I-PMA (ukuzala okusizwa ngemithi) noma i-AMP (ukuzala okusizwa ngemithi) ibhekisela kuwo wonke amasu asetshenziselwa ukukhiqiza kabusha engxenyeni yaselabhorethri yezinqubo zemvelo zokuzala kanye nokukhula kombungu kusenesikhathi. Benza kube nokwenzeka ukunxephezela ukungabi nenzalo okusungulwe ngokwezokwelapha noma ukuvimbela ukudluliswa kwezifo ezithile ezinzima.

Isinyathelo sokuqala enkambisweni yokusiza yokukhiqiza kabusha ukwenza ukuhlolwa kokuzala ukuze kutholakale izimbangela ezingaba khona zokuzala kwabesilisa kanye / noma kwabesifazane.

Ezingeni labashadile, ukuhlolwa kwe-Hühner (noma ukuhlolwa kwe-post-coital) ukuhlolwa okuyisisekelo. Kuhlanganisa ukuthatha isikhwehlela somlomo wesibeletho emahoreni ayisi-6 kuya kwayi-12 ngemva kokuya ocansini ngesikhathi sokuvuthwa kwamaqanda nokuyihlaziya ukuze kuqinisekiswe izinga layo.

Kwabesifazane, ukuhlolwa okuyisisekelo kufaka:

• ijika lokushisa lokuhlaziya ubude besikhathi kanye nokujwayelekile komjikelezo kanye nokuba khona kwe-ovulation
• ukuhlolwa kwesifanekiso somtholampilo ukuze kutholwe noma yikuphi ukungahambi kahle kwepheshana lesitho sangasese
• ukuhlolwa kwe-hormonal ngokuhlolwa kwegazi ukuhlola ikhwalithi ye-ovulation
• ukuhlolwa kwe-imaging yezokwelapha ukubuka izitho zangasese ezahlukahlukene (isibeletho, amashubhu, amaqanda). I-Ultrasound ukuhlolwa kokuqala komugqa wokuqala, kepha kungangezelelwa ngamanye amasu (i-MRI, i-laparoscopy, i-hysteroscopy, i-hysterosalpingography, i-hysterosonography) yokuhlola kabanzi.
• ukuhlolwa komtholampilo ukuze kutholakale ukuthi kukhona i-varicocele, ama-cysts, ama-nodules nokunye okungavamile eziteshini ezihlukahlukene.
• ukuhlaziya isidoda: i-spermogram (ukuhlaziywa kwenombolo, ukuhamba nokubukeka kwesidoda), isiko lesidoda (sesha ukutheleleka) kanye nokufuduka kwesidoda nokuhlolwa kokusinda.

Okunye ukuhlolwa okufana ne-karyotype noma i-endometrial biopsy kungenziwa ezimweni ezithile.

Emadodeni, ukuhlolwa kokuzala kubandakanya:

 Ngokuya ngemiphumela, kungahlolwa okunye ukuhlolwa: ama-hormone assays, i-ultrasound, i-karyotype, ukuhlolwa kofuzo. 

Ngokuya ngembangela (s) yokungazali etholakele, izindlela ezihlukene zokuzala zizonikezwa umbhangqwana:

• ukugqugquzelwa okulula kwe-ovarian ukuze kutholwe i-ovulation yekhwalithi engcono
• Ukushutheka ngesidoda sikazakwethu (COI) kuhlanganisa ukujova isidoda esilungiselelwe ngaphambilini endaweni yesibeletho ngosuku lokuphuma kweqanda. Ngokuvamile kwandulelwa ukugqugquzelwa kwe-ovarian ukuze kutholwe ama-oocyte ekhwalithi. Inikezwa ezimeni zokungazali okungachazwanga, ukwehluleka kokugqugquzelwa kwe-ovarian, ingozi yegciwane, inzalo yowesifazane wesibeletho-i-ovulatory noma ukungazali kowesilisa okulingene.
• i-in vitro fertilization (IVF) ihlanganisa ukukhiqiza kabusha inqubo yokuvundisa epayipini lokuhlola. Ngemuva kokugqugquzelwa kwe-hormonal kanye nokuqala kwe-ovulation, ama-follicle amaningana ayabhobozwa. Ama-oocyte kanye ne-spermatozoa abe eselungiswa elabhorethri bese evundiswa esitsheni samasiko. Uma kuphumelele, umbungu owodwa kuya kwemibili ube usudluliselwa esibelethweni. I-IVF inikezwa ezimweni zokungazali okungaqondakali, ukwehluleka ukuzala, ukuzala okuxubile, iminyaka yobudala kamama, ukuvaleka kwamashubhu esibeletho, ukungahambi kahle kwesidoda.
• I-ICSI (umjovo we-intracytoplasmic) ihlukile ye-IVF. Umanyolo uphoqelelwa lapho: umqhele wamaseli azungeze i-oocyte uyasuswa ukuze ujovwe ngqo isidoda esikhethwe ngaphambilini ku-cytoplasm yeqanda. Ama-oocyte anemijovo emincane abe esefakwa esitsheni samasiko. Le nqubo inikezwa ezimweni ezinzima zokungazali kwabesilisa.

Lawa masu ahlukene angenziwa ngomnikelo wama-gametes.

• umnikelo wesidoda unganikezwa esimweni sokungazali kowesilisa esimweni sokufakelwa isidoda se-donor (IAD), IVF noma i-ICSI.
• Umnikelo we-oocyte unganikelwa uma kwenzeka ukwehluleka kwe-ovari, ukungajwayelekile kwikhwalithi noma ubungako bama-oocyte noma ingozi yokudluliswa kwezifo. Kudinga i-IVF.
• ukwamukela umbungu kuhlanganisa ukudlulisa umbungu owodwa noma ngaphezulu oqandisiwe kumbhangqwana ongasenayo iphrojekthi yabazali, kodwa abafisa ukunikela ngombungu wabo. Lo mnikelo ungacatshangelwa esimweni sokungazali okuphindwe kabili noma ingozi ephindwe kabili yokudluliselwa kwe-genetic anomaly.

E-France, ukukhiqizwa okusizwayo kulawulwa umthetho we-bioethics n ° 2011-814 kaJulayi 7, 2011 (1). Ibeka imigomo esemqoka elandelayo:

• I-AMP igcinelwe imibhangqwana eyakhiwe owesilisa nowesifazane, abaseminyakeni yokuzala, abashadile noma abakwazi ukufakazela ukuthi sebehlale ndawonye okungenani iminyaka emibili.
• Umnikelo we-gamete awaziwa futhi mahhala
• ukusetshenziswa "komama obambele" noma umnikelo we-gamete kabili akuvunyelwe.

Umshwalense Wezempilo ubandakanya ukuzala okusizwayo ngaphansi kwezimo ezithile:

• 
  owesifazane kufanele abe ngaphansi kweminyaka engama-43 ubudala;
• Ukufakwa kukhawulelwe ku-4 IVF kanye ne-6 inseminations. Esimeni sokuzalwa kwengane, lesi sibali sisethwa kabusha sibe nguziro.

E-Quebec, ukukhiqizwa okusizwayo kubuswa Umthetho Wombuso Wokuzala ka-20042 obeka lezi zimiso ezilandelayo.

• imibhangqwana engazali, abantu abangashadile, izitabane, izitabane noma abantu abashintshashintshayo bangazuza ngosizo lokuzala
• umnikelo we-gamete umahhala futhi akaziwa
• i-surrogacy ayibonwa ngekhodi yomphakathi. Umuntu obelethayo uba ngumama wengane ngokuzenzakalelayo futhi abafake izicelo kufanele balandele inqubo yokutholwa ukuze babe abazali abasemthethweni.

I-Quebec Assisted Procreation Programme, eyaqala ukusebenza ngo-August 2010, isichitshiyelwe kusukela ekutholweni, ngo-2015, umthetho wezempilo owaziwa ngokuthi uMthetho 20. Lo mthetho uqeda ukufinyelela kwamahhala ohlelweni lokusiza ukuzala futhi uluthatha esikhundleni salo. ngesistimu yekhredithi yentela yomndeni engenayo ephansi. Ukufinyelela kwamahhala manje kugcinwa kuphela lapho inzalo isengozini (isibonelo ukulandela ukwelapha ngamakhemikhali) kanye nokuzalanisa okuzenzela.