Ukuhlolwa kwe-Ovarian reserve yingxenye eyisisekelo yokuhlolwa kokuzala futhi isinyathelo esibalulekile ngaphambi kokwelashwa kwe-IVF . Okunye ukuhlolwa kwe-ovarian reserve kulula ukukwenza futhi kungase kwenzeke ekuhloleni kwakho kokuzala nokuphuza. Ezinye izivivinyo ziyinkimbinkimbi noma engavamile, futhi angeke zenziwe kuze kube yilapho usemtholampilo wokuzala futhi ucabangela ukwelashwa kwe-IVF.
Sisho ukuthini ngama-ovarian reserves?
Kwenzekani uma imiphumela yakho ingabonakali kahle, noma uma imiphumela yakho ihle kakhulu ? Futhi konke lokhu kudlala kanjani ewashi lakho lezinto eziphilayo?
Kuyini Okubalulekile Ngezindawo Zakho Zama-Ovarian
Uma odokotela bekhuluma ngezinqolobane zakho zama-ovari, bakhuluma ngobuningi bamaqanda kuma-ovarie akho.
Uma sithi ubukhulu, kulokhu, asikhulumi ngokubalwa okuqondile. Okwamanje ayikho indlela yokwazi kahle ukuthi zingaki amaqanda angahle angama-ovarie wesifazane.
Ngokukodwa, ukuba nezindawo zokugcina ama-ovarian abampofu kusho ukuthi amathuba okuthola imithi ye-IVF aphansi. Izakhiwo ezimbi kakhulu ze-ovarian zandisa amathuba okukhansela kwe-IVF. Yilapho ukwelashwa kumiswa phakathi komjikelezo ngoba izidakamizwa zokuzala zahluleka ukukhuthaza ama-ovari ukuba akhiqize amaqanda anele.
Ingane yentombazane izalwa nayo yonke amaqanda ayoke abe nayo. Njengoba intombazane ikhula, inani lamaqanda emaqanda ayo ayancipha. Ikhwalithi lamaqanda nayo iyancipha, okuholela engozini enkulu yokukhulelwa kwesisu nokukhubazeka kokuzalwa kwabesifazane 35 nangaphezulu .
Kodwa njengoba kungenzeka ukuthi wazi ngokuhlangenwe nakho, iminyaka ayiyona kuphela into ebuningi nobuningi bamaqanda esibelethweni.
Kungenzeka ukuthi owesifazane osemusha abe nenani elingavamile lamaqanda emaqanda akhe. Kungenzeka futhi ukuthi owesifazane oseminyakeni engama-40 engezansi abe nenani eliphezulu elingenhla lamaqanda emaqanda akhe uma kuqhathaniswa nabanye besifazane ubudala bakhe.
Yilapho ukuhlolwa kwe-ovarian yokuhlola kufike khona.
Ukuhlolwa kwe-Ovarian reserve kungasiza udokotela wakho ukuba anqume ukuthi kungenzeka yini ukuthi uphendule kabi noma okungcono kunalindelekile, ngokuphathelene nabanye besifazane oneminyaka yakho.
Ukuhlolwa kwe-Ovarian ukugcinwa ngezizathu ezimbili eziyinhloko: ukuxilongwa kwesizathu sokungabikho nokuqonda ukuthi ama-ovari akho angaphendula kanjani ekwelapheni kokuzala.
Ukuhlolwa kwe-Ovarian Reserve njengethuluzi lokuxilonga
Emva kokukhuluma nodokotela wakho mayelana nokukhathazeka kwakho kokuzala, isazi sakho sezinkinga zegazi singase senze umsebenzi othile wegazi oluyisisekelo, ukuhlola amazinga akho e-hormone.
Ezinye zehomoni ezivivinywa zizokwenza udokotela wakho aqonde ukuthi kungenzeka yini ama-ovarian reserves.
Enye ye-hormone yokuqala evivinywa yizinsuku zakho ezingu-3 ze-FSH . Amazinga aphezulu angavamile we-FSH angabonakalisa izimpofu ezimbi ezikhungethwe ama-ovarian.
Amazinga e-FSH angase abe phezulu ngoba usukhulile, ngakho-ke izinga eliphezulu le-FSH lingabhekwa njengengxenye evamile yokuguga nokunciphisa ukuzala. Lezi zindaba ezimbi uma uzama ukukhulelwa, kodwa akusikho ngempela uphawu lokuthi kukhona "okungalungile" nawe.
Kodwa-ke, ngezinye izikhathi, abesifazane abasebasha bangaba namazinga aphezulu e-FSH.
Abesifazane abasebasha abatholakala ukuthi banezindawo zokugcina ama-ovarian abampofu bangatholakala ukuthi bane-Primary Ovarian Insufficiency noma i-POI.
I-POI futhi ngezinye izikhathi ibizwa ngokuthi ukuhluleka kwe-Ovarian yangaphambi kwesikhathi (POF).
Amazinga e-FSH yindlela eyodwa yokuhlola ama-ovarian reserves. Ungaba namazinga ajwayelekile we-FSH, kodwa ezinye izivivinyo zokugcina ama-ovari zingathola ukuthi izindawo zakho zokugcina ama-ovari zingaphansi kokuhle.
Khumbula ukuthi izindawo zokugcina ama-ovari ziyingxenye eyodwa kuphela yokuhlolwa kokuzala. Ungaba nezinqolobane ezinhle kakhulu ze-ovarian, kodwa usenenkinga nge-ovulation noma izinga leqanda. Kukhona futhi izibilini zesifo sofuba nezibeletho okufanele zicatshangelwe, i- endometriosis , nokungabi namuntu okungezona .
Khona-ke, kukhona nokuxilongwa okuphazamisayo kokungabonakali okungaqondakali.
Ukuphumelela Ukwelashwa Kwesizalo Ukuphumelela nokuhlolwa kwe-Ovarian Reserve
Ungase uzibuze ukuthi kungani ungeke nje uqhubeke nokuphathwa kokwelapha futhi weqa ukuhlolwa kwe-ovarian reserve.
Inkinga yukuthi ukwelashwa okuyisisekelo kokuzala kanye ne-IVF eyisisekelo ngeke inqobe izimpofu eziphansi zama-ovarian.
Ukungaqondi kahle kakhulu ukuthi i-IVF ingakwazi ukuxazulula cishe nganoma iyiphi inkinga yokuzala. Lokhu akulona iqiniso.
Uma izindawo zakho zokugcina ama-ovari ziphansi, izidakamizwa zokuzala ezihloselwe ukugqugquzela ama-ovari akho angasebenzi. Uma imithi ingashukumisi amaqanda okwanele ukuba athole, umjikelezo wakho ungase ukhanseke ngaphambi kokuba ufike ngisho nasekukhuliseni kanye nokudluliswa kombungu.
Lokhu akubanga nje kuphela lokhu kungabangela usizi olukhulu, kodwa futhi luwumthwalo wezezimali. Noma yikuphi imali oyisebenzisile emjikelezweni we-IVF kuze kube yilapho uzolahleka.
Lesi yisisekelo esiyinhloko sokuhlolwa kwe-ovarian reserve. Ngakho odokotela bangakwazi ukuhlola iziguli ezingase zibe nomjikelezo we-IVF.
Lokhu akusho ukuthi owesifazane onamafu omzimba ompofu akakwazi ukuthola ukwelashwa kokuzala, noma kunjalo. I-IVF ene-egg donor noma umnikeli wombungu kuyindlela ongayicela ngayo udokotela wakho.
Futhi, ungakhetha ukuqhubeka ne-IVF ngisho noma uthola ukuthi unezinqolobane eziphansi zama-ovarian. Udokotela wakho kumele akutshele ukuthi izinkinga zakho zokuphumelela ziphansi kakhulu, kodwa lokho akusho ukuthi awukwazi ukuzama IVF ngamaqanda akho uma umtholampilo uzimisele ukukuphatha.
Yazi nje ukuthi uthatha ingozi yezezimali nangokomzwelo ngokuya phambili.
Kuthiwani uma ukuhlolwa kwakho kwe-ovarian ukubuyela emuva kubuya okungaphezu kokuhle kakhulu? Ngamanye amazwi, kuthiwani uma uhlangothini oluhlukile lwe-spectrum?
Yebo, kungenzeka ukuthi ukuhlolwa kwe-ovarian reserve ukuthola ukuthi ama-ovari akho cishe angaphendula ngemithi yokuzala.
Lokhu akuyona izindaba ezimbi, kodwa akuzona izindaba ezinhle noma. Kusho ukuthi ingozi yakho yezinkinga ezifana ne- ovarian hyperstimulation syndrome (OHSS) iphakeme. Abesifazane abane-PCOS bavame ukubhekana nale nkinga.
Udokotela wakho angase anikeze umuthi ophansi wezokwelapha kulokhu, noma ukhethe i-protocol ehlukile yokwelapha kwe-IVF, okuzokwenza ukuthi ingozi yakho ibe yinkinga.
Yikuphi ukuhlolwa okungenakukutshela
Ukuhlolwa kwe-Ovarian reserve akukwazi ukukutshela okuningi ngekhwalithi yamaqanda.
Owesifazane otholwe ukuthi unezinqolobane ezimpofu ze-ovarian cishe kunamaqanda aphansi aphezulu. Kodwa owesifazane onamaqabunga ama-ovarian amahle angase abe namaqanda asemqoka atholakele.
Ngamanye amazwi, kungenzeka ukuthola inombolo enhle yamaqanda ngesikhathi se-IVF, kodwa-ke ubeke amaqanda ambalwa kunoma ubani. Noma owesifazane angase abe nomngcipheko omkhulu wokukhulelwa kwesisu, ngenxa yeqanda elibi kakhulu noma ikhwalithi le-embryo, noma ngenxa yezifo ezingenasifo sokubeletha.
Ikusasa lingasilethela ukuhlolwa okuzosiza ukunquma ikhwalithi noma ikhwalithi ye-embryo, kodwa akukho okuqinisekisiwe nokwethenjelwa okwamanje.
Kungenzeka futhi ukuba nemiphumela emihle ekuvivinyweni kwe-ovarian reserve, kodwa kusenombuzo omncane ongaqondanga kahle wemithi yokuzala futhi iphethe umjikelezo we-IVF okhanseliwe.
Impumelelo ye-IVF ingaphezu kokuthola amaqanda ananele okuthola. Impumelelo yangempela ye-IVF kusho ukukhulelwa futhi njengoba sishilo ngenhla, ubungakanani beqanda yingxenye eyodwa kuphela yesithombe esikhulu, esiyinkimbinkimbi. Ikhwalithi le- egg, izilimo ze-tubal nezizalo, kanye nokuzala komuntu kudlalela ekuphumeleleni kokwelashwa kokuzala.
Imikhuba emibi yempilo ingabamba iqhaza ekukhwaleni kweqanda nekhwalithi empofu, engathinta ingxabano yakho ye-IVF yokuphumelela.
Ama-Ovarian Reserves nobudala bakho
Ubudala budlala isici ekwelapheni kwe-IVF nokuphumelela kokukhulelwa. Ngeke ubuke iminyaka yobudala kuphela noma imiphumela kuphela yokuhlolwa kwe-ovarian reserves. Ulwazi kumele lucatshangelwe ndawonye.
Isibonelo, noma ngabe owesifazane oneminyaka engama-40 anemiphumela emihle ekuhlolweni kwe-ovarian reserve, izinkinga zakhe zokuphumelela kwe-IVF ziphansi kunomuntu oneminyaka engu-25 ubudala kanye nemiphumela efanayo.
Ungamnaki umlingani wakho womlingani wesilisa, noma. Ukuzala kwakhe futhi kunciphisa ngobudala, ngisho noma kungenjalo ngendlela ephawulekayo njengokwenza kowesifazane.
Imithombo:
Badawy A1, Wageah A, El Gharib M, Osman EE. "Ukuqagela nokuxilongwa kwempendulo empofu ye-ovarian: le nkinga." J Reprod Infertil. 2011 Oct; 12 (4): 241-8.
Broekmans FJ1, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. "Ukubuyekezwa okuhlelekile kokuhlolwa okubikezela isiphephelo se-ovarian kanye ne-IVF." Ukuvuselelwa kwe-Hum Reprod. 2006-Nov-Dec; 12 (6): 685-718. Epub 2006 Aug 4.
URamalho de Carvalho B1, Gomes Sobrinho DB, Vieira AD, MP MP, Barbosa AC, Silva AA, Nakagava HM. "Ukuhlolwa kwe-Ovarian reserve yokuphenywa kokungasebenzi." I-ISRN I-Obstet Gynecol. 2012; 2012: 576385. i-doi: 10.5402 / 2012/576385. Epub 2012 Jan 26.