Ingabe kufanele uphishekele ukwelashwa kokuzala noma uqhubeke uzama ngokwakho?
Iyiphi indlela engcono kakhulu yokukhulelwa uma ubhekene nokungasebenzi okungaqondakali ? Ayikho impendulo eqondile.
Ngokuvamile, uma ungakwazi ukukhulelwa , isinyathelo sokuqala ukuhlolwa kokuzala . Khona-ke, uma kubangelwa isizathu (noma izimbangela), ukwelashwa okufanele kulandelwa.
Uma ungenayo i- ovulating , i- Clomid ingase ivivinywe. Uma izibalo zesilisa ziphansi , i- IUI noma IVF inganconywa .
Kodwa uthini uma udokotela wakho engazi ukuthi yini engalungile?
Ukungasebenzi okungahlongozwayo kuphathwa ngendlela efanele. Lokhu kusho ukuthi uhlelo lwezokwelapha lusekelwe ekuhlangenwe nakho komtholampilo nokunye okuqagelayo.
Imephu yezokwelapha ejwayelekile kunazo zonke yokungabonakali okungabonakali kubonakala kanje:
- Izinguquko zokuphila zinconywa (njengokunciphisa isisindo, ukuyeka ukubhema)
- Qhubeka uzame ngokwakho (uma usemncane futhi uzimisele) izinyanga eziyisithupha unyaka
- I-Clomid noma i- gonadotropini kanye ne- IUI imijikelezo emithathu kuya kweyisithupha
- Ukwelashwa kwe- IVF imijikelezo emithathu kuya kweyisithupha
- (Ngokuvamile) ukwelashwa kwe-IVF yangaphandle (njengokusebenzisa i-egg donor noma i-surrogate)
Ngezinye izikhathi, ezimweni zokungazalwa okungaziwa okuqhubekayo ngaphandle kwe-IVF eyisisekelo, kunezinkinga ezithile eziphikisanayo ezicatshangelwayo.
Ngezansi ukuhlolisisa ngayinye yalezi zindlela kanye nezinkinga zokuphumelela kokukhulelwa.
Ukuphila Kwezinguquko Ekuhlinzekeni Okungaqondakali Okungaqondakali
Ikakhulukazi lapho imbangela yokungabi namntwana ingaziwa, ukuthuthukisa impilo yakho yonke kubalulekile.
Izindlela zokuphila zokuphakanyiswa ezivame kakhulu ukuthuthukisa ukuzala kwakho ngokwemvelo yizi:
- Gwema isisindo ( uma ukwedlula ngokweqile ) nokuzivocavoca.
- Yeka ukubhema .
- Gwema ukusebenzisa ngokweqile utshwala.
- Yeka emuva iziphuzo ze-caffeinated .
- Ncishisa ukucindezeleka jikelele .
Ngalokhu konke okushiwo, akukho cwaningo olubonisa ukuthi ukwenza lezi zinguquko kungakusiza ukuba ukhulelwe.
Kubalulekile ukwazi.
Njengoba unikezwe indlela yokudubula ekutheni ukwelashwa okungaqondakali okungaqondakali, noma yikuphi ukuguqula indlela yokuphila wena nomlingani wakho okwenzayo ukuze uthuthukise impilo yakho yonke engcono ngeke ikwazi ukulimaza futhi ingasiza.
Ukuzama Ukuthola Ngaphandle Ukwelashwa Okuqondile Kokuzala
Cishe awufuni ukuzwa kudokotela wakho ukuthi isinyathelo sokuqala "ukuqhubeka uzama ngokwakho" izinyanga eziyisithupha.
Nokho, kwezinye izimo, kungase kube uhlelo oluhle.
(Kodwa kuphela emva kokuvivinya ukuqinisekisile ukuthi ukuhlolwa kwakho kungabonakali . Akusilo umqondo omuhle ukuqhubeka uzama ngokwakho ngaphambi kokuthi uhlolwe kokubili ngoba ezinye izimbangela zokungaboni ziba nzima nakakhulu.)
Ukuphathwa okulindelekile lapho udokotela wakho engabonisi ukwelashwa ngokushesha, kodwa uqhuba ukuhlolwa okuyisisekelo kokuzala futhi angase aqaphe isimo njengoba uzizama ngokwakho isikhathi esilinganiselwe.
Isivivinyo somtholampilo esingahleliwe senziwa ngokuqhathaniswa nokuphathwa okulindelekile (imibhangqwana enesibikezelo esihle) nge-IUI kanye nemithi yokuzala.
Ucwaningo lwenzeka esikhathini esingangezinyanga eziyisithupha.
Kulabo besifazane abathola izidakamizwa ze-IUI kanye nokuzala ...
- Amaphesenti angu-33 abesifazane abhekana nokukhulelwa
- Amaphesenti angu-23 okukhulelwa ekupheleni kokufunda
Kulabo besifazane abangazange bathole ukwelashwa, bahamba umzila wokuphatha okulindelekile ...
- Amaphesenti angu-32 akhulelwe eyedwa
- Amaphesenti angu-27 okukhulelwa ayeqhubeka ekupheleni kwesifundo
Imithi ye-IUI kanye nokuzala inzalo kulabo abanesibikezelo esihle asizange bathuthukise ukuhluleka kwabo kokukhulelwa. Imibhangqwana eyaqhubeka izama ngokwazo yayingase ikwazi ukukhulelwa njengalabo abathola ukwelashwa.
Izindleko zokwelapha ezinikeziwe , izingozi zomuthi wokuzala , kanye nengozi yokukhulelwa okuhlukahlukene , ukuzizama ngokwakho isikhathi esincane kungase kube yisinqumo esihle kakhulu.
Ukwakha kulolu cwaningo, esinye isifundo sibheke okwenzekayo lapho imibhangqwana ibelwa uhlelo lokwelapha olusekelwe ekuchazeni.
(Isibikezelo sabo senziwa ngokubheka iminyaka yabo nokuthi bazama kangakanani ukukhulelwa ngokwabo.)
Kulolu cwaningo, imibhangqwana yanikezwa enye yezindlela ezintathu: qala ngokuphathwa okulindelekile, qala nge-IUI ngemithi yokuzala, noma uhambe ngokuqondile emitholampilo ye-IVF.
Amaphesenti angaphezu kwamaphesenti angama-90 emibhangqwana abelwe umsebenzi wokulinda-iqembu lokuqala.
Ngokuphela kwesifundo, amaphesenti angu-81.5 emibhangqwana aphumelele ukukhulelwa.
Kulabo abakhulelwe, amaphesenti angu-73,9 abelethwe ngaphandle kokwelashwa kokuzala.
Lokho kuyizinto ezinzima kakhulu, ikakhulukazi uma ucabanga amazinga okuphumelela ekungabhubhi ngokujwayelekile.
(Uma ubheka zonke izimbangela zokuhlukunyezwa kanye namacala, amanani okubeletha aphilayo emva kokuphathwa angaphansi kwamaphesenti angama-50.)
Uqhubeka uzama ukukhetha okulungile kuwe?
Ngokuvamile, xoxani nodokotela wakho ngokukhetha kwakho. Zombili lezi zifundo ezingenhla zihlanganisa kuphela imibhangqwana enesibikezelo esihle. Babebehlangothini oluncane futhi bebengakalingi iminyaka.
Ngokuvamile, ukulindela okulindelwe izinyanga eziyisithupha ngonyaka kuyindlela enhle kuphela uma ...
- Ukwenziwa komsebenzi wokubeletha kwenziwa, kokubili ukuzala okunomama nabesifazane kuhlolwe. (Ukuxilongwa kufanele kube "okungacacisiwe.")
- Ukuhlolwa kwe-Ovarian reserve ( FSH , AMH, nokubala kwe-antral follicle ) kubonakala kuhle.
- Uzame iminyaka engaphansi kweyodwa kuya kwemibili uwedwa.
- Uneminyaka engama-35 noma encane.
Ingabe I-Clomid Yodwa Yisinqumo Esihle Sokungaqondile Okungaqondakali?
I-Clomid iyisidakamizwa esivamile kakhulu sokuzala, futhi ingasiza abesifazane abangenayo i-ovulating. (Kungase futhi kukhulise ukukhiqizwa kwesilisa ngenxa yezimbangela zokungabi namuntu.)
Udokotela wokuqala uzobona uma uzama ukwelapha ukungakwazi kwakho ukubeletha kungumgogodla wakho wezifo. Kungenzeka ukuthi bayakubeka i-Clomid, noma ngabe une-infertility engaqondakali, futhi ikuthumele endleleni yakho.
Lokhu kungase kube ukuchitha isikhathi futhi kukuveze engozini nemiphumela emibi ngaphandle kwenzuzo.
Ukuhlolwa okungahleliwe kokulawula eScotland kwakuhlanganisa nabesifazane abangu-580 abanezinkinga ezingabonakali.
Laba besifazane babehlelwe ngamanye amaqembu amathathu kwaphela izinyanga eziyisithupha zokwelashwa:
- Ukuphathwa okulindelekile
- Ukwelashwa kwe-Clomid
- IUI yedwa (ayikho imithi yokuzala)
Isilinganiso sokuzalwa esibukhoma eqenjini ngalinye kwaba:
- Amaphesenti angu-17 ngokuphathwa okulindelekile
- Amaphesenti angu-13 ku-Clomid
- Amaphesenti angu-22 we-IUI yokwelapha
Kuyathakazelisa ukuqaphela ukuthi amazinga okuzalwa aphilayo aphansi kancane kunokuphathwa okulindelekile, futhi lokhu kunengqondo. Imiphumela emibi ye-Clomid empeleni inciphise izici ezithile zokuzala kwakho.
Ukuhlaziywa kwe-meta yezinkinga eziningana zokulawula okungahleliwe kwe-Clomid ye-infertility engachaziwe ibhekwe imiphumela yezifundo eziyisikhombisa ezahlukene. Ukuqhathaniswa kwemibhangqwana engu-1,159 kufakwe kulolu cwaningo.
Lolu cwaningo luphinde lwathola ukuthi abukho ubufakazi bokuthi i-Clomid yedwa yindlela yokwelapha ephumelelayo yokungasebenzi okungaqondakali.
Ukwelashwa kwe-Clomid akuyona ingozi. Ukwelashwa kuphakanyiswa kuphela kumjikelezo ayisithupha, ngenxa yengozi engase ibe yingozi yomdlavuza .
Uma udokotela wakho ephakamisa u-Clomid wodwa, cocinga ukuthi kungaba ngcono yini ukuqhubeka uzama ngokwakho okwesikhashana, noma uxoxe ukuthi ngabe bazocabangela ukuhamba ngqo ku-IUI ne-Clomid.
(Lokhu kungahle kudinga ukuthuthela emitholampilo yokuzala kanye ne- endocrinologist yokubeletha . Abambalwa bezinkinga zokubeletha banokuthula noma bahlangenwe nakho ekuphatheni ukwelashwa kwe-IUI.)
IUI kanye nezidakamizwa zezokwelapha ngenxa yokungenzi lutho okungaqondakali
Kulabo abangenalwazi olungabonakali, i-IUI yodwa noma imithi yokwelapha iye yaboniswa ukuthi ukwandisa kancane izimo zakho zokukhulelwa.
Ubufakazi abuqine kakhulu. Kodwa-ke, ngenxa yezindleko eziphakeme kakhulu nokungahambi kahle kwe-IVF, i-IUI nemithi yokuzala kufanelekile.
Ngenxa yokungasebenzi okungaqondakali, i-Clomid ne-IUI ibonakala iyisinqumo esikhethwe ngaphezu kwe-IUI nge-gonadotropins.
Esifundweni sokulawula okungahleliwe, imibhangqwana yayingakaze ibe yimijikelezo emithathu ye-IUI ne-Clomid, noma i-IUI ene-gonadotropins, noma i- IVF.
Izinga lokukhulelwa lalingu:
- 7.6 amaphesenti umjikelezo ngamunye weClomid ne-IUI
- Amaphesenti angu-9,8 ngomjikelezo we-gonadotropins ne-IUI
- Amaphesenti angu-30.7 ngomjikelezo we-IVF
Ama-gonadotropini ayabiza futhi angase akwazi ukuholela e-ovarian hyperstimulation syndrome (OHSS) nokukhulelwa okuningi . Kodwa angeke athuthukise izinga lokukhulelwa ngokwanele ukuze kulungiswe lezo zingozi.
Zingaki imijikelezo ye-IUI okufanele uzame? Lokhu kuncike eminyakeni yakho kanye nesithakazelo sakho ekuphishekeleni ukwelashwa kwe-IVF uma IUI kufanele ihluleke.
Kulabo abavulelekile ku-IVF, imijikelezo emithathu ye-IUI ne-Clomid cishe inhle ngokwanele ngaphambi kokunyuka kwi-IVF.
Ngokwesifundo esifanayo okukhulunywe ngenhla, imibhangqwana eyazama i-IUI nge-gonadotropin ngaphambi kokuba idlulele kwi-IVF yathatha isikhathi eside ukuze ikhulelwe futhi ichithe imali engaphezulu kokwelapha jikelele.
Kulabo abangafuni noma abakwazi ukuphishekela ukwelashwa kwe-IVF, ucwaningo lukhombisa ukuthi i-IUI nemithi yokuzala kufanelekile ukuzama imijikelezo eyisishiyagalolunye.
Izindlela Ezinhle Zakho Zokuphumelela Nge-IVF
Uma kuziwa ekuphatheni ukungasebenzi okungaqondakali, IVF inezinkinga ezingcono kakhulu zokukhulelwa.
Izinga lokukhulelwa kwe-IVF yokwelashwa ziphindwe kathathu ukuthi ziyini i-IUI ne-Clomid. (Lokhu kuzohluka ngobudala, noma kunjalo.)
Njengoba kushiwo ngenhla, izinga lokukhulelwa kwe-Clomid ne-IUI lingamaphesenti angu-7.6. Isilinganiso sokukhulelwa ngomjikelezo ngamunye we-IVF singama-30.7%.
Akukhona nje ukuthi amazinga okuphumelela aphezulu ku-IVF, imbangela ye-"engaqondakali" yokungabi nalutho ngezinye izikhathi kutholakala ngesikhathi sokwelashwa.
Kuphela ngesikhathi se-IVF singaqanda izinga leqanda, inqubo yokukhulelwa, nokuthuthukiswa kombungu kubonakala ngokucophelela.
Konke okwakushoyo, i-IVF iyinhlekelele futhi iyabiza .
Ungase ucabange ukuya ngqo ku-IVF yisona esingcono kunazo zonke (kunikezwe amazinga aphezulu okuphumelela). Empeleni kungcono ukuthi iningi lamabhangqwana linike i-IUI ne-Clomid uzame kuqala.
Izinkampani eziningi zomshuwalense (ezinikezela noma yiluphi uhlobo lwe-IVF coverage) zidinga ukwelashwa okungabizi okumele uzame kuqala.
Kodwa-ke, ukuqhubeka ngqo ku-IVF nokweqa i-IUI kungaba yinto engcono kakhulu uma uneminyaka engu-38 noma ngaphezulu.
Lokhu kuyinto yokuxoxa nodokotela wakho.
Ngaphandle kwe-IVF ye-Infertility engaqondakali
Kuthiwani uma i-IVF yodwa inganele? Noma kuthiwani uma i-IVF yendabuko ihluleka?
Kungase kube nezinye izinketho.
Ukwelashwa kwe-immunological : Kukhona inkolelo yokuthi amangqamuzana ebulalayo angadlala indima ekungabonakali okungaqondakali, ukwehluleka okuphindaphindiwe kwe-IVF, noma ukukhulelwa kwesisu okuphindaphindiwe.
Naphezu kwegama labo, "amangqamuzana ebulalayo wemvelo" awabi. Uyabathanda. Awufuni nje ukuthi basebenze ngokweqile noma baningi kakhulu kubo.
Ukwehliswa okungahambi kahle ngezinto ezibizwa ngokuthi i-intralipids phakathi nokwelapha kwe-IVF kunganciphisa umthelela wamangqamuzana abulala ngokwemvelo.
Kodwa-ke, okwamanje akakho ubufakazi obuqinile lokwelapha okungathuthukisa ama-IVF aphilayo amazinga okuzalwa.
Ukususwa kwe-deposometer deposits : Abanye bakholelwa ukuthi ukungakwazi ukuzala okungabonakali kungabangelwa ukuphela kwe- endometriosis .
Kulokhu, i-endometrial deposits kungenzeka ingabangeli ubuhlungu noma iphazamise ngokuqondile ukuvuthwa noma ama-tubespian tubes, kodwa ukuba khona kwabo kungandisa "ukucasuka" kwendlela yokuzala.
Lokhu kungase kube imbangela yokuhluleka okuphindaphindiwe kwe-IVF, ngokusho kwale ncazelo.
Abanye odokotela bazophakamisa ukuhlinzeka kwe-laparoscopic ukuxilongwa nokususa i- endometriosis engakafiki ngaphambi kwe-IVF. Abanye bayiphakamisa kuphela ngemuva kokuhluleka okuphindaphindiwe kwe-IVF.
Kungakhathaliseki ukuthi ukwelashwa kungakuthuthukisa amazinga okuzalwa okuphilayo akucaci.
Iminikelo yeGamete : Uma kutholakala izinkinga zeqanda, i-sperm, noma i-embryo ngesikhathi se-IVF, udokotela wakho angancoma ukusebenzisa i-gamete noma umlenze womnikelo womjikelezo we-IVF wakho olandelayo.
I-egg donation iyona ndlela ebiza kakhulu, elandelwa umnikelo wombungu, bese umnikelo wesilisa.
Amanani abaphumelelayo ngama-egg donors ngokuvamile aphakeme, okuyizindaba ezinhle.
Izinga lomnikelo womama lizohlukahluka ngokuya emthonjeni we-embryo. Isibonelo, iminikelo eminingi ye-embryo ivela emibungu eyengeziwe eyenzelwe omunye ukwelashwa kwe-couple IVF.
Ukuziqhenya : Uma ukwelashwa kwe-IVF kwehluleka ngokuphindaphindiwe kokudluliselwa kombungu, ukuzondla kungaba yisinyathelo esilandelayo.
Ukuzihlola kuyabiza kakhulu futhi akusikho (kalula) etholakala ngokomthetho kuzo zonke izindawo. Kulabo abangakwazi ukukhokhela kanye nokufinyelela izinsizakalo ze-surrogacy, kungaba yindlela yabo yokubeletha.
> Imithombo:
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