Ukukhulelwa okujwayelekile kwe-vitro

Uhlelo lokwelashwa kokukhulelwa kwe-in vitro ludinga ukuqokwa okuningi nochwepheshe, abalungiselela lo mbhangqwana inqubo. Lo mbhangqwana kufanele ufundiswe ngezinyathelo eziyinkimbinkimbi ezifanaumjovo wezidakamizwa ze-hormonal, izingozi kanye Okuqhamuka uma udla imishanguzo, kanye ne isikhathi sokulinda kuyadingeka. Imithi yokwelapha iyabiza.

EQuebec, kusukela ngo-2010, i-Régie de l'Assurance Maladie (i-RAMQ) isungule iQuebec Assisted Procreation Programme enikezela mahhala mahhala uhla oluphelele lwezinsizakalo ezibhekene nokungazali, kufaka phakathi nezindleko zemijikelezo emithathu evuselelwe⁹.

EFrance, Izilingo ezi-4 zokukhulelwa kwe-vitro zimbozwe ngokuphelele yi-Health Insurance.

1. Ukukhuthazwa kwamaqanda

Isinyathelo sokuqala ukunikeza owesifazane i-hormone therapy, imvamisa i-GnRH agonist (I-Gonadotropin Ikhulula iHormone) ukuphumuza amaqanda (bheka isigaba semithi), isibonelo iDecapeptyl®, iSuprefact®, i-Enantone® Synarel®, noma iLupron®.

Ngemuva kwalokho, ukwelashwa kuhlose ukukhulisa inani lama-follicles akhiqizwe yi- i-ovary futhi ulawule isikhathi se-ovulation. Owesifazane kufanele athole imijovo yama-gonadotropin ngomsebenzi we-FSH noma we-LH ukukhuthaza ama-follicles ukuba akhule futhi awavumele ukuthi akhiqize ama-oocyte amaningi. Lokhu ngokwesibonelo iPuregon®, Gonal F®, Fostimon® Metrodin-HP®, Bravelle®, Humegon® Ménopur® Merional® Repronex® Fertinex® Fertinorm®, Humegon® Ménopur® Merional® Repronex® Fertinex® Fertinorm®, Elonva®, I-Luvéris®…

Lapho ama-follicles esekhule ngokwanele futhi amazinga e-hormone enele, i-ovulation ibangelwa umjovo wehomoni HCG (I-human Chorionic Gonadotropin), ngokwesibonelo HCG endo 1500®, HCG endo 5000® (Fr), Pregnyl®, Choriomon®, Profasi-HP®, Chorex®, Novarel®, Ovitrelle® Ovidrel® ®

Ukuhlolwa kwe-pelvic ultrasound nokuhlolwa kwegazi kwenziwa esinyathelweni ngasinye ukuhlola ukukhula kwezintambo.

Akusekho follicles, amaqanda awasekho…

Amaqanda esifazane ngokuvamile akhiqiza futhi adedele iqanda elilodwa kuphela elivuthiwe ngomjikelezo ngamunye. Yize lokhu kwanele ekukhulelweni okujwayelekile, ukuze kuvundiswe ngempumelelo in vitro, kufanele kutholakale amaqanda asekhule ngokwengeziwe. Ngakho-ke kuyadingeka ukukhuthaza umsebenzi we-ovarian wesiguli ngokuqinile kunokujwayelekile. Izidakamizwa ezinikezwa ngesikhathi sokwelashwa kwe-in vitro zidala ukuthi ukuthuthukiswa kwezilonda eziningi zama-ovari, ngaleyo ndlela kwandiswe inani lamaqanda, ngaleyo ndlela kube namathuba okuthola umbungu ongafakwa.

2. Ukuqoqwa kwama-oocyte avuthiwe

Ngemuva kwamahora angama-32 kuye kwangama-36 okuvuselela ama-hormone, ama-oocyte avuthiwe aqoqwa kusetshenziswa ithubhu elincane nenaliti efakwa esithweni sangasese. Lokhu kungenelela kwenziwa ngaphansi kwe-anesthesia yendawo noma ejwayelekile ngokulawulwa kwe-ultrasound ngoba kungaba buhlungu kakhulu. Ama-oocyte abe esekhethwa elebhu.

Le isidoda siqoqwa emahoreni ambalwa ngaphambili (noma ancibilikiswe ngalo lolo suku), bese isidoda sehlukaniswe noketshezi lwendoda bese sigcinwa ku-37 ° C.

3. Ukuvundisa

Ngemuva kwamahora ambalwa kuvunyiwe, i-spermatozoa nama-oocyte kufakwa oxhumana nakho kuketshezi lwesiko amahora amaningana ekushiseni komzimba. I-motile spermatozoa iza ngokuzenzekelayo, ngaphandle kosizo lwangaphandle, lapho ixhumana ne-oocyte. Kepha yisidoda esisodwa kuphela esizovundisa lesi. Ngokuvamile, ngokwesilinganiso, Ama-oocyte angama-50% avundiswa.

Ama-oocyte avundisiwe (noma ama-zygotes) aqala ukwanda. Emahoreni angama-24, ama-zygote aba imibungu yamaseli amabili kuya kwayi-2.

4. Ukudluliswa kombungu

Ezinsukwini ezimbili kuya kweziyisihlanu emva kokukhulelwa, imibungu eyodwa noma emibili idluliselwa esibelethweni sowesifazane. Ukudluliswa kombungu kuyinqubo elula futhi engenabuhlungu eyenziwa nge-catheter ezacile futhi eguquguqukayo efakwa ngaphakathi kwisibeletho. Umbungu ufakwa ngaphakathi kwesibeletho futhi ukhulele lapho uze ufakwe.

Ngemuva kwalesi sinyathelo, owesifazane angaqala kabusha imisebenzi yakhe ejwayelekile.

Umbungu owodwa noma eminingi (ebizwa ngokuthi ama-supernumeraries) nayo ingagcinwa ngokubanda ukuze kuhlolwe kamuva.

Ngemuva kwalokho, udokotela anganikeza ukwelashwa ngamahomoni, kanye nemiyalo yokuhlolwa kokukhulelwa ukuze abone ukuthi ngabe i-IVF iphumelele yini.

Imijikelezo eminingi yokwelashwa kwesinye isikhathi iyadingeka ngaphambi kokuthi ukukhulelwa kuphumelele. Futhi ngeshwa, eminye imibhangqwana ayikhulelwa naphezu kwemizamo eminingi.

Iseluleko ngaphambi kwe-IVF: 

• Yeka ukubhema (owesilisa nowesifazane!), Ngoba kunciphisa kakhulu amathuba okukhulelwa.
• Ukuzivocavoca umzimba futhi ulwele isisindo esinempilo. Kuyasiza ukuzala okuhle.
• Kwabesifazane: thatha uvithamini B9 ngaphambi kokukhulelwa, ngoba lokhu kunciphisa ubungozi bokungalungi enganeni engakazalwa.
• Thola umkhuhlane (kungaholela ekuphuphumeni kwesisu).