In vitro fertilization (IVF)

In vitro fertilization (IVF) kubatanidzwa kwezai remukadzi uye mbeu yemurume mudhishi rerabhoritari. In vitro zvinoreva kunze kwemuviri. Kuberekesa kunoreva kuti urume hwakanamira nekupinda muzai.

Kazhinji, zai nembeu zvinosanganiswa mukati memuviri wemukadzi. Kana zai rakabatanidzwa rakanamatira pamucheto wechibereko uye richienderera richikura, mwana anozvarwa kwapera mwedzi mipfumbamwe. Maitiro aya anonzi echisikigo kana asina kubatsirwa kubata.

IVF imwe yemhando yekubatsirwa tekinoroji yekubereka (ART). Izvi zvinoreva kuti hunyanzvi hwekurapa hunoshandiswa kubatsira mukadzi kubata pamuviri. Inowanzoedzwa kana dzimwe nzira dzisingadhuri dzekubereka dzakundikana.

Pane matanho mashanu ekutanga kune IVF:

Nhanho 1: Kukurudzira, inonziwo super ovulation

• Mishonga, inonzi mishonga yekubereka, inopihwa kumukadzi kusimudzira kugadzirwa kwemazai.
• Kazhinji, mukadzi anobereka zai rimwe pamwedzi. Mishonga yekubereka inotaurira mazai kuti abudise mazai akati wandei.
• Pakati peiyi nhanho, mukadzi anogara aine transvaginal ultrasound kuti aongorore mazai uye kuongororwa kweropa kutarisa mahormone.

Nhanho 2: Kudzosa mazai

• Kuvhiya kudiki, kunonzi follicular aspiration, kunoitwa kubvisa mazai kubva mumuviri wemukadzi.
• Kuvhiya kunoitwa muhofisi yechiremba nguva zhinji. Mukadzi anozopihwa mishonga saka haanzwe kurwadziwa panguva yekuitwa. Achishandisa mifananidzo ye ultrasound senge gwara, mutarisiri wehutano anoisa tsono nhete kuburikidza nemukadzi mukati meiyo ovary nemasaga (follicles) ane mazai. Tsono yacho yakabatana nemudziyo wekukweva, uyo unodhonza mazai nemvura kubva mune imwe follicle, imwe panguva.
• Iyo nzira inodzokororwa kune imwe ovary. Panogona kuve nekupwanya mushure mekuita, asi zvinopera mukati mezuva.
• Mune zvisingawanzoitika zviitiko, pelvic laparoscopy inogona kudikanwa kubvisa mazai. Kana mukadzi asingagone kana asingakwanise kuburitsa mazai, mazai akapihwa anogona kushandiswa.

Nhanho 3: Insemination uye Fertilization

• Mbeu yemurume inoiswa pamwechete nemazai emhando yepamusoro. Iko kusanganisa kwehurume nezai kunodaidzwa kunyorera.
• Mazai nehurume zvinobva zvachengetwa mukamuri rinotarisirwa nharaunda. Urume hunowanzo kupinda (hunosanganisa) zai maawa mashoma mushure mekumisikidzwa.
• Kana chiremba achifunga kuti mukana wekusangana wakaderera, hurume hungapinda jekiseni rakananga muzai. Izvi zvinodaidzwa kuti intracytoplasmic sperm jekiseni (ICSI).
• Mapurogiramu mazhinji ekubereka anowanzoita ICSI pane mamwe mazai, kunyangwe zvinhu zvikaita sezvakajairwa.

Nhanho 4: Embryo tsika

• Kana zai rakaparadzaniswa rinova "embryo". Vashandi veLaborari vanogara vachitarisa iyo embryo kuti ive nechokwadi chekuti iri kukura zvakanaka. Mukati memazuva mashanu, "embryo" yakajairika ine maseru akati wandei ari kuganhura.
• Vakaroorana vane njodzi huru yekupfuudza hutachiona (nhaka) kusagadzikana kumwana vanogona kufunga pre-kudyara genetic kuongororwa (PGD). Maitiro acho anowanzoitwa mazuva matatu kana mashanu mushure mekuberekwa. Varabhoritari masayendisiti vanobvisa sero rimwe chete kana masero kubva muchibereko chimwe nechimwe uye vanoongorora izvo zvinhu kune chaiwo majini kusagadzikana.
• Sekureva kweAmerican Society for Reproductive Medicine, PGD inogona kubatsira vabereki kusarudza kuti ndeapi mazai avanoda kuisa. Izvi zvinoderedza mukana wekupfuudza kusagadzikana pamwana. Iyo nzira inopokana uye haina kupihwa kunzvimbo dzese.

Nhanho 5: Embryo kuchinjisa

• Mazai akaiswa mudumbu remukadzi mazuva matatu kusvika mashanu mushure mekudzoserwa kwezai uye kusangana.
• Maitiro acho anoitwa muhofisi yechiremba apo mukadzi akamuka. Chiremba anoisa chubhu nhete (katheta) ine tuvana tuviri mukati memukadzi, kuburikidza nemuromo wechibereko, uye mudumbu. Kana "embryo" ikanamatira kune (implants) mumucheto wechibereko uye ichikura, nhumbu inoitika.
• Inopfuura imwe embryo inogona kuiswa mudumbu panguva imwechete, izvo zvinogona kutungamira kumapatya, matatu, kana zvimwe. Iyo chaiyo nhamba yemazai akatamisirwa inyaya yakaoma iyo inoenderana nezvinhu zvakawanda, kunyanya zera remukadzi.
• Mazai asina kushandiswa anogona kuomeswa nechando akaiswa kana kupihwa pane rimwe zuva.

IVF inoitwa kubatsira mukadzi kuti ave nepamuviri. Iyo inoshandiswa kurapa zvikonzero zvakawanda zvekushaya mbereko, kusanganisira:

• Kuchembera zera remukadzi (akura makore echikadzi)
• Yakakuvara kana yakavharirwa Fallopian machubhu (anogona kukonzerwa nechirwere chepamuviri kana chirwere chepamberi chekubereka)
• Endometriosis
• Male factor kushaya mbereko, kusanganisira kuderera kwesperm count uye kuvhara
• Kusabereka kusingatsanangurike

IVF inosanganisira huwandu hwakawanda hwesimba uye hwepamoyo simba, nguva, nemari. Vazhinji vakaroorana vanosangana nekushaya mbereko vanotambura nekushushikana uye kushushikana.

Mukadzi anotora mishonga yekubereka anogona kuve nekuzvimba, kurwadziwa mudumbu, kusanduka kwemamiriro, kutemwa nemusoro, uye mimwe mhedzisiro. Kudzokororwa kweIVF majekiseni kunogona kukonzera kupwanya.

Muzviitiko zvisingawanzoitika, mishonga yekubereka inogona kukonzera ovarian hyperstimulation syndrome (OHSS). Aya mamiriro anokonzeresa kuwanda kwemvura mudumbu nepachipfuva. Zviratidzo zvinosanganisira kurwadziwa kwemudumbu, kuzvimba, kukurumidza kuwedzera huremu (10 mapaundi kana 4.5 makirogiramu mukati memazuva matatu kusvika mashanu), kudzikira kwehurongwa kunyangwe uchinwa zvinwiwa zvakawanda, kusvotwa, kurutsa, uye kupera mweya. Makesi akapfava anogona kurapwa nekuzorora kwemubhedha. Dzimwe nyaya dzakakomba dzinoda kuburitswa kwemvura netsono uye pamwe kuchipatara.

Zvidzidzo zvekurapa zvakaratidza kusvika parizvino kuti mishonga yekubereka haina kubatana nekenza yemazai.

Njodzi dzekudzosa mazai dzinosanganisira maitiro kune anesthesia, kubuda ropa, hutachiona, uye kukuvara kwezvivakwa zvakakomberedza maevhari, senge ura uye dundira.

Iko kune njodzi yekubata nhumbu kwakawanda kana inopfuura imwechete embryo yakaiswa mudumbu. Kutakura anopfuura mwana mumwe panguva kunowedzera njodzi yekuzvarwa nguva isati yakwana uye huremu hwekuzvarwa. (Zvisinei, kunyangwe mwana mumwechete akazvarwa mushure meIVF ari panjodzi huru yekutangira kukura uye huremu hwekuzvarwa.

Hazvina kujeka kana IVF inowedzera njodzi yekuremara kwekuberekwa.

IVF inodhura kwazvo. Dzimwe, asi kwete dzese, dzinoti dzine mitemo inoti makambani einishuwarenzi ehutano anofanira kupa imwe mhando yekuvhara. Asi, mazhinji einishuwarenzi marongero haavhare kurapwa kwekushaya mbereko. Mari yechimwechete IVF kutenderera inosanganisira mutengo wemishonga, kuvhiya, anesthesia, ultrasound, kuongororwa kweropa, kugadzirisa mazai nembeu, kuchengetedza embryo, uye kuendesa embryo. Iyo chaiyo yakazara yeiyo imwechete IVF kutenderera inosiyana, asi inogona kuita inodarika madhora 12,000to $ 17,000.

Mushure mekudzorerwa kwemwana, mukadzi anogona kuudzwa kuti azorore kwasara zuva racho.Kuzorora kwemubhedha kwakazara hakuna basa, kunze kwekunge paine njodzi yakawandisa yeOHSS. Vazhinji vakadzi vanodzokera kuzviito zvakajairika zuva rinotevera.

Vakadzi vanoenda IVF vanofanirwa kutora mapfuti ezuva nezuva kana mapiritsi ehomoni progesterone kwemavhiki masere kusvika gumi mushure mekuberekwa kwembriri. Progesterone ihormone inogadzirwa zvakasikwa nemazai ayo anogadzirira mutsetse wechibereko (chibereko) kuitira kuti "embryo" ibatanidze. Progesterone inobatsira zvakare mwana akaiswa mudumbu kukura uye kusimbiswa muchibereko. Mukadzi anogona kuramba achitora progesterone kwemavhiki masere kusvika gumi nemaviri mushure mekubata pamuviri. Zvishoma progesterone mukati memavhiki ekutanga epamuviri zvinogona kutungamira mukuparara.

Anenge mazuva gumi nemaviri kusvika gumi nemana mushure mekuchinjiswa kwemwana, mukadzi anodzoka kukiriniki kuitira kuti nhumbu iitwe.

Fonera mupiki wako ipapo kana iwe uine IVF uye uine:

• Fivha inopfuura 100.5 ° F (38 ° C)
• Kurwadziwa kwepamuviri
• Kubuda ropa kwakanyanya kubva mukati memukadzi
• Ropa mune weti

Statistics inosiyana kubva kukiriniki kuenda kune imwe uye inofanira kutariswa zvakanyatsonaka. Nekudaro, huwandu hwevarwere hwakasiyana mukiriniki yega yega, saka zviyero zvekuzvitakura hazvigone kushandiswa sechiratidzo chaicho cheimwe kiriniki inosarudzika kune imwe.

• Mitengo yepamuviri inoratidza huwandu hwevakadzi vakave nepamuviri mushure meIVF. Asi haisi dzose nhumbu dzinoguma nekuzvarwa kuri kurarama.
• Hupenyu hwekuzvarwa huwandu hunoratidza huwandu hwevakadzi vanozvara mwana mupenyu.

Maonero ehupenyu hwega hwekuzvarwa anoenderana nezvimwe zvinhu senge amai zera, pamberi pekuzvarwa kurarama, uye imwechete embryo kuendesa panguva yeVIV.

Sekureva kweSosaiti yeAkubatsira Kubereka Technologies (SART), mukana wekufungidzira wekuzvara mwana mupenyu mushure meVIV ndeaya anotevera:

• 47.8% yevakadzi vari pasi pemakore makumi matatu nemashanu
• 38.4% yevakadzi vane makore makumi matatu kusvika makumi matatu nemanomwe
• 26% yevakadzi vane makore makumi matatu nemasere kusvika makumi mana
• 13.5% yevakadzi vane makore makumi mana kusvika makumi mana nemana

IVF; Unyanzvi hwekubereka hwekubereka; ART; Kwayedza-chubhu mucheche maitiro; Kusabereka - in vitro

Catherino WH. Kubereka endocrinology uye kushaya mbereko. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 223.

Choi J, Lobo RA. In vitro kuberekesa. Mune: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Yakakwana Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017: chitsiko 43.

Dzidzira Komiti yeAmerican Society Yekubereka Mushonga; Dzidzira Komiti yeSosaiti yeiyo Inobatsira Kubereka Kubereka. Nhungamiro pamiganhu kune huwandu hwemazai kutamisa: komiti inofunga. Chibereko Steril. 2017; 107 (4): 901-903. PMID: 28292618 pubmed.ncbi.nlm.nih.gov/28292618/.

Tsen LC. In vitro fertilization uye imwe yakabatsira tekinoroji yekubereka. Mune: Chestnut DH, Wong CA, Tsen LC, et al, eds. Chestnut's Obstetrics Anesthesia. 6th ed. Philadelphia, PA: Elsevier; 2020: chits. 15.