Okufanele Ukwenze Uma Ukufinyelela Kwakho Kuzokwelapha Ukwelashwa Kunomkhawulo

by URachel Gurevich; Kubukezwe ngu-Anita Sadaty, MD

Ukunqoba izithiyo zomshuwalense wezezimali, ezingokoqobo, nezempilo

Ukwelashwa kobubele kanye nobuchwepheshe buhlinzeka ngamadoda nabesifazane abangenakukwazi ukuba nezingane ithuba lokuba nomndeni. Ngeshwa, lezi zindlela zokwelashwa azitholakali njalo noma zifinyeleleka kalula. Eqinisweni, ucwaningi lubonisa ukuthi iningi lamabhangqwana angenasifo akakwazi ukuthola imithi yokwelapha abayidingayo.

Ezingxenyeni zikazwelonke zokuPhepha koMndeni zokuLawula ukugula, amaphesenti angu-11 abesifazane kanye namaphesenti ayisishiyagalolunye wamadoda abike ukuthi bezama ukukhulelwa .

Le nhlolovo efanayo ithola ukuthi amaphesenti angu-38 kuphela abesifazane abangenabantwana abanezinkinga zokusola okusolakala ukuthi bazala noma bafuna ukunakekelwa kokuzala. Phakathi kwaleli qembu labesifazane, iningi lathola ukuhlola kokuzala kanye nezeluleko-kodwa hhayi ukwelashwa.

Uma kuziwa ekwelapheni kwe-IVF e-United States, kulinganiselwa ukuthi eyodwa kuphela emibhangqwaneni emine edinga lolu buchwepheshe lobuchwepheshe bokusiza ngempela uyayithola.

Kungani abantu abaningi kangaka bengakwazi ukuthola imithi abayidingayo? Uma unenkinga yokuthola ukwelashwa kwe-infertility, ingabe kukhona ongakwenza ukuze uthuthukise ukufinyelela kwakho? Futhi, uma ukuphathwa kokwelashwa akuyona inketho kuwe, yini ongayenza ukuze ukwandise izinkinga zakho zokuphumelela kokukhulelwa?

Awunayo Yedwa: Izithiyo Ezivame Ukutholakala Ukwelashwa Kwesizalo

Uma unenkinga yokuthola ukwelashwa okudingayo, uwedwa kude. Ungabhekana nesithiyo esisodwa, noma eziningana. Nazi ezinye izithiyo ezingase zenze ukunakekelwa kokuzala:

Ukuntula Izinzuzo Zokuzala Emshuwalense Wezempilo: Lokhu kuncike lapho uhlala khona nokuthi ubani osebenzela khona. ECanada naseYurophu, ukutholakala kokuzala kunikwe igunya emthethweni ezindaweni eziningi. Lokhu akulona iqiniso e-United States. Izifunda ezingu-11 kuphela zinemithetho efuna ukutholakala komshuwalense wokuzala. Kulabo abangu-11, amathandathu kuphela afuna ukufakwa okuphelele.

E-US, amaphesenti angama-75 enqubomgomo yomshuwalense wangasese ayibophe ngokwanele ukungasebenzi. Uma usuhlelo lomshuwalense womphakathi, cishe akunakwenzeka ukuthi unomsebenzi wokuvuna.

Ukungabi Nempilo Yomshuwalense : Abantu abanomshwalense wezempilo-ngisho nangaphandle kokuthola usizo lokungakhulelwa-bangathola okungenani ukunakekelwa okuyisisekelo kokuzala. Ngezinye izikhathi, lokhu kungokwanela ukuphatha izinkinga ezilula zokuzala. Isibonelo, i-OB / GYN yakho ingahle ibeke i-Clomid uma ukuvota kwakho kungavamile . Kungase kudingeke ukhokhe inani eliphelele lamaphilisi, kodwa ukuqokwa kwakho nodokotela kanye nokuhlolwa okuyisisekelo kakhulu kokuzala kungase kutholakale.

Kodwa-ke, uma ulahlekelwa yimuphi umshuwalense wezempilo, ikhono lakho lokuthola ukunakekelwa kokuzala lilinganiselwe. Lokhu kuyiqiniso futhi uma unomgomo womshuwalense wempilo kuphela.

Ukuntuleka Kwesikhwama (Ngaphandle Noma Ngaphandle Kwomshuwalense): Ngisho noma unomshwalense wezempilo omkhulu, izindleko zingakwazi ukuma phakathi kwakho kanye nemithi oyidingayo. Ukukhokhwa kwakho kokusebenza kungase kube kakhulu kakhulu kubhajethi yakho. Izingxenye zokwelashwa kwakho angeke zihlanganiswe nhlobo. Uma udinga i- surrogacy noma i- egg donor ukuze ube nengane , lokhu kuyiqiniso ngokukhethekile.

Indawo : Kungase kungabi khona okwanele ekupheleni kokuzala kokubeletha esifundazweni noma ezweni lakho. E-United States, uma uhlala eMpumalanga noma eWest Coast, kungenzeka kakhulu ukuba nomtholampilo wokuzala endaweni eqondile yokushayela kunokuba uhlala eMidwest.

Kukhona ama-16 ase-USA ase-odokotela abavunyelwe ukuzala abakwa-SART abahlanu noma abaphansi.

Kukhona lapho kunakekelwa ukunakekelwa okwengeziwe okutholakala emazweni adinga ukutholakala komshuwalense wezempilo wokuzala. Ungabheka ukuthi amazinga wakho wombuso at ikhasi le-RESOLVE's Fertility Scorecard.

Ukubunzima Ukuthola Ukunakekelwa Okuhle Ngenxa Yobanikazi Bokuhlinzeka Ngokunakekelwa: Ezweni elihle, ukukhathalela udokotela akufanele kungavinjelwa ukuzikhethela komuntu siqu. Kodwa odokotela bangabantu, futhi izinkolelo zabo ngezinye izikhathi zithola indlela yokwelashwa.

Izizathu odokotela baye benqaba ukunakekelwa kwesiguli, noma banikeze ulwazi olungalungile (etshela isiguli ukuthi abakwazi ukunakekelwa, uma bekwazi), bafaka:

Udokotela noma isikhalazo senkolo esibhedlela i-IVF
Isimo sezenhlalakahle (noma isimo esaziwayo senhlalo yomphakathi) sesiguli
Isigulane esingaphezu kwesisindo (hhayi ngenxa yezizathu zezokwelapha ezivumelekile, kodwa ngenxa yokuzikhethela komuntu siqu)
Isimo somshado (umshuwalense othile wempilo yomshuwalense wokuzala ufuna ukuthi isiguli sishade)
Isimo socansi
Ubunikazi obunikazi
Ubuhlanga noma ubuhlanga
Ubudala

Lo mgwaqo ungase uvele kudokotela oyinhloko yokwelapha noma izinga le-OB / GYN, noma lingase liqhubekele phambili kulolu chungechunge nochwepheshe wokuzala. Labo abahlangabezana nokukhathazeka ezingeni lokuqala lokunakekela bangase bangabi nhlobo amathuba okuthola usizo emtholampilo wokuzala. (Kungenzeka bangakwazi ngisho ukuthi bayakwazi uma befuna, kuye ngokuthi yiluphi ulwazi udokotela wokuqala owabelwana ngawo.)

Umthetho uvikela ezinye zalezi zifiso. Kodwa-ke, ukubandlulula okungekho emthethweni akuvimbeli ukuthi kungenzeki.

Ukubunzima Ukufuna Ukunakekelwa Ngenxa Yobuntu Bomuntu Nokwesaba : Lesi sithiyo senziwa ngaphakathi kwenzalo eyinselele ngokwayo. Abesilisa nabesifazane abaningi bayazi ukuthi banzima ukukhulelwa, kepha baqede ukufuna usizo lokuzala (noma ungafune usizo).

Izizathu ezingenzeka ukuthi umuntu angase angafinyeleli usizo lokuzala, kufaka phakathi ukucwaswa kwamasiko , ukungazethembi noma ukwesaba odokotela, ukucabanga ukuthi abakwazi ukukhokhela noma yikuphi ukwelashwa, imibono yenkolo noma inkolelo yokuthi isikhathi esiningi noma inhlanhla kuyokwanela ukunqoba ukungabi nabantwana.

Ungacabangi ngokuzenzakalela ukuthi awukwazi ukunakekela ukwelashwa okudingayo

Eminye imibhangqwana engalokothi ikhulume nodokotela bayo ngokukhathazeka kwabo kokuzala ngoba bacabanga ukuthi ngeke bakwazi ukukhokhela ukwelashwa. Lokhu kuyadabukisa, kunikezwa ukuthi ukwelashwa okuningi kokuzala kungabizi kakhulu.

Okokuqala, bheka udokotela wakho. Thola ukuhlolwa okuyisisekelo kokuzala. (Lokhu kucabanga ukuthi unomshuwalense wezempilo, bheka ngezansi ukuthi yini ongayenza uma untula umshuwalense omuhle.)

Khona-ke, uma udokotela wakho enza ukuhlola, thola ukuthi iziphi izincomo zokwelashwa eziphakanyisiwe kanye nezindleko zabo. Iphesenti elincani kakhulu lesiguli sokuzala sidinga i-IVF .

Zifundise Ngokukhethwa Kwezidingo Zokunakekelwa Kwezezimali

Yebo, ezinye izindlela zokwelapha zingabiza. Uma udinga i -jectjectables , i- IUI , nanoma yikuphi ubuchwepheshe bokuzala bokusiza, izindleko eziphezulu zingakuvimbela ekutholeni ukwelashwa okudingayo.

Lokho kusho, kunezinketho ongase ungacabangi ngazo. Usizo olungezansi lwezezimali lungakusiza ukuba ungabikho-kungenzeka ukuthi u-yebo-singakwazi.

Ezinye izinketho zokubuka zibandakanya:

Thatha Inzuzo Yezinsiza Zempilo Zamahhala noma Ezikhokhelwayo

Ake sithi awunayo umshuwalense wezempilo, noma umshuwalense wakho wezempilo kuyinto eyisisekelo kakhulu. Ungakwazi ukuthola ukunakekelwa okungabizi okuvela emtholampilo wezempilo wamahhala noma esaphunduliwe.

Ngeke uthole imithi ye-IVF lapha. Kodwa ukunakekelwa okuyisisekelo okufanele kutholakale kufanele kutholakale, kuhlanganise nokuhlolwa okuyisisekelo kakhulu kokuzala. Ezinye zalezi mitholampilo zezempilo zomphakathi noma ezithathwe isaphulelo zingahle zibeke izidakamizwa zokuzala ezifana ne-Clomid .

Ukuthola Isikhungo Sempilo Esifanelekile (Federally Qualified Health Centre) (FQHC), ungasebenzisa ithuluzi lokusesha kwi-website ye-Health Resources kanye ne-Service Administration (HRSA):

Thola Isikhungo Sempilo Samahhala noma Esikhokhelwayo

Enye indlela ukuxhumana nehhovisi lasekhaya lase-United Way noma umtholampilo we-Planned Parenthood wendawo.

Ukwelapha Izifo Ezicindezelayo Ngokuhle Kakhulu Kunokwenzeka

Uma ucabanga ngezinkinga zokuzala, cishe ucabanga ukuthi udaba luvela ohlelweni lokuzala. Kodwa lokhu akulona iqiniso ngaso sonke isikhathi. Ngesinye isikhathi, isimo esingokwempilo esingokwempilo (esingathinti kuphela ukuzala) kubangela ukungasebenzi. Ukungabi nalutho kungase kube uphawu oluqala oluqaphelayo.

Isibonelo, ukukhuluphala kuyisisindo esivamile (esivinjelwe) sokungabikho. Ukungalingani kwe-thyroid nesifo sikashukela kungabangela izinkinga zokuzala. Isifo se-celiac esingahlosiwe sisolakala ukuthi sibangela ukungasebenzi.

Lesi esinye isizathu sokuthi kungani kufanele ubone udokotela wakho uma unzima ukukhulelwa, ngisho noma ungenayo izinzuzo zokuzala emshwalense wakho wezempilo. Ungase ungadingi "ukwelashwa kokuzala" ukuze ukhulelwe.

Buza udokotela wakho wokulima ukuze unciphise izindleko ngangokunokwenzeka

Ake sithi udinga ukwelashwa kokuzala. Ngezinye izikhathi, uma uchazela umtholampilo wokuzala, isimo sakho sezezimali, singakwazi ukunciphisa izindleko (okunye).

Ezinye izindlela ezingenzeka izindleko zingancishiswa zihlanganisa:

Ukuqapha okuncane
Ukusebenzisa okukhethwa kukho kwemithi engabizi
Ukuzama umjikelezo wemvelo noma we-mini-IVF

Yiqiniso, kunezingozi nezinzuzo zokuqapha kancane noma ukuzama umjikelezo we-mini-IVF esikhundleni sejwayelekile. Lezi zinketho zokunciphisa izindleko azikho njalo. Xoxa ngezinketho zakho nodokotela wakho.

Ukwandisa Impilo Yonke Njengoba Kunokwenzeka Kakhulu

Indlela yokuphila enempilo ngeke ivule amashubhu akho , aphulukise ukungakwazi ukusebenza kwe-ovarian , noma abuyele i- azoospermia (isibalo se-zero sperm) . Kodwa-ke, imibhangqwana ebhekene nezinkinga zokuzala izitshalo zingase zenze izinkinga zokukhulelwa zibahambele.

Ezinye izinto okufanele uzicabangele:

Yidla ukudla okunempilo . Ucwaningo luye lwathola ukuthi ukudla kudlala indima ekukhuliseni . Ukudla okunempilo ngezinye izikhathi kungabiza kakhulu. Ukupheka okunempilo kungathatha isikhathi, okungenzeka ungabi nayo uma usebenza amahora amaningi.

Ukuthola imithi eminingi ekudleni kwakho, ukuthenga umkhiqizo ngenkathi, futhi ukhumbule ukuthi imifino efriziwe ifana neyomsoco njengoba intsha.

Futhi, ungabi namahloni okusebenzisa kahle ibhange lakho lokudla (uma ufaneleka). Ezinye izindawo ziye zaveza izinhlelo zokusiza imindeni ephansi engenayo ukuthola ukudla okunye okusha ekudleni kwabo.

Ukuze ugcine isikhathi ngokupheka, bheka ku-intanethi nasemtatsheni wezincwadi ngolwazi ekulungiseleleni kokudla okuphambili kanye nokupheka okusheshayo nokulula. I-slow-cooker ingaba utshalomali omuhle. Ezempilo akudingeki ukuthi zisho ukuthi zifisa noma zinkimbinkimbi.

Thola ukulala okwanele, ngesikhathi samahora afanele . Ukulala kubalulekile empilweni yakho yonke nokuzala kwakho. Abasebenzi beShift bangabhekana nengozi eyengeziwe yokukhulelwa nokukhulelwa . Uma uzama ukukhulelwa, yenza ubuthongo kuqala.

Phula imikhuba emibi yezempilo . Ingabe uyabhema? Ingabe iziphuzo ezidakayo zenzeka zonke izinsuku ekuphileni kwakho? Imikhuba engenampilo ingalimaza ukuzala kwakho.

Yenza isikhathi sokuphumula . Ukucindezeleka akubangeli ukukhulelwa, kodwa ukungabi nabantwana kungabangela ukucindezeleka okukhulu. Ukucindezeleka ngokweqile akulungile impilo yakho yonke. Imithi yomzimba yengqondo ingakusiza ukuba ubhekane kangcono.

Zifundise Ngokungahambi kahle futhi Xhuma nabanye

Uma wazi ngokwengeziwe, nakakhulu ungakwazi ukuzisiza. Zifundise ekunganeni, ukukhetha kokwelashwa kwakho kokuzala, nokuthi yiziphi izinyathelo ongazithatha ukuze uthuthukise ubunzima bokukhulelwa ngokwakho (uma kungenzeka).

Futhi, funa ukusekelwa komphakathi ngemibango yakho yokuzala. Ukuxhuma nabanye abasebenzisana nokungabi nabantwana kungakusiza ubone ukuthi "awuphukile" nokuthi akukho lutho olungamahloni ngalo. Lokhu kushintshwa kwesimo sengqondo kungenza kube lula ukufuna usizo.

Yiba Ummeli Wakho

Sidinga ukuthi udokotela wethu uzosinika iseluleko esingcono kakhulu sezokwelapha, ngaphandle kokuzikhethela. Ngokudabukisayo, lokhu akuwona njalo iqiniso. Ukuqaphela ukuthi kungenzeka yini ukusizwa kungasiza. Kungenzeka ukuthi uyayibona, futhi wazi ukuthi omunye umhlinzeki wokunakekela anganikeza izinketho ezahlukene.

Isibonelo, imibhangqwana engenasibindi yatshelwa odokotela bayo ukuthi "abanakho okukhethwa kukho" ukuba babe nengane, kanti empeleni i-IVF yayiyindlela yokukhetha, kodwa udokotela wayephikisana nenkolo kule nqubo. Abesifazane baye batshelwe ukuthi "banamafutha kakhulu" ekunakekeleni ukwelashwa, lapho omunye udokotela eyokhipha ukwelashwa. Abanye baye batshelwe ukuthi babenakho ukwelapha ukwelashwa ngenxa yokuthi udokotela wayecabanga ukuthi abakwazi ukukhokhela ukwelashwa abakudingayo.

Uma ungenelisekile ngezimpendulo udokotela wakho anikeza, noma into engazizwa kahle, funa umbono wesibili.

Unomtholampilo owodwa wokuzala endaweni yakho? Abanye odokotela bazohlinzeka ngokubonisana ngefoni noma i-video conferencing. Kungase kungadingeki uhambe ukuze uthole ukuthi kufanelekile ukuthola usizo kwenye indawo.

Kuthiwani uma usola (noma wazi) ukuthi umtholampilo wendawo yokuzala wenqaba ukukuphatha ngenxa yesimo sakho somshado, ukuziphatha ngokobulili, noma ubunikazi obunikazi? I-American Society of Medicine Reproductive (ASRM) kanye ne-American College of Obstetrics ne-Gynecologists (i-ACOG) ikhuthaza amalungu awo ukuba aphathe zonke iziguli ngokulinganayo, kungakhathaliseki ukuthi isimo somshado, ukuziphatha ngokobulili, noma ubunikazi. Noma kunjalo, abakwazi ukuphoqelela lesi simo sengqondo kudokotela babo.

Kungase kudingeke uhambe kwelinye idolobha noma umbuso ngomtholampilo oyokunikeza ukwelashwa, kungakhathaliseki isimo sakho somshado, ukuziphatha ngokobulili, noma ubunikazi. Ngeshwa ufaka umthwalo owengeziwe wezezimali.

Enye indlela ukucabangela ukubonisana nommeli obaluleke kakhulu emndenini noma ngomthetho wokuzala. Umthetho cishe uhlangothini lwakho, kodwa hhayi ngempela. Amanye amazwe anemithetho evikela iziguli ze-LGBT ekubandlululweni kwezokwelapha, kanti ezinye zivumela odokotela ukuba benqabe ukwelashwa ngezizathu "zenkolo" noma "zokuziphatha".

Ungase ufune ukuxhumana ne-Lambda Legal, inhlangano engeyona inzuzo ekhuthaza amalungelo omphakathi we-LGBT. Banikeza "Idesksi Yosizo Lwezomthetho" nge-website yabo, kanye nolwazi ukukusiza ukwazi nokuqonda amalungelo akho.

Ukukhuthaza abanye: Thatha isenzo sokuthuthukisa ukufinyeleleka ekunakekelweni

Thatha ukukhungatheka kwakho bese ulisebenzisa ukusiza abanye. Imizamo yakho yokukhuthaza ingase ingenzi umehluko ngesikhathi sokwakha umndeni wakho, kodwa kungenza umehluko komunye umuntu esikhathini esizayo.

Ukuba ummeli wokuzala kungaba yinto evulekayo . Uma unesithakazelo sokubandakanyeka, xhumana ne- RESOLVE: I-National Infertility Association . Bangakwazi ukunikeza ulwazi ngendlela yokwenza umehluko ezingeni lendawo kanye nezwe.

Ukungahambi kahle yisifo, futhi ukutholakala kokwelashwa kokuzala kufanele kube ilungelo lomuntu. Ngokumemezela nokuqwashisa, ngethemba ukuthi sizofika esikhathini esiseduze lapho labo abadinga ukwelashwa kokuzala kungakuthola ukunakekelwa okukudingayo, kungakhathaliseki ukuthi bahlalaphi, bangakanani imali abayisebenzayo, noma ukuthi bayayibona kanjani.

> Imithombo:

> Ukufinyelela Ukwelashwa Kwesizalo AmaGays, Lesbians, nabangashadile: I-Opinion yeKomidi . UmNyango we-American for Medicine Reproductive.

IKomiti Yezokuziphatha ye-American Society for Medicine Reproductive. "Ukungalingani ekufinyeleleni ukwelashwa okuphumelelayo kokungabi nabantwana e-United States: Umbono weKomiti Yezokuziphatha. " Fertil Steril . 2015 Nov; 104 (5): 1104-10. doi: 10.1016 / j.fertnstert.2015.07.1139. I-Epub 2015 Sep 10.

> I-Ethics Webinar: Ukufinyelela ekunakekelweni kokungenzi lutho. UmNyango we-American for Medicine Reproductive.

> Ifoni Ingxoxo. UDawn Brubaker, MSW (ophethwe yi-DSW.) NgoLwesithathu, ngoMashi 22.