Ukwelashwa kokungazali: Imibuzo eyi-9 Yokubuza Udokotela Wakho

-Delile

• Uyini umugqa wokuqala wokwelashwa kokuzala?
• Impilo ikuthinta kanjani ukuzala ngaphambi kokukhulelwa?
• Ukwelashwa kowesilisa nokuzala kwabesifazane
• Busebenza kanjani ubuchwepheshe bokuzala?
• Kuhlinzwa nini ukwelashwa kokuzala?
• Ziyini izingcuphe kumzali nasenganeni?
• Ayini amathuba okuba nezingane eziningi?
• Lithini izinga lokuphumelela lokwelashwa kokuzala?
• Ingabe kuthatha isikhathi esingakanani ukwelashwa kokuzala?
• Ukudla okudlela endlini

Ngenkathi ukukhulelwa kungabonakala njengomoya ovunguzayo kwabanye abantu, kwabanye kungaba yisikhathi esinzima kakhulu empilweni yabo. Ungahle ube nesihlobo esinezinhloso ezinhle esibuza ukuthi ungalizwa yini lelo washi lokuzalwa likhathaza, abangane abanabantwana, kanye nesifiso sokuthola nokuhlala ukhulelwe sithatha imicabango yakho.

Yize kunethuba elingamaphesenti angama-25 kumjikelezo wokuya esikhathini wokuthi owesifazane uzokhulelwa uma eseneminyaka engama-20 noma engama-30, akulula kanjalo kwabanye. Futhi kubo bobabili abesifazane nabesilisa, amathuba okukhulelwa ngokwemvelo ancipha ngokukhula.

Uma wena nomlingani wakho nibhekene nezinkinga zokuzala, kubalulekile ukwazi ezinye izisekelo mayelana nezinhlobo ezahlukahlukene zokwelashwa ukuze ukwazi ukuzuza kakhulu ekuqokweni kwakho nodokotela wakho.

Sebenzisa imibuzo elandelayo njengomhlahlandlela ongahamba nawo. Udokotela wakho angakunika izeluleko ezinhle kakhulu ngokuya ngezimo zakho.

Uyini umugqa wokuqala wokwelashwa kokuzala?

Ukuzwa igama elithi "ukungazali" kungalimaza kakhulu imibhangqwana eminingi. Kepha izindaba ezinhle ukuthi ukuthuthuka kwezokwelapha kukwenza kube nokwenzeka kakhulu ukuthi ekugcineni uzokwazi ukukhulelwa (noma uhlale) ngokungenelela, ngokuya ngesimo sakho esithile.

Imithi imvamisa iyindlela yokwelashwa komugqa wokuqala uma udokotela ekuxilonga ekutholile ukungabi nenzalo. Le mithi yenzelwe ukusiza ukwandisa amathuba okukhulelwa nokukhulelwa.

Zingeza ngesimo sokufakwa esikhundleni kwamahomoni ukukhuthaza i-ovulation kwabesifazane, noma imithi yokwelapha ukungasebenzi kahle kwe-erectile emadodeni.

Odokotela bayakwazi nokukunikeza imithi yokwandisa amathuba akho okuhlala ukhulelwe uma ukhulelwe, kuya ngezizathu zakho zokuphuphuma kwesisu kwangaphambilini.

Ngaphezu kwalokho, udokotela wakho angancoma ushintsho lwendlela yokuphila kubo bobabili abalingani, njengokudla ukudla okunempilo, ukunciphisa ukusetshenziswa kotshwala, noma ukuyeka ukubhema.

Impilo ikuthinta kanjani ukuzala ngaphambi kokukhulelwa?

Yize kuyiqiniso ukuthi ukuzala kungancipha ngeminyaka, kwesinye isikhathi lokhu kuhlobene nezimo zezempilo ezingakhula njengoba ukhula. Isibonelo, izimo ze-thyroid kwabesifazane zingathinta ukuzala. Ukutheleleka, umdlavuza, nokungondleki kahle kungathinta amathuba okuzala owesilisa nowesifazane.

Futhi, ukuphuza utshwala, ukubhema, nemithi ethile kungaphazamisa ukuzala. Hlola ukuthi uhlu lwakho lwemithi - kanye nozakwenu - luyahambisana yini nokuzama ukukhulelwa (i-TTC, njengoba kungenzeka ukuthi uyibonile ifushanisiwe ezinkundleni zokuxhumana).

Ngokufanelekile, wena nomlingani wakho nizofuna ukuba nempilo enhle ngaphambi ukukhulelwa. Lokhu akusizi kuphela ukwandisa amathuba okukhulelwa, kodwa impilo yabazali nayo ithinta ngqo impilo yengane.

Ukubuyekezwa kwezifundo zango-2019 kunqume ukuthi ukusetshenziswa kotshwala ngamadoda noma ezinyangeni eziyisithupha ngaphambi kokukhulelwa kungakhuphula ingozi yezifo zenhliziyo ezelwe enganeni. Ososayensi bancoma ukuthi abesifazane bayeke ukuphuza unyaka ngaphambi kwe-TTC.

Udokotela wakho uzokwenza izincomo ezithile ukukusiza ungene empilweni engcono kakhulu ekuhlolweni kwakho kwezokwelapha.

Ukwelashwa kowesilisa nokuzala kwabesifazane

Ngenkathi abesifazane kwesinye isikhathi bekhathazeka ukuthi bayimbangela yokungazali, akunakwenzeka ukwazi ngaphandle kokuhlolwa kwezokwelapha kubo bobabili abalingani. Udokotela anganquma ukuthi ukungabi nenzalo kowesilisa noma kwabesifazane (noma kokubili) kukugcina ungakhulelwa.

Ukubalwa kwesidoda okuphansi noma ukungakwazi ukuthola noma ukugcina ukwakhiwa ngesikhathi sokuya ocansini kungathinta ukuzala emadodeni. Kwezinye izimo, imithi yokungasebenzi kahle kwe-erectile ingasiza.Ukubalwa kwesidoda esiphansi noma ikhwalithi akusho ukuthi ukukhulelwa akukwazi ukwenzeka, kepha kungenza kube nzima kakhulu noma kungathatha isikhathi eside.

Abesifazane abathola ukungazali bangaduduzeka ngokuthi kunezindlela eziningi zokusiza ngobunzima be-ovulation, nokuyinto ejwayelekile yezinkinga zabesifazane zokungazali.

Abanye besifazane bamane badinga ukukhuthazwa ngokuvuthwa, noma ngokuvuthwa njalo. Udokotela wakho futhi angakunikeza ama-hormone anomthamo omkhulu, njenge-estrogen, ukusiza ukwenza i-ovulation.

Eminye imishanguzo enamandla kakhulu ifika ngendlela yokujova, inqubo ebizwa ngokuthi yi-ovarian hyperstimulation (COH).

Lokhu kungaphathwa nge-in vitro fertilization (IVF). Le nqubo ifaka ukuvundisa isidoda ngeqanda elabhorethri. Lapho inqubo yokufaka umquba isiqediwe, amaqanda adluliselwa esibelethweni sakho ngesikhathi sokuvuthwa.

IVF yisixazululo esihle kweminye imibhangqwana, kepha kungabonakala kungafinyeleleki kwabanye njengoba kungabiza kakhulu.

Enye indlela entsha futhi eshibhile ye-IVF ibizwa nge-INVOcell (IVC). Lokhu kuveze ukuthi "i-IVF ne-IVC kukhiqize ama-blastocyst afanayo okudluliswa okuholela emazingeni afanayo okuzalwa bukhoma."

Umehluko omkhulu phakathi kwalezi zinqubo ezimbili ukuthi nge-IVC, isitho sowesifazane sangasese sisetshenziswa njengesihlanganisi se-blastocyst (ingane yesikhathi esizayo) isikhathi sezinsuku ezinhlanu ngaphambi kokudluliselwa esibelethweni. Le nqubo ifaka imishanguzo emincane yokuzala kune-IVF, ngakho-ke iyithegi lentengo ephelele.

Busebenza kanjani ubuchwepheshe bokuzala?

Lapho imibhangqwana eyi-TTC icabanga ukwelashwa kokuzala, imvamisa icabanga ngemithi ne-IVF, kepha kunezinye izindlela ezingatholakala.

Ubuchwepheshe bokuzala obusizwayo (i-ART) igama lezindlela zokwelashwa ezibandakanya izinqubo namasu athuthuke kakhulu. Lokhu kufaka phakathi i-IVF. I-ART ifaka nokufakwa ngaphakathi kwe-intrauterine (IUI), uhlobo lwenqubo lapho isidoda sijojelwa khona ngqo esibelethweni ukuze sisize ukuvundisa amaqanda.

I-ART esizwa umuntu wesithathu enye inketho lapho imibhangqwana ingakhetha khona ukunikela ngeqanda, umbungu, noma iminikelo yesidoda. Isinqumo sokuthola iqanda, isidoda noma umbungu onikelwayo kungaba inqubo engokomzwelo, futhi udokotela wakho angakuholela ebuhleni nasebubini balesi sixazululo.

Umehluko omkhulu phakathi kwe-ART ne-COH ukuthi ukukhulelwa kwenzeka ngosizo lwelebhu ene-ART. I-COH ivumela ukukhulelwa emzimbeni ngaphandle kwesidingo sokuya ehhovisi likadokotela.

Kuhlinzwa nini ukwelashwa kokuzala?

Udokotela wakho angancoma ukuhlinzwa uma bethola izingqinamba ngezitho zakho zokuzala. Ukuhlinzwa kwesinye isikhathi kusetshenziselwa ukulungisa amashubhu adabukile noma avinjiwe ukuze iqanda likhishwe ngempumelelo futhi livundiswe.

Ukuhlinzwa kwabesifazane kokuzala kungasiza ekwelapheni:

• izibazi ezithweni zokuzala
• imicu yesibeletho
• i-endometriosis
• polyps

Emadodeni, izinketho zokuhlinza zingasetshenziselwa ukulungisa imithambo ye-varicose, ebizwa ngokuthi i-varicoceles, kumasende angasiza ekungazali kwamanye amadoda (yize amadoda amaningi analesi simo engenankinga nokuzala).

Kuze kube kwamadoda aba nama-varicoceles ezimpilweni zabo. Zenzeka kumaphesenti angama-35 amadoda anokuzala okuyinhloko.

Lokhu kubuyekezwa kocwaningo ngo-2012 kuphakamisa ukuthi ukuhlinzwa kwe-varicoceles kuthuthukisa ukungazali okungaqondakali - yize abacwaningi bethi kudingeka izifundo eziningi ezibika amazinga okuzalwa bukhoma noma amazinga okukhulelwa njengomphumela ohlosiwe.

Ukuhlinzwa kwesinye isikhathi kusetshenziselwa ukusiza ukuvula amashubhu adlulisela isidoda esithweni sangasese.

Ziyini izingcuphe kumzali nasenganeni?

Ngenkathi izinqubo eziningi zezokwelapha zinezinga elithile lobungozi, ubuchwepheshe buguquke kangangokuba izindlela eziningi zokwelashwa manje sezithathwa njengeziphephe kakhulu kubazali nakubantwana abasazoba khona.

Ukuhlinzwa kungabandakanya izingozi, njengokutheleleka, nokuhlinzwa kwabesifazane kungakhuphula nobungozi bokukhulelwa kwe-ectopic (isimo esibi kakhulu lapho iqanda nombungu olandelayo kukhula khona ngaphandle kwesibeletho sakho).

Buza udokotela wakho imibuzo eminingi njengoba kudingeka ukuze uqinisekise ukuthi uyazi futhi unethezekile nganoma iyiphi ingozi engaba khona ngaphambi kokuqala ukwelashwa.

Ososayensi bazama ukuthola ukuthi ukwelashwa kwenzalo kuletha noma yiziphi izinsongo empilweni yengane lapho izelwe. Enye yezingane ezinqunyiwe ezizalwe ngemuva kokudluliswa kombungu okuneqhwa zaba nengozi encane yomdlavuza wezingane. Kodwa-ke, lokhu kusebenza kuphela ekudlulisweni kombungu okufriziwe, hhayi ezinganeni ezizalwe ngemuva kwe-IVF noma ezinye izindlela zokwelapha.

Ezinye izingozi zingabekwa enganeni, lapho kungenzeka khona isisindo sokuzalwa esiphansi. Ngokusho kuka-a, kukhona nethuba eliphakeme lokuzalwa ngaphambi kwesikhathi lapho i-ART isetshenziselwa ukuzala. Ukuzalwa ngaphambi kwesikhathi kwenzeka lapho ingane yakho izalwa ngaphambi kokukhulelwa kwamasonto angama-37. Ingozi iphezulu kakhulu uma uphethe izingane eziningi.

Ayini amathuba okuba nezingane eziningi?

Imishanguzo ye-ART ingaveza ukukhulelwa okuningi ngasikhathi sinye. Ngenkathi amacala anjalo ehla, abacwaningi balinganisela ukuthi ngo-2011 cishe amaphesenti angama-35 amawele azalwa kanye namaphesenti angama-77 okuzalwa kathathu noma okuphezulu e-United States kubangelwe ukukhulelwa okusizwa yimithi yokwelapha inzalo.

Odokotela manje sebengakunciphisa lokhu ngokunciphisa inani lemibungu elidluliselwe esibelethweni ngasikhathi sinye.

Lithini izinga lokuphumelela lokwelashwa kokuzala?

Ngokwe-American Society for Reproductive Medicine, kuphakathi kwamaphesenti angama-85 kuya kwangu-90 amacala okuzala. Lezi yizindaba ezamukelekile emindenini eminingi efuna ukunqoba ukungabi nenzalo eMelika. Kepha ngaphandle kobudala nempilo, izinga lempumelelo lincike ohlotsheni lwezokwelapha olukhethayo.

Isibonelo, i-IUI ingaba nezinga lokuphumelela elingamaphesenti angama-20 lokukhulelwa uma kuqhathaniswa nezinga lempumelelo elingamaphesenti angama-50 kusuka kumnikelo wombungu. Udokotela wakho angakusiza ukukunikeza umbono ongcono ngamathuba akho ngamanye okuphumelela ngokuya ngemithi ehlukene.

Ingabe kuthatha isikhathi esingakanani ukwelashwa kokuzala?

Ngeshwa, ayikho impendulo eqondile lapha. Abanye abashadikazi baphumelela ngenyanga yokuqala bethola usizo lwezokwelapha, kanti abanye bazama iminyaka. Inqubo yokwelashwa kokuzala ingaba yinde futhi iyakhathaza, engakhuphula ukucindezeleka uma ngabe ubukade uzama ukukhulelwa.

Ukukusiza ukhethe izindlela zokwelashwa ezingcono kakhulu, udokotela wakho uzobuyekeza umlando wakho wezempilo futhi afune noma yiziphi izinkinga ezingaba khona zokuzala kini nobabili.

I-COH ingase izanywe ngaphambi kwe-ART, kuya ngemiphumela yophenyo lukadokotela wakho. Noma kuzanywa i-ART, kungathatha imizamo eminingi ngaphambi kokukhulelwa. Ngaphezu kwalokho, lokhu kwenziwa kanye ngenyanga, njengoba owesifazane ekhipha kanye kuphela esikhathini sezinsuku ezingama-28 ngokwesilinganiso.

Ukukhetha ukwelashwa kokuzala akuyona into elula, kepha udokotela wakho angakusiza ukuthi unqume inkambo efanelekile yomphumela ophumelele kakhulu ongaba khona.

Ukudla okudlela endlini

Kwabashadikazi abazama ukukhulelwa umntwana, amathemba amahle okuba nokukhulelwa okunempilo futhi ajabulele umlingo wokuba ngumzali.

Kuze kufike kubantu abayi-9 kwabangu-10 abathathwe njengabangenanzalo abangasizwa ngemithi yokwelapha inzalo. Yize ezinye izindlela zokwelapha zingabiza futhi zicindezele, futhi zibe nezingozi ezithile, kusafanele ukuqhuba ingxoxo nodokotela wakho mayelana nenkambo engcono yokwenza.

Ukungenelela kwezokwelapha sekuguqukile, futhi kungenye yezikhathi ezihamba phambili emlandweni ukuthola usizo ohambweni lokukhulelwa.