Uyazi ukuthi isifo sikashukela sithathwa njengesifo sowesifazane? Ngokwezibalo, abesifazane bathambekele kulesi sifo esithembisayo kaningi kaningi. Izimpawu zesifo sikashukela kowesifazane azivezwa kangako kunakwabesilisa, ngakho-ke ukuthola ukuxilongwa okulungile ngesikhathi akulula. Kepha lokhu akupheleli: isifo singashaya uhlelo lokuzala futhi senze kube nzima ukukhulelwa ngokuzimela. Sibuze udokotela we-gynecologist-reproductologist u-Irina Andreyevna Gracheva ukuthi akhulume ngokuthi uhlelo lwe-IVF luhlanganiswa kanjani nesifo sikashukela.
U-Reproductologist-gynecologist Irina Andreevna Gracheva
Ngithweswe iziqu eRyazan State Medical University ngithole iziqu ku-General MedicineUkuhlala kabusha kuma-Obstetrics kanye ne-Gynecology.
Uneminyaka eyishumi yesipiliyoni.
Wadlula ku-ejwayelekile lobuchwepheshe kubuhlakani bakhe.
Kusukela ngo-2016 - udokotela weSikhungo se-IVF Ryazan.
Abesifazane abaningi abamane nje banake izimpawu zokuqala zesifo sikashukela. Kubikwa ukuthi ukusebenza ngokweqile, ukucindezelwa, ukuguquguquka kwe-hormonal ... Vuma, uma unesifo sokuqwasha, ukudinwa phakathi nosuku, ukukhathala noma umlomo owomile nekhanda, ngeke usheshe ukuyobona udokotela.
Ngoshukela (lapha - isifo sikashukela) Izithiyo zingavela zisendleleni ekhulelwe. Kunezinkinga eziningi lapho “isimo esithandekayo” (nenqubo ye-IVF) kungadala ingozi enkulu empilweni. Ngizoklelisa abambalwa kuphela:
- I-Nephropathy (izinqubo ze-pathological ezinso);
- I-Polyneuropathy ("isifo sezinzwa eziningi" lapho iziphetho zezinzwa zilimala noshukela omningi. Izimpawu: ubuthakathaka bemisipha, ukuvuvukala izingalo nemilenze, ubunzima bokulinganisela, ukuhlangana okungahambi kahle, njll.);
- I-retinal Angiopathy (Imikhumbi yonakaliswa ngenxa yamazinga aphezulu kashukela, ngenxa yalokho esingathola khona isifo esibuthakathaka ngenxa yokuvuswa. Ngenxa yalokhu, i-myopia, i-glaucoma, i-cataralog, njll. ingaqala).
Ukukhulelwa kungenzeka ngokwemvelo ngesifo sikashukela sohlobo 1 (umzimba ulahlekelwa amandla okukhiqiza i-insulin edingekayo, isiguli ngeke siphile ngaphandle kwale hormone. -. Umhl.). Ukukhulelwa kufanele kuphathwe kakhudlwana, kuhlolwe njalo nodokotela. Ubunzima bungavela kuphela uma owesifazane eba nezinkinga.
Ngesikhathi sami e-IVF Center, ngangineziguli eziningana ezinesifo sikashukela sohlobo 1. Iningi labo lazala futhi manje likhulisa izingane. Azikho izincomo ezikhethekile zokubeletha kuleli cala, ngaphandle kwephuzu elilodwa elibalulekile. Akunakusho ukuthi kufanele uyeke ukuthatha i-insulin. Kuyadingeka ukumelana nokulaliswa esibhedlela ukuze ulungise umthamo we-hormone (isonto 14-18, 24-28 no-33-36 ku-trimester yesithathu).
Futhi nazi iziguli onesifo sikashukela sohlobo 2 imvamisa ungayi ku-rectologist. Lesi sifo sivame ukubonakala kubantu ngemuva kweminyaka engamashumi amane kwabesifazane base-postmenopausal. Bengineziguli eziningana ezazifuna ukuzala ngemuva kweminyaka engamashumi amahlanu, kepha akekho noyedwa kubo owathola isifo sikashukela. Ngiphawula ukuthi kwezinye izikhathi, ngesifo sikashukela sohlobo 2, inqubo yokuvuthwa kweqanda ingaphazamiseka.
Cishe i-40% yazo zonke iziguli zami nge futhiukumelana ne-insulin.Lokhu i-endocrine, into evamile yokungazali. Ngokuphulwa kwalokhu, umzimba ukhiqiza i-insulin, kepha ungayisebenzisi kahle. Amangqamuzana awaphenduli esenzweni se-hormone futhi awakwazi ukwengeza ushukela egazini.
Amathuba okukhulisa lesi simo akhuphuka uma ukhuluphele, uphila impilo yokuhlala phansi, othile ovela emndenini wakho ube nesifo sikashukela, noma ubhema. Ukukhuluphala kunomthelela omubi kakhulu ekusebenzeni kwe-ovarian. Ukuphazamiseka okulandelayo kungenzeka lapho ukuqala kwemvelo kokukhulelwa kunzima:
- kwenzeka ngokungahambi kahle kokuya esikhathini;
- akukho-ovulation;
- ukuya esikhathini kuba yivelakancane;
- ukukhulelwa akwenzeki ngokwemvelo;
- i-polycystic ovary ikhona.
Uma ngaphambili, isifo sikashukela sasiwukuphambana kokuhlelela ukukhulelwa, manje odokotela balulekisa kakhulu lolu daba. Ngokusho kwe-WHO, ezweni lethu ama-15% emibhangqwana angazalani, phakathi kwawo kunemibhangqwana enesifo sikashukela.
Iseluleko esibaluleke kakhulu - ungaqali lesi sifo! Kulokhu, ubungozi bezinkinga bungakhuphuka kaningana. Uma ushukela wegazi weqa izindinganiso ze-WHO, lokhu kuzoba ukweqa umthetho wokungena kuphrothokholi (kusuka ku-3.3 kuye ku-5.5 mmol / l wegazi le-capillary, i-6.2 mmol / l yegazi eline-venous).
Uhlelo lwe-IVF cishe alufani ne protocol evamile. Ngokuvuselelwa kwe-ovulation, umthwalo wehomoni ungaba mkhulu. Kepha lapha, kunjalo, yonke into iyodwa. Amaqanda azwela kakhulu i-insulin. Imithamo yayo inyuka ngama-20- 40%.
Le ntwasahlobo, odokotela bakwazile ukufakazela ukuthi umuthi iMetmorfin, olawula amazinga kashukela egazi, ukhuthaza ukukhulelwa kwabesifazane abanesifo sikashukela. Ngokukhuthaza kwe-hormonal, umthamo wayo ungandiswa.
Izinyathelo ezilandelayo ukubhoboza nokudluliswa kwe-ovarian (ngemuva kwezinsuku ezinhlanu). Uma kwenzeka unesifo sikashukela esincike ku-insulin, owesifazane uyanconywa ukuba angadluli umbungu owodwa. Kuzo zonke ezinye izimo, ezimbili zingenzeka.
Uma ukwelashwa kwe-hormone kukhethwe kahle futhi isiguli singaphansi kokuqondisa kukadokotela, isifo sikashukela asithinti ukufakwa kwe-umbungu (emtholampilo wethu, ukusebenza kwazo zonke iziqubulo ze-IVF kufinyelela kuma-62,8%). Ngokwesicelo sesiguli, izakhi zofuzo zingabona ukuba khona kohlobo lwesifo sikashukela embungu usebenzisa i-PGD (ukuxilongwa kofuzo kusengaphambili). Isinqumo sokuthi yini okufanele siyenze uma lolu hlobo lokutholwa sitholiwe senziwa ngabazali.
Vele, inkambo yokukhulelwa kwabesifazane abanjalo ihlale iyinkimbinkimbi. Konke ukukhulelwa abakudinga ukubonwa yi-endocrinologist. Bathatha i-insulin konke ukukhulelwa, iMetformin - kuze kufike kumaviki awu-8. Udokotela wakho uzokutshela okuningi ngalokhu. Akukho okuphikisana nokuzalwa kwengane emvelo kushukela uma kungekho sibi esinamandla noma enye i-pathology.
