Ukungabi nenzalo

Ukungabi nenzalo kusho ukuthi awukwazi ukukhulelwa (ukukhulelwa).

Kunezinhlobo ezi-2 zokuzala:

• Ukungabi nenzalo okuyisisekelo kusho imibhangqwana engakhulelwanga ngemuva kokungenani unyaka owodwa yenza ucansi ngaphandle kokusebenzisa izindlela zokuvimbela inzalo.
• Ukungabi nenzalo kwesibili kusho imibhangqwana eye yakwazi ukukhulelwa okungenani kanye, kepha manje ayisakwazi.

Izici eziningi zomzimba nezingokomzwelo zingadala ukungabi nenzalo. Kungahle kube ngenxa yezinkinga zowesifazane, owesilisa, noma zombili.

UKUNGALIMBI KWABESIFAZANE

Ukungabi nenzalo kwabesifazane kungenzeka lapho:

• Iqanda noma umbungu okhulelisiwe awuphili uma usunamathele kulayini wesibeletho (isibeletho).
• Iqanda elikhulelisiwe alinamatheli kulwelwesi lwesibeletho.
• Amaqanda awakwazi ukusuka emaqandeni aye esibelethweni.
• Ama-ovari anezinkinga zokukhiqiza amaqanda.

Ukungabi nenzalo kwabesifazane kungabangelwa:

• Ukuphazamiseka okuzenzakalelayo, njenge-antiphospholipid syndrome (APS)
• Ukukhubazeka kokuzalwa okuthinta umgudu wokuzala
• Umdlavuza noma isimila
• Izinkinga zokuvala
• Isifo sikashukela
• Ukuphuza kakhulu utshwala
• Ukuzivocavoca ngokweqile
• Ukuphazamiseka kokudla noma ukungondleki kahle
• Ukukhula (okufana ne-fibroids noma ama-polyps) esibelethweni nasemlomo wesibeletho
• Imithi efana nemithi yokwelapha ngamakhemikhali
• Ukungalingani kweHormone
• Ukhuluphele ngokweqile noma ukukhuluphala
• Ukuguga
• Ama-cysts ama-ovari kanye ne-polycystic ovary syndrome (i-PCOS)
• Ukutheleleka kwe-pelvic okuholela ekuqhekekeni noma ekuvuvukeni kwamashubhu e-fallopian (hydrosalpinx) noma isifo sokuvuvukala kwe-pelvic (PID)
• Ukuqubuka kokutheleleka ngocansi, ukuhlinzwa esiswini noma i-endometriosis
• Ukubhema
• Ukuhlinzwa ukuvimbela ukukhulelwa (i-tubal ligation) noma ukwehluleka kokubuyiselwa emuva kwe-tubal ligation (reanastomosis)
• Isifo sendlala yegilo

UKUNGAKHOLELWA KWABESILISA

Ukungabi nenzalo kwabesilisa kungabangelwa:

• Ukwehla kwenani lesidoda
• Ukuvaleka okuvimbela isidoda ukuthi singadedelwa
• Amaphutha esidoda

Ukungabi nenzalo kwabesilisa kungabangelwa:

• Izinkinga zokuzalwa
• Ukwelashwa komdlavuza, kufaka phakathi i-chemotherapy ne-radiation
• Ukuvezwa ukushisa okuphezulu isikhathi eside
• Ukuphuza kakhulu utshwala, insangu, noma i-cocaine
• Ukungalingani kweHormone
• Ukungabi namandla
• Ukutheleleka
• Imithi efana ne-cimetidine, i-spironolactone, ne-nitrofurantoin
• Ukukhuluphala ngokweqile
• Ukuguga
• Phinda wenze kabusha i-ejaculation
• Ukuqubuka kwezifo ezithathelwana ngocansi (STIs), ukulimala, noma ukuhlinzwa
• Ukubhema
• Ubuthi emvelweni
• IVasectomy noma ukwehluleka kokuguqulwa kwe-vasectomy
• Umlando wokutheleleka kwe-testicular kusuka kumamephu

Imibhangqwana enempilo engaphansi kweminyaka engama-30 eya ocansini njalo izoba namathuba angaba ngu-20% ngenyanga okukhulelwa inyanga ngayinye.

Owesifazane uvundile kakhulu eminyakeni yakhe yokuqala yama-20. Ithuba lokuthi owesifazane athole ukukhulelwa kwehle kakhulu ngemuva kweminyaka yobudala engama-35 (futhi ikakhulukazi ngemuva kweminyaka engama-40). Iminyaka lapho ukuzala kuqala ukwehla kuyahlukahluka kuye ngowesifazane.

Izinkinga zokungazali kanye namanani okuphuphuma kwesisu akhula kakhulu ngemuva kweminyaka engama-35 ubudala. Manje kukhona izinketho zokubuyisa amaqanda zakuqala nokugcinwa kwabesifazane abakwiminyaka yabo yama-20. Lokhu kuzosiza ukuqinisekisa ukukhulelwa okuyimpumelelo uma ukuzala kubambezeleka kuze kube ngemuva kweminyaka yobudala engama-35. Lokhu kuyindlela ebizayo. Kodwa-ke, abesifazane abaziyo ukuthi bazodinga ukubambezela ukuzala bangakucabanga.

Ukunquma ukuthi uzokwelashwa nini ukungabi nenzalo kuya ngeminyaka yakho. Abahlinzeki bezempilo baphakamisa ukuthi abesifazane abangaphansi kweminyaka engama-30 bazame ukukhulelwa bebodwa unyaka owodwa ngaphambi kokuhlolwa.

Abesifazane abangaphezu kweminyaka engama-35 kufanele bazame ukukhulelwa izinyanga eziyisithupha. Uma kungenzeki ngaleso sikhathi, kufanele bakhulume nomhlinzeki wabo.

Ukuhlolwa kokungabi nenzalo kufaka umlando wezokwelapha nokuhlolwa komzimba kubo bobabili abalingani.

Ukuhlolwa kwegazi nemifanekiso kuvame ukudingeka kakhulu. Kwabesifazane, lokhu kungafaka:

• Ukuhlolwa kwegazi ukuhlola amazinga ama-hormone, kufaka phakathi i-progesterone ne-follicle stimulating hormone (FSH)
• Amakhithi wokutholwa kokuvuthwa komchamo wasekhaya
• Ukukala izinga lokushisa komzimba njalo ekuseni ukubona ukuthi amaqanda awakhipha yini amaqanda
• Ukuhlolwa kwenselele ye-FSH ne-clomid
• Ukuhlolwa kwe-hormone ye-Antimullerian (AMH)
• IHysterosalpingography (HSG)
• I-pelvic ultrasound
• I-Laparoscopy
• Ukuhlolwa komsebenzi we-thyroid

Ukuhlolwa kwamadoda kungafaka:

• Ukuhlolwa kwesidoda
• Ukuhlolwa kwamasende nomthondo
• I-Ultrasound yesitho sangasese sowesilisa (kwesinye isikhathi kwenziwe)
• Ukuhlolwa kwegazi ukuhlola amazinga ama-hormone
• I-testicular biopsy (ayivamisile ukwenziwa)

Ukwelashwa kuya ngesizathu sokuzala. Kungabandakanya:

• Imfundo nokwelulekwa ngalesi simo
• Imithi yokwelapha efana ne-intrauterine insemination (IUI) kanye ne-in vitro fertilization (IVF)
• Imithi yokwelapha ukutheleleka nokuphazamiseka kokuqina
• Imithi esiza ukukhula nokudedelwa kwamaqanda avela esibelethweni

Imibhangqwana ingakhuphula amathuba okukhulelwa inyanga ngayinye ngokuya ocansini okungenani njalo ezinsukwini ezimbili ngaphambi nangesikhathi sokukhulelwa.

I-ovulation yenzeka cishe amasonto ama-2 ngaphambi kokuqala komjikelezo olandelayo (isikhathi). Ngakho-ke, uma owesifazane ethola ukuya esikhathini njalo ezinsukwini ezingama-28 lo mbhangqwana kufanele aye ocansini okungenani njalo ezinsukwini ezimbili phakathi kosuku lwe-10 kanye nele-18 ngemuva kokuqala kwesikhathi sakhe.

Ukuya ocansini ngaphambi kwe-ovulation kuyasiza kakhulu.

• Isidoda singahlala ngaphakathi komzimba wowesifazane okungenani izinsuku ezimbili.
• Kodwa-ke, iqanda lowesifazane lingavundiswa kuphela yisidoda kungakapheli amahora ayi-12 kuye kwangama-24 seliphumile.

Abesifazane abangaphansi noma abakhuluphele ngokweqile bangezelela amathuba abo okukhulelwa ngokuthola isisindo esinempilo.

Abantu abaningi bakuthola kuwusizo ukubamba iqhaza emaqenjini okweseka abantu abanezinkinga ezifanayo. Ungacela umhlinzeki wakho ukuthi ancome amaqembu endawo.

Imibhangqwana engaba ngu-1 kwaba-5 etholakale ingenayo inzalo ekugcineni ikhulelwa ngaphandle kokwelashwa.

Imibhangqwana eminingi enokuzala iyakhulelwa ngemuva kokwelashwa.

Shayela umhlinzeki wakho uma ungakwazi ukukhulelwa.

Ukuvimbela izifo ezithathelana ngokocansi, njenge-gonorrhea ne-chlamydia, kunganciphisa ubungozi bokuzala.

Ukugcina ukudla okunempilo, isisindo, nendlela yokuphila kungakhuphula amathuba akho okukhulelwa nokukhulelwa okunempilo.

Ukugwema ukusebenzisa izinto zokuthambisa ngesikhathi socansi kungasiza ekuthuthukiseni ukusebenza kwesidoda.

Ukungakwazi ukukhulelwa; Ayikwazi ukukhulelwa

• I-laparoscopy yomzimba
• I-anatomy yokuzala yabesifazane
• I-anatomy yokuzala yowesilisa
• Ukungabatholi abantwana ngokuyinhloko
• Isidoda

UBarak S, uGordon Baker HW. Ukuphathwa kwemitholampilo kokuzala kwabesilisa. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, abahleli. I-Endocrinology: Eyabantu Abadala Neyengane. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 141.

IBroekmans FJ, iFauser BCJM. Ukungabi nenzalo kwabesifazane: ukuhlolwa nokuphathwa. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, abahleli. I-Endocrinology: Eyabantu Abadala Neyengane. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 132.

UCatherino WH. I-endocrinology yokuzala nokungazali. Ku: Goldman L, Schafer AI, eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 223.

Lobo RA. Ukungabi nenzalo: i-etiology, ukuhlolwa kokuxilongwa, ukuphathwa, ukubikezelwa. Ku: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. I-Gynecology ephelele. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2017: isahluko 42.

Ikomidi Lokuzivocavoca le-American Society for Reproductive Medicine. Ukuhlolwa kwesifo sowesifazane ongazali: umbono wekomidi. Umanyolo Oyinyumba. 2015; 103 (6): e44-e50. I-PMID: 25936238 www.ncbi.nlm.nih.gov/pubmed/25936238.

Ikomidi Lokuzivocavoca le-American Society for Reproductive Medicine. Ukuhlolwa kokuhlonza owesilisa ongazali: umbono wekomidi. Umanyolo Oyinyumba. 2015; 103 (3): e18-e25. I-PMID: 25597249 www.ncbi.nlm.nih.gov/pubmed/25597249.