U-Elena Kalinina, udokotela wesigqirha-gynecologist , MD, umvuzo weRF kaRhulumente ngomsebenzi "Iprogram ye-IVF ekwonyango komtshato ongenasiphelo" Ekuqaleni, indlela yokuvumba in vitro (IVF), equka ukuxhamla kweqanda elivuthiweyo kunye ne-spermatozoon ngaphandle komzimba wesibini kunye nombungu olandelayo uterus, ithathwa njengesisombululo seengxaki enye. Kwaye malunga neemeko xa, ngenxa yesizathu esithile, umama ozayo akanalo na mathupha omama: ukungabikho kwabo kwenza ukuba ukukhulelwa kungenakwenzeka, kuba yilapho iqanda lidibana nomdaka, kubo iqanda elichumayo lihamba liye laza kufakwa kwisibeletho ukuba linamathele eludongeni lwayo kwaye uqale ukuphuhlisa. Amalinge okukhusela le ngxaki ngoncedo lwe-IVF yenziwa ngabaphandi abavela kumazwe ahlukeneyo, kwaye ngoNovemba 1977 imizamo yezilwimi zeNgqungquthela ze-embrologist zacaca ukuba i-ECO yayiza kunceda ukunqoba iintlobo ezahlukeneyo zokungabikho, kwaye i-gynecologist evela kwikliniki yase Born Born yaphumelela. Umva olandelayo, u-601-th ukutshintshwa kwisibeleko sombungu okhulile ngaphandle komzimba wowesifazane okhokelela ekuzalweni kukaLouise - "wokuqala umntwana" kwi-tube test ".
E-Russia, ukuphuhliswa kwale ndlela kwathatha iminyaka engama-6 kamva: iinzame zikaVladimir Ivanovich Kulakov, umlawuli we-All-Union Union Centre yoPhando loKhuselo lweMpilo yabaMama nabantwana (ngoku i-SC ye-Obstetrics, iGynecology nePeratatology), kunye noBris Vasilievich Leonov, oya kwiqela leengcali, ngokusekelwe kwikliniki kwakukho uphando lwebhubhoratri. Apha, ephakathi, uLenochka wabonakala - nangona kungabikho kwamathumbu omama wakhe ovela kumama kunye neyesibini ze-IVF. Ukulandela i-Muscovite Lenochka ngoDisemba 1986 eLeningrad, kwi-Institute of Research ye-Obstetrics ne-Gynecology. U-Otto, owokuqala kwimbali yenkwenkwe yaseVF yasekhaya. Iingcali zeZiko loNyango lokuSweleka kwiSibhedlele se-Grad 1st, ezikhokelwa nguNjingalwazi VM Zdanovsky, zenze iziphumo eziphawulekayo. Ngoko, ngemizamo yamaqela ahlukeneyo abaphandi, indlela ye-ECO ifumane ilungelo lokuphila elizweni lethu, kwaye ukususela ngoko uphuhliso lwayo lwaqala ngokukhawuleza lukhula.
Abazali abonwabileyo
Emva kwexesha, saqonda ukuba ii-IVF zinokunceda ukunqoba iintlobo ezahlukeneyo zokungabikho komntwana, kokubhinqa kunye nendoda. Olu luhlu ngoku lubonisa iingxaki ebezicingelwa ngaphambili ukuba zingenakukhutshwa: ukukhutshwa kwamathambo e-fallopian, angenakubuyiselwa ngokuhlinzwa; izifo ezinzima zehommoni; ukungabikho kwempilo kubangelwa zizathu ezingabonakaliyo. Ukongezelela, le ndlela isinike ithuba lokuphuhlisa iinkqubo zabaxhasi, apho izigulane ezingenayo amaqanda azo, zifumana kwabanye abafazi. Kuyaziwa ngoku kunye nethuba lokuthabatha kwiinkonzo zomama onomdla okhuthazelayo aze abelethe umntwana okhulelwe ngoncedo lweqanda kunye nesidoda sa "abathengi".
Indlela ye-IVF ibe yiphumelelo lokwenyani kunyango lokungabikho komntwana . Ukuba inani le-spermatozoa kwi-papa elizayo lincinci okanye lihambahamba ngokungenangqiqo, asikwazi kuphela ukucacisa "umviwa" onokusebenza ngokubanzi, kodwa uyayifaka ngqo kwiqanda lomfazi, ngokugqithisela imingcele yemvelo nokuqinisekisa ukhuseleko lwazo zonke iimpahla zayo. Le nqubo, ebizwa ngokuthi i-ICSI, yaphuhliswa kutshanje: umntwana wokuqala, wakhulelwa ngoncedo lwakhe, wazalwa ngo-1993.
Ngokutsho kwam, indlela ye-IVF ngoku yaziwa kakhulu: inxenye ngenxa yokwandiswa kwamandla ayo, inxenye ngenxa yokuba izibangela zokungabikho kwengqondo zanda. Omnye wabo: abafazi bacinga ngokuzalwa komntwana kuloo minyaka, xa iingxaki zempilo zongezwa.
I-Valentin Lukin, i-Ph.D. , i-RF Government Prize yomsebenzi wayo "Iprogram ye-IVF ekwonyango komtshato ongenasiphelo" I-ECO yindlela eya kuba sisiseko sokuphuhliswa komntu. Kwixesha elizayo, akuyi kuvumela kuphela ukuphathwa kakubi kubantu besetyhini kunye namadoda, njengokuba kunjalo nanamhlanje, kuya kusinika amathuba amatsha okukhusela kunye nokuphilisa izifo ezinzulu ezinokufumana ilifa. Emva koko, i-IVF ivumela iingcali ukuba zisebenze kunye neeseli ezinika umntu, kwaye, mhlawumbi, siya kuba nethuba lokuchaphazela la maseli. Namhlanje kunzima ngathi ukucinga - ingcamango yokulondoloza ubomi bomntu ngoncedo lokumpontshelwa igazi kubonakala iyinto engakholeki ekuqaleni kwekhulu lama-20 - kodwa izihlandlo, njengoko ziyaziwayo, zitshintsha.
Enye yamanqaku okuqala anikezelwe kwindlela entsha, eyanika ubomi kwiLenochka. Ngomhla weMpilo, Matshi 1986 Ngomntwana osanda kuzalwa, u-Elena Kalinina (ngoko ube ngumhlobo ophangayo wophando kwi-All-Union Research Centre ye-Mother and Child Health) kunye noValentin Lukin (owayengumntu ophezulu kwiziko), ngoFebruwari 1986 .
Kodwa siya kubuya namhlanje. Ngokuza kwe-IVF, ukungabi nantoni kwaba lula: kungakhathaliseki ukuba yintoni idatha yokuqala, ibhinqa eliphendulela kuthi uncedo linamathuba angama-30 okufumana ukukhulelwa kumjikelezo wokuqala. Kwaye ngoku izigulane asisasichitha iminyaka, zixhaphaza zonke iindlela ezikhoyo zokusombulula iingxaki zabo, kuba ziyakwazi ukuzigqitha.
Ngaba kukho ipros and cons Sithe sathetha malunga neenzuzo zendlela. Nangona kunjalo andinakuyincoma kubo bonke abatshatileyo abaneengxaki. Kukulungele ukutyelela uncedo lwakhe xa ezinye iimeko zokusombulula ingxaki, umzekelo, abagqirha, abasebenzi. Omnye umzekelo: abazali bexesha elizayo bafumana inkqubo yenkqubo yophando, kwaye i-cause of infertility ayifumanekanga, ngaphezu koko, iminyaka yabo idlulile ngaphaya kweminyaka engama-40-kule meko, ukuyeka ukutyelela kwiSebe le-ECO akufanelekanga. Ngokubhekiselele kwiimigodi zendlela, kufuneka ukhumbule oku: kubandakanya impembelelo enzulu kwimvelaphi ye-hormone yowesifazane, oku kungabangela iingxaki ezingathandekiyo. Ukongezelela, unyango lokungabikho kwengqondo kunye ne-IVF luyinto enqabileyo.
Kutheni emva kokuba inkqubo ye-IVF yenza amawele kunye neentathu zivela rhoqo?
Njengoko sele kuthethwe ngaye, kwenzeka ukuba akukho enye kuphela kodwa imibusi emibili okanye emithathu ifakwa kwisisu. Nangona kunjalo, wonke umntu uyazi ukuba kunzima ukunyamezela "inkampani" enjalo kunomntwana omnye (ngakumbi ukuba umama ozayo ungaphantsi kwama-40). Yingakho iingcali ze-IVF emhlabeni jikelele zikhokelwa yi "indalo" yokukhulelwa okungondlekiyo - kwiintlobo zowesifazane kunye nosana. Yingakho ukuba isibini esitshatileyo sifuna umntwana omnye kuphela, kwisebe le-IVF baya kumhlangabeza kwaye baya kuthwala i-embryo enye, kangangoko kunokwenzeka. Yintoni eyenzekayo kuloo maqanda athathwe kwintombi, enxulumene ne-spermatozoa, kodwa engadluliselwa kwisibeletho? Ngemvume ye "makhosikazi" baqhwabile kwaye, ukuba umzamo wokuqala ungaphumeleli, yenza okulandelayo, ungahambisani nabo abaye bahlala. Ukuba isitokisi siphelile, inkqubo iyaqala ukususela ekuqaleni.
Ngaba ukukhulelwa kwe-ECO nokubeletha kwahluke "kwinto eqhelekileyo"?
Emva kwemizamo yeengcali zeSebe le-IVF, umfazi ukhulelwe, umama okhuselekileyo unokuqhubeka egcinwa kuyo nayiphi na indawo efanelekileyo (umzekelo, kwintsebenziswano yabesifazane). Ukukhulelwa okunjalo kudinga ugqirha loogqirha, kodwa kungekhona ngenxa yokuba into ehlukileyo kwizinto ezizimele. Kungoko ngokuqhelekileyo abafazi bathatha i-IVF (ngelishwa) ngelixesha xa baneengxaki ezinokuthi zikhusele ikhondo elizilileyo leemeko. Ziyintoni na? Okokuqala, iminyaka, yesibini, izifo ezingapheliyo, ubunzima obunzima. Ukuzalwa okuzayo akufani nakwezinye eziqhelekileyo. Enyanisweni, abasetyhini beSebe le-ECO banokukwazi ukwenza isigaba se-caesarean ecwangcisiweyo. Kulo mbandela, iinguqu ezifanayo njengoko zikhankanyiwe ngasentla ziqwalaselwa: iminyaka, iingxaki zempilo, ukukhulelwa okubanzi. Ngendlela, ukuba kufike kwiintathu, ngoko nayiphi na imeko bavela ekukhanyeni ngokuhlinzwa, kwaye unyaka umama akanalo nantoni na.
Ngaba abazali bangacela isazi ukuba 'sitshale' imbilini yesini esithile?
Bayakwazi, kodwa kuphela xa sele benamantombazana amathathu okanye abafana abathathu okanye kwimbali yentsapho kukho izifo zofuzo ezinxulumene nesini esithile, umzekelo we-hemophilia. Zonke ezinye iimeko zigqitywe yisisombululo se-World Health Organisation, esingacebisi abazali ukuba bakhethe ngesondo somntwana wabo ozayo.
Kutheni iVIV ibiza kakhulu?
Ngeendlela ezininzi, ixabiso lichongwa ngamachiza e-hormonal. Ukongeza, zonke izixhobo oogqirha basebenzisayo zilahla kwaye zifaneleke kakhulu. Enye inzame iya kuhlawula i-$ 3.5 yeeyure. Ukuba nethemba loncedo lombuso alukho mfuneko: umgaqo-myalelo, ngokubhekiselele kuyo i-IVF yokuqala iya kukhululeka, usalinde iyure.