Lokhu kungenxa yokuthi eminye imibungu ngeke isinde kwinqubo kanti abanye (noma bonke) bangabuya ngemiphumela embi.
• Ngosuku lwesishiyagalolunye lwe-biopsy, kunengozi encane yokwahlukana okufanayo.
• Amaphutha amanga kanye nokungalungi okungamanga kungenzeka. Ngamanye amazwi, imibungu engavamile ingase ihlole "evamile," futhi imibungu enempilo ingase itholakale ngokungalungile njengengavamile futhi ilahlwe. Ngenxa yokuphazamiseka ngokweqile, kunengozi engamaphesenti angu-2 ombungu othola umphumela ovamile uma kungavamile, futhi ingozi ye-11 yamaphesenti okuphazamiseka kwezakhi zofuzo.
• Uma yonke imibungu ibuya ngemiphumela embi, kungenzeka ukuthi akekho ozokudlulisela.
• Imiphumela engabonakali ingase ivele. Futhi eyaziwa ngokuthi imibungu yama-mosaic, yilapho amanye amangqamuzana evela ngokujwayelekile e-chromosomally futhi abanye abawenzi. Ucwaningo oluthile luye lwathola ukuthi imibungu yama-mosaic ingazilungisa futhi ingaholela ekukhulelweni okunempilo nengane.
• Ukwehliswa kwegazi kanye nokususwa okulandelayo kungaholela ekulahlekelweni kwemibungu enempilo enye.
• Eminye imibungu enempilo enhle ingase ingaphinde iphile kuze kube yiSuku 5 emva kokubuyiswa kweqanda.
• I-Biopsy Day Day emibungu ingaholela ekuboshweni kombungu, lapho umbungu uyeka ukukhula.
• I-PGD / i-PGS ayinangqondo, kanti ingane enezifo zofuzo noma isifo singase isenze. Ukuhlolwa kwangaphambi kokubeletha ngaphezu kwe-PGD / PGS kunconywa ngesiqinisekiso esengeziwe.
• I-PGD / i-PGS emihle nokuhlolwa kokubeletha akuqinisekisi ukuthi ingane ngeke ihlaselwe ukukhubazeka ngokomzimba noma kwengqondo kwezinye izinhlobo.
• Ingozi yokukhulelwa kwesisu ingase ibe ngaphansi kwemibungu ejwayelekile ye-PGS, kodwa kusengcupheni yokulahleka kokukhulelwa.
• Ukulindela imiphumela kanye nokudinga ukwenza izinqumo mayelana nemibungu ngemiphumela engavumelekile kungaba nzima kanzima.
• Ubuchwepheshe bubusha kangangokuthi asazi ngokuqinisekile ukuthi umphumela wesikhathi eside ungaba kanjani kubantwana abazalwa emva kwe-IVF-PGD / PGS. Noma kunjalo, imiphumela yokuqala ibukeka kahle. Izifundo ezimbili ezincane zathola ukuthi lezi zingane azikho engozini yokwephuza okuthuthukiswayo. Baye baba nezisindo ezijwayelekile zokuzalwa.

Ingakanani Imali ye-PGS / PGD?

I-IVF isivele ibiza. Ukwengeza ngezindleko ze-PGS noma i-PGD kuphakamisa ukuthi amanani entengo aphezulu nakakhulu. Ngokwesilinganiso, i-PGD / i-PGD ihlanganisa phakathi kuka-$ 3,000 no-7,000 kuya ku-IVF yokwelapha. Izindleko zakho zokujikeleza kwe-IVF eyodwa ne-PGS / PGD zingaba phakathi kuka-R17 000 no-25,000.

Ngaphezulu kwalokhu, kungase kudingeke ukhokhele umjikelezo we-embrying transfer (FET) umjikelezo. Lokhu kuyoba imali engu-3,000 kuya ku-5,000. Ngezinye izikhathi, iziguli zifuna ukuhlela umjikelezo we-FET ngokushesha ngemva kokujikeleza kwe-IVF. Ngale ndlela, ngokushesha nje lapho imiphumela yokuhlola i-genetic ibuya, ingadlulisela noma yimiphi imibungu ejwayelekile ngaphandle kokulinda inyanga eyengeziwe.

Kodwa-ke, inkinga kungenzeka ngale ndlela ukuthi uma kungekho emibungu evamile yokudlulisa, ezinye zezindleko ze-FET zizolahlekelwa. Noma yimiphi imithi yokwelapha ethathwe ekunqandeni ukuvuthwa kwegazi nokulungisa isibeletho sokufakelwa komzimba izothathwa ngaphandle kwesizathu.

Ukulinda inyanga eyengeziwe kungase kube nzima ngokomzwelo, kodwa kungase kube nomqondo ozwakalayo ngokwezimali. Nge-PGD, ungase ube nezindleko ezingaphezu kwelashwa lokuzala. I-PGD ngezinye izikhathi idinga ukuhlolwa kofuzo lwamalungu omndeni, futhi lezo zindleko ngeke zifakwe emgqeni wakho womtholampilo wokuzala futhi angeke ifakwe ngumshuwalense.

Izwi elivela ku-Verywell

Ukuhlolwa kwe-genetic kuye kwasiza imindeni ngezifo zofuzo noma ukudluliselwa kwe-chromosomal kunethuba elingcono lokuba nengane enempilo nokugwema ukudlula izifo ezibhubhisayo. Ukuhlolwa kwe-genetic kuye kwasiza nodokotela ukuba bakhethe ukukhethwa kwe- embryo kumjikelezo owodwa wokudlulisela umbungu .

Kungakhathaliseki ukuthi i-PGD / PGS ingathuthukisa ngempela amazinga okuzalwa okuphilayo ngaphesheya kwalezi zimo akucacile. Ubuchwepheshe namanje busha futhi buyaqhubeka njalo. Ukusebenzisa i-PGS ukuthuthukisa amazinga okuzalwa okuphilayo ku-IVF uma ubuchwepheshe bengaboniswa ngokuqondile buphikisana.

Abanye odokotela bathi bayabona impumelelo, kuyilapho abanye bebuza ukuthi kuwufanele yini izindleko ezengeziwe nezingozi. Abanye bacabanga ukuthi kufanele banikezwe isiguli ngasinye se-IVF; abanye bakholelwa ukuthi kumele kuhlinzekwe okungavamile, ezimweni eziqondile kakhulu.

Kungenzeka ukuthi i-PGS ingasiza ekugwemeni ukudlulisa ama-embungu okuzophela ekugcineni kokukhulelwa komzimba. Kodwa-ke, lokhu akusho ukuthi lo mbhangqwana awungeke ube nomphumela wokukhulelwa okunempilo ngokudluliselwa kwe-embryo eqhamukayo (FET) okuvela emjikelezweni ofanayo.

Isibonelo, ake sithi umbhangqwana uthola imibungu emithathu eqinile. Ake sithi benza i-PGS futhi bathola imibungu emibili evamile. Omunye noma ababili badluliselwa, futhi ake sithi ukukhulelwa kwenzeka emjikelezweni owodwa noma emibili. Manje, ake sithi lo mbhangqwana ofanayo wanquma ukungenzi iPGS, futhi kwenzeka ukuthumela kuqala umbungu nge-chromosomal engavamile. Lo mjikelezo uzophela ekukhulelweni kwesisu. Kodwa basenemibungu emibili noma emibili elinde ukuba ishawed futhi idluliselwe, futhi kungenzeka ukuthi ithole ingane enempilo kusuka kwenye yale mibungu. (Esikhathini esingcono kakhulu isimo, yiqiniso.)

Njengamanje, ucwaningo luthi izinkinga zokuzalwa okuphilayo zifana nesimo ngasinye-ngaphandle nangaphandle kwe-PGS. Kodwa kukhona izindleko ezingokomzwelo zokuthola isisu. I-PGS ayinqamuli izinkinga zokulahlekelwa-nakuba kubonakala kunciphisa leyo ngozi.

Nguwe kuphela nodokotela wakho onganquma ukuthi i-IVF ne-PGD / PGS ilungile yini emndenini wakho. Ngaphambi kokwenza isinqumo, qiniseka ukuthi uyaqonda ukuthi kungani udokotela wakho ancoma ubuchwepheshe bokuzala bokusiza kuwe, izindleko eziphelele (kufaka phakathi imijikelezo ye-cryopreservation ne-FET), kanye nezingozi ezingenzeka.

> Imithombo:

> Forman EJ1, Tao X, Ferry KM, Taylor D, Treff NR, Scott RT Jr. "Ukudluliswa kombungu ongenawo umphumela wokuhlola ukuhlolwa okuqhubekayo ekuthuthukiseni izinga lokukhulelwa okuqhubekayo nokunciphisa izinga lokukhulelwa kwesisu. "Uhlehlisiwe. 2012 Apr; 27 (4): 1217-22. doi: 10.1093 / humrep / des020. I-Epub 2012 Feb 16.

> Ikomidi lezenzo zokuzivocavoca zeNhlangano Yezobuchwepheshe Zokukhiqiza Ezisiziwe; IKomiti Yokuzivocavoca yaseMelika Society for Medicine Reproductive. "Ukuhlolwa kwangaphambi kokusungula izakhi zofuzo: umbono wekomidi lomkhuba." I-Fertil Steril. 2008 Nov; 90 (5 Suppl): S136-43. i-doi: 10.1016 / j.fertnstert.2008.08.062.

> Schattman, u-Glenn L; Xu, Kangpu. Ukuhlolwa kwangaphambi kokusungula izakhi zofuzo. UpToDate.com.

> Schattman, Glenn L. Ukuhlolwa kwe-genetic pre-plantation. UpToDate.com.

> Intshumayelo K1, Capalbo A2, Cohen J3, Coonen E4, De Rycke M5, De Vos A6, Delhanty J7, Fiorentino F8, Gleicher N9, Griesinger G10, Grifo J11, Handyside A12, Harper J7, Kokkali G13, Mastenbroek S14, Meldrum D15 , Meseguer M16, Montag M17, Munné S18, Rienzi L19, Rubio C20, Scott K21, Scott R22, Simon C23, Swain J24, Treff N22, Ubaldi F19, Vassena R25, Vermeesch JR26, Verpoest W6, Wells D27, Geraedts J4. "Kungani, kanjani futhi nini i-PGS 2.0: imikhuba yamanje kanye nemibono yobuchwepheshe bophiko lokuzala, izazi zezinto eziphilayo ze-molecular and embryologists. "Mol Hum Uhlambalazile. 2016 Aug; 22 (8): 845-57. doi: 10.1093 / molehr / gaw034. Epub 2016 Jun 2.