Kufuneka uqale ngokuvavanya indlela eninzi ngayo amathuba okukhulelwa. Baqala ukuhla ukuqala ukusuka kwiminyaka engama-37 ubudala. Emva kweminyaka engama-40 kuphela ubudala, kuphela i-4-5% yemigudu yokuqhelisa ibangela ukukhulelwa. Oku kubangelwa ukuba emva kwexesha inani, kwaye kubaluleke kakhulu - umgangatho wamaqanda wehla.
Nangona kunjalo, oogqirha bayaqiniseka ukuba kuyafaneleka ukuzama. Kukho imeko xa amabhinqa aneminyaka engama-60 eba ngumama wabantwana kwi-tube test. Ukubikezelwa kwangaphambili, zingaphi iifowuni eziza kufuneka, akukho bani uya kunika. Nangona kunjalo, uqeqesho lubonisa ukuba kuma-80% wabasetyhini, ukukhulelwa kuqale ngokuqala ngesibini okanye kwisithathu kwindlela yokwelashwa kwabantwana abangenasiphelo. Nguye kuphela ugqirha onokukwazi ukuchonga ngokuchanekileyo ukuba le nkqubo iphakanyisiwe.
INQUBO YOKUQALA
Okokuqala, ugqirha uya kufuna iimvavanyo eziqhelekileyo: i-ECG, igazi kwi-RW, i-HIV, i-hepatitis B ne-C, i-swabs kwi-flora kunye ne-oncocytology, izityalo (okanye ezinye iimvavanyo) ngezifo ezithathelwana ngocansi, iimvavanyo ezininzi zegazi ngama-hormone, Umhla womjikelezo (i-estradiol, iprolactin, i-FSH, i-LH, i-TTG - ezi ziimfuneko zamaparitha). Kwakhona kuyimfuneko ukungenisa uhlalutyo lwamachiza e-rubella, ubukho bezityalo ezisuka kwintambo yomlomo wesibeleko kunye ne-bacal sperm. Zonke ezi zifundo zifunekayo ukucacisa umgangatho wokulungela umzimba wakho kwenkqubo, kwakunye nokuphepha iingxaki ezinokwenzeka.
Kwinqaku: ukuhlaziywa kwe-IVF kunokuhanjiswa kwangaphambili kwintlanganiso yabesifazane besithili (ngaphandle kwentlawulo), kwiziko lezonyango okanye kwi-laboratory yangasese. Into ephambili xa inkqubo ye-IVF iqalisiwe, kuyimfuneko ukugcina ingcali eyodwa eya kukukhokela kwaye iphendule ngenxa yesiphumo.
UKUKHETHA INDLELA
Emva kwakho kunye nogqirha wakho uqinisekisa ukuba akukho zichaso malunga nezizathu zempilo, unokuxoxa ngeziphi iindlela zokuphatha unyango olungileyo. Akukho zikhetho ezininzi, kwaye ukhetho lwabo kufuneka lusetyenziswe, ngokusekelwe kwimimiselo ethile.
Ukukhuthazwa kwe-ovulation ukuba ngaba isibini sinako ukukhulelwa ngokuzimeleyo, kodwa ngenxa yezizathu ezimbalwa umsebenzi we-ovari ungasebenzi. Kwiimeko ezinjalo, khuthaza ama-ovari, ukubala okusemgangathweni wokukhulelwa komhla, kwaye ke yonke into eyenzeka ngokwemvelo - njengoko ilawulwe yendalo.
Ukutshatyalaliswa kwempahla kunye nesidoda somyeni kunye nomnini wesilwanyana kuyimeko xa i-spermatozoa yindoda "ibeka isohlwayo" yokungabikho. Isisombululo esilungiselelwe ngokukhethekileyo se-spermatozoa sijoyiwe kwisibeletho, sasihlolwe ngeprogramm.
Enyanisweni, i-IVF inceda kwiimeko xa kukho ukuvinjelwa kwamathambo okulala, ukungabikho kwabo ngokupheleleyo okanye umonakalo, kunye ne-endometriosis, engachazwanga ngoogqirha abangenasifo okanye emva kokuzama ukuphumelela ekugqibeleni. Kwakhona le ndlela iboniswa kwimeko yokungabikho komntwana kwaye ukuba umfazi unesilinganiselo esiphakamileyo se-antibodies ukuya kwidoda. Xa i-spermatozoa ingenayo imisebenzi eyaneleyo, i-ICSI iya kunceda-ukufakwa kwesidoda kwi-cytoplasm yeqanda ngoncedo lwabantu abakhethekileyo be-micromanipulators.
Kwinqaku. Ngokuchasene nenkolelo eninzi, i-ICSI ayilona ndlela eyahlukileyo, kodwa kuphela isigaba esongezelelweyo sokunyanga ukungabikho komntwana nge-IVF, kwaye akunakufuneka ihlale ifuneka.
Ngoko, ugqirha wakhuthaza ii-IVF. Inkqubo ingaqaliswa ngokukhawuleza emva kokubhalwa kwemviwo, ngomhla we-2-3 womjikelo (kunye nexesha leentsuku ezingama-28). Ukususela kwangoku, uya kufumana unyango lwe-hormonal ukukhusela i-pituitary gland. I-ultrasound - ukhetho lweyeza - ukulungiswa kwenzululwazi ye-ultrasound. Kule ndlela, iintsuku eziyi-14 ziya kudlula.
Kwinqaku. Ngokuchasene neenkolelo eziqhelekileyo, unyango olunjalo lwe-hormone aluyingozi kwimpilo. Ngaphezu koko, namhlanje amapilisi athatyathwa ngamagciwane kwaye akukho monakalo kubo ngaphandle kweziyobisi ezisetyenzisiweyo, umzekelo, kwonyango lomkhuhlane.
Emva ezimbini kweeveki, izidakamizwa zisetyenziselwa ukuvuselela ukuvuthwa kwee-follicles. Kubalulekile ukwenza ii-ovari zivelise ama-5 ukuya kuma-10 ngaphezu kwesiqhelo. Kwiintsuku eziyi-10-12, iiyure ezingama-48-72 ugqirha uya kubeka iliso kwinkqubo nge-ultrasound kunye nokuhlolwa kwegazi. Ngelo thuba kuya kubakho ukuqinisekisa ukuthotyelwa kokutya kwiprotheni, ukusela ngaphezu kweeli-2 ilitha zamanzi ngosuku kwaye, ngokuqinisekileyo, awukwazi ukusela utywala kunye nomsi.
Eli nqanaba lonyango lokungabikho kwengqondo luyingozi kuba i-3% yamatyala e-hyperstimulation syndrome angakhula-ukwandisa ngokweqile kwi-ovari. Ngethamsanqa, iirimenjethi zonyango zanamhlanje kunye nokubeka iliso kwinqanaba lama-hormone egazini kunciphisa umngcipheko weengxaki ezinjalo. Kwinqaku. Xa ukuvuselela kungenzi nantoni na, ngaphandle kokuba intlungu e-ovari iyakwenzeka-kuba ngoku isebenza ngokugqithiseleyo kunokuba iqhelekileyo.
Amaqanda athatyathwa akhula kwaye afunyanwa, i-spermatozoa yazinikezelwa. Icala elincinci: iiyure ezingama-4 ukuya kubamba amaqanda kwi-incubator ekhethekileyo kwiitya ezizaliswe ngumgangatho wezondlo, emva kokuxutywa ngokukhethekileyo inxalenye yesidoda kubo. Uqhagamshelwano luhlala malunga neeyure ezingama-20. Ekupheleni kweli xesha, sele kusenokwenzeka ukuthetha ukuba ukuchumisa kwenzeka okanye akunjalo. Uya kwaziswa ngefowuni xa kufuneka uvele kwinkqubo yokugqibela
Kwinqaku. Ukuba inzala yomyeni onobungakanani obubi, kukho umngcipheko wokuba ukhulelwe aluyi kwenzeka. Kule meko, gcina nje i-ICSI, xa iqanda ngalinye lihlanganiswe ne-spermatozoa ekhethiweyo. Inkqubo ayibuhlungu kwaye iyakhawuleza. Ngoxa uncedwa ngumkhotha ongciniweyo, "abaviwa" bangeniswa kwisibeletho. Iyure kufuneka ilele kwiklinikhi - kwaye unako ukuya ekhaya. Nokuba konke kuhamba kakuhle, kuya kwaziwa emva kweveki ezimbini.
Kuya kuba namawele, ama-triple okanye umntwana omnye, akunakwenzeka ukuqikelela. Ngokwezibalo, omnye umntwana uzalwa kuphela kwisiqingatha seemeko. Phantse nganye yesithathu isigulane se-IVF sizimisele ukuba ngumama wamamawele, esinye sesithandathu sizalela ezintathu.
Kwinqaku. Ungazami ukubona ukukhulelwa ngawe phambi kweentsuku ezili-14 usebenzisa iimvavanyo: ngenxa yonyango lwe-hormone, nayiphi impendulo iya kuchaneka kuphela ngo-30%.
UKUPHILA KWE-LONG-AWAY FINAL
Umjikelezo wonke we-IVF uthatha inyanga. Ngelishwa, emva kwexesha elide elindelwe "yee", abaninzi banokuphumla: kubonakala ngathi yonke into ixhomekeke kwimvelo. Kodwa kwiimeko ezininzi, ngaphandle kwenkxaso yokongezwa kwemithi kwinyanga yokuqala, ukunamathela kokutya kunye neerimim ehambelana nodokotela, akulula ukugcina umntwana ozayo. Ngokuqinisekileyo yonke into ye-ECO ikulungele ukuyeka i-cigarettes, ikhofi, utywala, iilekese ngobuninzi. Kodwa kufuneka uphuze amanzi amaninzi (ngaphezu kwama-2 ilitha ngosuku) kunye nokuya kumgqirha oqeqeshwe.
IMIBUZO EYA KUYISEBENZA KONKE
1. Zingaphi iinzame? Ngaba kunobungozi ukuphumeza amaxesha amaninzi?
Emva kokutshintshwa kweembungu, ama-35-40% kuphela kwabasetyhini abakhulelwe. Kungcono ukulungele ukuthatha imizamo engama-3-4 okanye ngaphezulu. Ukudla ixesha elide kweemodemoni akuyingozi - namhlanje usebenzisa izidakamizwa zezizukulwana zakutsha kwaye ziqwalasele zonke iimpawu zendalo yomama.
2. Akufanele uhlambuluke ukuba umbungu awuqhelekanga?
I-IVF engaphumelelanga ayichaphazeli umzimba nganoma yiphi indlela: akukho mfuneko yokulinda ukukhulelwa kwesisu okanye iingxaki ezisongela ukucoca. Kodwa akukho mfuneko ukuba uqale umnxeba wesibini ngexesha elilodwa - ukuphuka kufuneka kube ubuncinane kwiinyanga eziyi-3-4.
3. Angilungele ukuzala amawele, makungabikho ama-triplets. Kwimeko yokunyanga ukungabikho kokunyanga kwabasebenzi nge-IVF, le nto inokwenzeka. Yintoni endiyenzayo?
Iimbumba ezininzi zitsalwa, iphakamileyo amathuba okukhulelwa. Kodwa umngcipheko wokuba ngumama omkhulu uphakamileyo. Ngako oko, ngokuqhelekileyo kuphela ama-embrosi 2-3 atyalwe, amanye aphelile. Ukuba kuyimfuneko, kunokwenzeka ukunciphisa - enye okanye ngaphezulu "iimbusi ezingenasidingo". Le ndlela inokuphikisana nendawo yokujonga, nangona kunjalo, iteknoloji ikhona, kwaye inokuthi ibhekiswe kuyo xa kuyimfuneko.
4. Inkulu kangakanani umngcipheko wokuba umntwana uza kuzaliswa ngengxaki yokuzalwa komntwana?
I-ECO-abantwana abafaniyo nomntwana ngendlela engokwemvelo. Baye banenzuzo: iteknoloji yanamuhla yenza ukuba kunokwenzeka ukukhusela ukuphuhliswa kwezifo ezininzi. Ukuqiniseka ukuba umntwana uya kulungeleka uya kunikwa ukuxilongwa kwangaphambili kokuvelisa izifo ze-genetic (PGD). Ivumela ukubonakalisa ukuphambuka ekuphuhlisweni kwembungu, ukufumaneka kwezifo zofuzo. Kwaye ngee-ruble ezingamawaka angama-60 unokukhetha ukwesini kwentsana ezayo.
5. Ingaba kukho indlela yokuqhuba i-IVF ngokusetyenziswa kakubi kwamahomoni?
Ewe, le ndlela ibizwa nge-IVF kwimjikelezo wemvelo. Iziyobisi ezikhuthaza ukukhula kobugqwetha, kulo mzekelo awusebenzi. Kodwa oku kunokwenzeka kuphela ukuba iqela elilodwa livuthwa. Le ndlela ininzi "inobungane" emzimbeni, kodwa iphinde iphumelele (ukukhulelwa kwenzeka kuphela kuma-16% amatyala). Phakathi kweemigodi kunye nobunzima obuphezulu beprogram: kuba ukuba i-follicle yodwa, kukho naziphi na iimpazamo (umzekelo, ekubaleni ixesha leyeza kwixesha le-ovulation) alwamkelekanga.
INDLELA YOKUKHETHA I-ECO-CENTER?
1. Okokuqala, iziko kufuneka libe nelayisenisi efanelekileyo ye-IVF (ngesiseko se "Isiqinisekiso se-Embryology kunye noMtholampilo").
2. Qinisekisa ukuba iklinikhi inomsebenzi omncinci oyimfuneko kwiinkqubo eziphumelelayo:
umgqirha-gynecologist (uyingcali yokuzala);
iimbumbulu;
kunye ne-andrologist (oku kubalulekile ukuba ufuna olunye uphando kwimpilo yeqabane);
i-anesthesiologist;
umongikazi kunye nomongikazi.
3. Zama ukuhamba nge-mini-excursion kwaye uvavanye umgangatho kunye nekhwalithi yezixhobo: umatshini we-ultrasound wamanje kunye nezihlalo zomoya, i-thermostats, i-sperm analyzers, i-incubators ... Ukuba ungekho kumayeza, ubuncinane ubuze imibuzo xa izixhobo zigcine zihlaziywa, indlela yokuphucula iindlela zokuxilongwa kunye neenkqubo.
4. Cacisa, nokuba ngaba kwenzeka kule klinikhi ukuba kuyimfuneko ukuqhuba uphando olongezelelweyo.
5. Eliziko kufuneka libe lula ngokufanelekileyo - uya kudla ukutyelela kwikliniki.
ECO NGOKUBHALA
Abambalwa abantu bayazi ukuba ukususela kwangoko, abafazi baseRashiya banethuba lokuya kwinkqubo ngaphandle kokuhlawula ipenny, iiprogram ze-ECO kwiMoscow zisebenzise i-CPPS. Le nkqubo iquka:
imizamo emibini ye-IVF + PE;
iqhwa kunye nokugcinwa kwemibungu ngexesha lonyaka;
i-cryoperation yama-embrosi;
amayeza afanelekileyo.
Ukusebenzisa ilungelo lokukhulula ii-IVF, kufuneka ufumane ukuhanjiswa kwi-Federal Health Agency. Kukulungele ukuhamba iphepha elixhobileyo: kunye nezicatshulwa, ukuhlalutya, i-spermogram kunye nesigqibo sokuba unesisu kwaye indlela yokuphela isisombululo sinokuphela kwe-IVF. Ukongeza, kufuneka ufezekise imigaqo ethile:
ubudala - iminyaka engama-22-38 ngexesha lokufakwa kwenkqubo;
inyaniso yokuhlala yokuhlala eMoscow;
ubukho bomtshato obhalisiweyo kunye nokungabikho kwabantwana abaqhelekileyo;
ubukho bentsholongwane engaphezulu kweminyaka emi-2 ngokungabikho kwamanye unyango, okanye ukungabikho komzimba, okanye ukudibanisa iifom zokungabikho;
ukungabikho komphumo kwiindlela zokugqirha zonyango, ukufakelwa kwe-classical of ovulation kwiinyanga ezili-6 kunye nokunyanga kweqabane;
ukungabikho kwezifo ze-somatic neengqondo.