Mankhwala Osabereka: Mafunso 9 Omwe Mungafunse Dokotala Wanu

Zamkati

• Kodi njira yoyamba yothandizira osabereka ndi iti?
• Kodi thanzi limakhudza bwanji chonde musanabadwe?
• Mankhwala ochiritsira amuna ndi akazi
• Kodi ukadaulo wothandizira uchembere umagwira ntchito bwanji?
• Kodi opaleshoni imagwiritsidwa ntchito liti kuchipatala?
• Kodi chiopsezo kwa kholo ndi mwana ndi chiani?
• Kodi mwayi wokhala ndi ana angapo ndi uti?
• Kodi phindu la chithandizo cha chonde ndi chiyani?
• Kodi chithandizo chamankhwala chimatenga nthawi yayitali bwanji kuti chigwire ntchito?
• Tengera kwina

Ngakhale kutenga pakati kumawoneka ngati mphepo kwa anthu ena, kwa ena imatha kukhala nthawi yovuta kwambiri m'moyo wawo. Mutha kukhala ndi wachibale wokhala ndi cholinga chofunsa ngati mungamve kuti nthawi yotulutsayo ikukondera, abwenzi okhala ndi ana, ndikulakalaka kukhala ndi pakati ndikulanda malingaliro anu.

Ngakhale pali mwayi wapa 25% pamasamba kuti mayi atenge mimba ngati ali ndi zaka 20 kapena 30, sizovuta kwa ena. Ndipo kwa amayi ndi abambo, mwayi wokhala ndi pakati mwachilengedwe umachepa ndi msinkhu.

Ngati inu ndi mnzanu mukukumana ndi mavuto okhudzana ndi chonde, ndikofunikira kudziwa zina mwazosiyanasiyana zamankhwala kuti muthe kupindula ndi nthawi yomwe mwakumana ndi dokotala.

Gwiritsani ntchito mafunso otsatirawa ngati chitsogozo choti mutenge nawo. Dokotala wanu akhoza kukupatsani upangiri wabwino kwambiri kutengera momwe mumakhalira.

Kodi njira yoyamba yothandizira osabereka ndi iti?

Kumva mawu oti "kusabereka" kumatha kukhala kopweteka kwambiri kwa mabanja ambiri. Chosangalatsa ndichakuti kupita patsogolo kwamankhwala kumapangitsa kuti mukhale ndi mwayi wopeza (kapena kukhala) ndi pakati polowererapo, kutengera mkhalidwe wanu.

Mankhwala nthawi zambiri amakhala mankhwala oyamba ngati dokotala wakupezani kuti mulibe chonde. Mankhwalawa adapangidwa kuti athandizire kukulitsa mwayi wokhala ndi pakati komanso kutenga pakati.

Amatha kubwera ngati mawonekedwe amalo amtundu wa mahomoni kuti athandize ovulation mwa akazi, kapena mankhwala othandizira kuthana ndi erectile mwa amuna.

Madokotala amathanso kukupatsani mankhwala kuti akuchulukitsireni mwayi wokhala ndi pakati mukadzakhala ndi pakati, kutengera zifukwa zomwe munapangidwira kale.

Kuphatikiza apo, dokotala wanu angakulimbikitseni kusintha kwa moyo wa onse awiri, monga kudya chakudya chopatsa thanzi, kuchepetsa kumwa mowa, kapena kusiya kusuta.

Kodi thanzi limakhudza bwanji chonde musanabadwe?

Ngakhale zili zowona kuti kubereka kumatha kuchepa ndi ukalamba, nthawi zina izi zimakhudzana ndi thanzi lomwe lingakule mukamakula. Mwachitsanzo, momwe chithokomiro mwa amayi chimakhudzira chonde. Matenda, khansa, komanso kusowa zakudya m'thupi zimatha kukhudza mwayi wobereka.

Komanso kumwa mowa, kusuta fodya, komanso mankhwala ena amatha kusokoneza chonde. Onetsetsani ngati mndandanda wamankhwala anu - komanso wa mnzanu - ukugwirizana ndi kuyesa kutenga pakati (TTC, monga mwina mwawonapo chidule m'mabwalo ochezera).

Momwemo, inu ndi mnzanu mudzafuna kukhala ndi thanzi labwino kale kutenga pakati. Izi sizimangothandiza kuwonjezera mwayi wokhala ndi pakati, koma thanzi la makolo limakhudzanso thanzi la mwanayo.

Kuwunikanso kwa 2019 kwamaphunziro kumatsimikizira kuti kumwa mowa mwa amuna ngakhale miyezi isanu ndi umodzi asanatenge pathupi kumatha kuonjezera chiopsezo cha matenda obadwa nawo amtima mwa mwana. Asayansi amalimbikitsa kuti amayi asiye kumwa mowa chaka chimodzi TTC isanachitike.

Dokotala wanu apanga malingaliro apadera kuti akuthandizeni kukhala ndi thanzi labwino kwambiri mukamayesedwa kuchipatala.

Mankhwala ochiritsira amuna ndi akazi

Ngakhale azimayi nthawi zina amakhala ndi nkhawa kuti ndiomwe amayambitsa kusabereka, ndizosatheka kudziwa popanda kuwunika kwa anzawo onse awiri. Dokotala amatha kudziwa ngati kusabereka kwa amuna kapena akazi (kapena onse awiri) kukulepheretsani kutenga pakati.

Kuchuluka kwa umuna kapena kulephera kupeza kapena kusunga erection panthawi yogonana kumatha kukhudza chonde mwa amuna. Nthawi zina, mankhwala osokoneza bongo a erectile amatha kuthandiza. Kuchuluka kwa umuna kapena mtundu waubweya sizitanthauza kuti mimba siyingachitike, koma itha kuipangitsa kukhala yovuta kwambiri kapena itha kutenga nthawi yayitali.

Amayi omwe akukumana ndi kusabereka amatha kulimbikitsidwa podziwa kuti pali njira zingapo zothandizira pamavuto ovulation, zomwe zimakonda kuchititsa kuti amayi azikhala osabereka.

Amayi ena amangofunikira kulimbikitsidwa ndi ovulating, kapena ovulating pafupipafupi. Dokotala wanu amathanso kukupatsani mahomoni amtundu wambiri, monga estrogen, kuti athandizire ovulation.

Mankhwala ena amphamvu amabwera ngati jakisoni, njira yomwe imadziwika kuti ovarian hyperstimulation (COH).

Izi zitha kuthandizidwa ndi in-vitro feteleza (IVF). Izi zimaphatikizapo kuthira umuna ndi dzira labu. Njira yolumikizira ikamalizidwa, dzira limasamutsira m'chiberekero chanu nthawi yovundikira.

IVF ndi yankho labwino kwa mabanja ena, koma zitha kuwoneka ngati zosatheka kwa ena chifukwa zitha kukhala zotsika mtengo.

Njira yatsopano komanso yotsika mtengo ya IVF imatchedwa INVOcell (IVC). Izi zidawulula kuti "IVF ndi IVC zidatulutsa ma blastocyst ofanana kuti amasamuke zomwe zimabweretsa kubadwa komweko."

Kusiyanitsa kwakukulu pakati pa njira ziwirizi ndikuti ndi IVC, nyini imagwiritsidwa ntchito ngati chofungatira cha blastocyst (mwana wamtsogolo) kwa masiku asanu asadatumizidwe m'chiberekero. Njirayi imaphatikizapo mankhwala ochepa obereka kuposa IVF, chifukwa chake ndi mtengo wotsika kwambiri.

Kodi ukadaulo wothandizira uchembere umagwira ntchito bwanji?

Maanja omwe ali TTC amalingalira za chithandizo chamankhwala, nthawi zambiri amangoganiza zamankhwala ndi IVF, koma pali njira zina zomwe zingapezeke.

Tekinoloje yothandizira kubereka (ART) ndi dzina la chithandizo chamankhwala chomwe chimakhudza njira ndi njira zapamwamba kwambiri. Izi zikuphatikizapo IVF. ART imaphatikizaponso intrauterine insemination (IUI), mtundu wa njira yomwe umuna umalowetsedwa mwachindunji m'chiberekero kuti zithandizire mazira.

ART yothandizidwa ndi anthu ena ndi njira ina yomwe maanja angasankhe kupereka mazira, mluza, kapena zopereka za umuna. Chisankho chopeza dzira, umuna kapena mluza woperekedwa chingakhale chosangalatsa, ndipo adotolo angakutsogolereni pazabwino ndi zoyipa za yankho ili.

Kusiyana kwakukulu pakati pa ART ndi COH ndikuti kutenga pakati kumachitika mothandizidwa ndi labotale yokhala ndi ART. COH imalola kutenga pakati mthupi popanda kufunika kopita kuofesi ya adotolo.

Kodi opaleshoni imagwiritsidwa ntchito liti kuchipatala?

Dokotala wanu angakulimbikitseni kuchitidwa opaleshoni ngati akupeza zovuta ndi ziwalo zanu zoberekera. Nthawi zina opaleshoni imagwiritsidwa ntchito pokonza timachubu tomwe tang'ambika kapena kutsekeka kuti dzira limasulidwe bwino ndikubereka mbeu.

Kuchita maopareshoni achikazi kumathandizanso kuchiza:

• zipsera m'magazi oberekera
• chiberekero cha fibroids
• endometriosis
• tizilombo tating'onoting'ono

Mwa amuna, njira zopangira opaleshoni zitha kugwiritsidwa ntchito kukonza mitsempha ya varicose, yotchedwa varicoceles, m'matumbo omwe amatha kupangitsa kuti amuna ena asabereke (ngakhale amuna ambiri omwe ali ndi vutoli alibe vuto ndi chonde).

Mpaka kwa amuna amakumana ndi ma varicoceles m'miyoyo yawo. Amapezeka mwa 35 peresenti ya amuna omwe ali ndi vuto lakubereka.

Kuwunika kumeneku mu 2012 kukuwonetsa kuti opaleshoni ya varicoceles imathandizira kusabereka kosafotokozedwa - ngakhale ofufuza akuwonetsa kuti pakufunika maphunziro ena omwe amafotokoza za kubadwa kwa mwana kapena pakati pathupi monga zotsatira zake.

Opaleshoni nthawi zina imagwiritsidwanso ntchito kuthandizira kutsegula machubu omwe amatumiza umuna ku mbolo.

Kodi chiopsezo kwa kholo ndi mwana ndi chiani?

Ngakhale njira zambiri zamankhwala zimakhala zoopsa pang'ono, ukadaulo wasintha kotero kuti njira zambiri zothandizira kubereka tsopano zimawoneka ngati zotetezeka kwa makolo ndi kwa omwe adzakhale nawo.

Kuchita opaleshoni kumatha kukhala ndi zoopsa, monga matenda, komanso opaleshoni yamankhwala azimayi amathanso kuonjezera chiopsezo cha ectopic pregnancy (vuto lalikulu lomwe dzira ndi mwana wosabadwa amakula kunja kwa chiberekero chanu).

Funsani dokotala mafunso ambiri omwe akufunikira kuti muwonetsetse kuti mukudziwa komanso kukhala omasuka ndi chiopsezo chilichonse musanayambe mankhwala.

Asayansi akuyesera kudziwa ngati chithandizo cha kubereka chingayambitse thanzi la mwana akabadwa. Mwana wakhanda wobadwa pambuyo poti mazira asungunuka amakhala pachiwopsezo chochepa cha khansa yaubwana. Komabe, izi zimangogwiritsidwa ntchito posamutsa mwana wosazizira, osati kwa ana obadwa pambuyo pa IVF kapena chithandizo china.

Zowopsa zina zimatha kupezeka kwa mwana, pomwe kulemera kotsika ndikotheka. Malinga ndi a, palinso mwayi wapamwamba wobadwa msanga pomwe ma ART amagwiritsidwa ntchito ngati chonde. Kubadwa msanga kumachitika mwana wanu akangobadwa asanakwanitse kutenga milungu 37. Chiwopsezo chimakhala chachikulu kwambiri ngati mukunyamula ana angapo.

Kodi mwayi wokhala ndi ana angapo ndi uti?

Mankhwala a ART amatha kupanga mimba zingapo nthawi imodzi. Ngakhale milandu yotereyi ikuchepa, ofufuza akuganiza kuti pofika chaka cha 2011 pafupifupi 35% yamapasa obadwa ndi 77% ya ana amapasa atatu kapena apamwamba ku United States adachokera pamimba pothandizidwa ndi chithandizo chamankhwala.

Madokotala tsopano atha kuchepetsa izi poletsa kuchuluka kwa mazira omwe amasamutsira m'chiberekero nthawi imodzi.

Kodi phindu la chithandizo cha chonde ndi chiyani?

Malinga ndi American Society for Reproductive Medicine, pakati pa 85 ndi 90 peresenti ya matenda osabereka amatha kuchiritsidwa. Iyi ndi nkhani yabwino kwa mabanja ambiri omwe akufuna kuthana ndi kusabereka ku America. Koma kupatula zaka ndi thanzi, kuchuluka kwakudaliranso kumadalira mtundu wa mankhwala omwe mungasankhe.

Mwachitsanzo, IUI itha kukhala ndi gawo lokwanira 20 peresenti poyembekezera poyerekeza ndi 50% yopambana pamitengo ya kamwana. Dokotala wanu akhoza kukuthandizani kuti mudziwe bwino za mwayi wanu wopambana malinga ndi mankhwala osiyanasiyana.

Kodi chithandizo chamankhwala chimatenga nthawi yayitali bwanji kuti chigwire ntchito?

Tsoka ilo, palibe yankho lolunjika apa. Mabanja ena amachita bwino mwezi woyamba kulandira chithandizo chamankhwala, pomwe ena amayesa kwa zaka. Njira yothandizira anthu kubereka imatha kukhala yayitali komanso yotopetsa, yomwe imatha kukulitsa nkhawa ngati mwakhala mukuyesera kutenga pakati.

Pofuna kukuthandizani kusankha njira zabwino kwambiri zochiritsira, adotolo adzawunikanso mbiri yanu yaumoyo ndikuyang'ana zovuta zilizonse zoberekera mwa inu ndi mnzanu.

COH ikhoza kuyesedwa pamaso pa ART, kutengera zotsatira za kafukufuku wa dokotala wanu. Ngakhale ART ikuyesedwa, imatha kutenga mayesero angapo mimba isanachitike. Kuphatikiza apo, izi zimachitika kamodzi pamwezi, chifukwa wamkazi amatulutsa kamodzi masiku 28 tsiku lililonse.

Kusankha chithandizo chamankhwala si ntchito yophweka, koma dokotala akhoza kukuthandizani kudziwa njira yoyenera yopezera zotsatira zabwino.

Tengera kwina

Kwa mabanja omwe akuyesera kutenga pakati, chiyembekezo ndi chabwino chokhala ndi pakati komanso kusangalala ndi matsenga oti mukhale kholo.

Kufikira anthu 9 mwa 10 omwe awonedwa kuti ndi osabereka atha kuthandizidwa ndi chithandizo chamankhwala. Ngakhale mankhwala ena atha kukhala okwera mtengo komanso opanikizika, komanso kukhala ndi zoopsa zina, ndibwino kupitiliza kukambirana ndi dokotala za njira yabwino kwambiri.

Njira zamankhwala zasintha, ndipo ndi nthawi yabwino kwambiri m'mbiri kulandira thandizo paulendo wobereka.