Zvokufunga nezvazvo
Kusarudza imwe yembramu kuendesa (eSET) ndeyekuti unenge uine huwandu hwakanaka hwehutachiona huri muhutano hweVIV asi sarudza kutumira imwe chete kumubereki. Mamwe mazai akasara anogona kudonhedzwa , akazununguswa, ndokuendeswa mukutevera-up. Mukurwara kwakanaka kwevarwere, eSET inogona kuderedza dambudziko rekuzvitakura kakawanda asi kwete kunyanya kuderedza maitiro ekubudirira.
Zvisinei, kusarudza pamusana pekuberekwa kwemukomana hakusi nyore. IVF mishonga inodhura . Kushandura mashoma embryo kunogona kutungamirira kune zvinonetsa kuti mhirizhonga isingashandisi, iyo inogona kureva mamwe maitiro, chikwereti chikuru, nekuwedzera kutya kwekukundikana. Inogonawo kuedza kutarisira kubata mapatya , zvichida "kupedzisa" mhuri yako mune imwe nzira.
Kuenda kune imwe mubereki kusina kukodzera kune varwere vose. Kune avo vanobvumirwa, kune zvikonzero zvakanaka kwazvo zvekufungisisa zvakanyanya. ICDC neAmerican Society yeRecductive Medicine (ASRM) vanotarisira iwe. Heino chikonzero.
Mubvunzo Wokuti Mafuro Akawanda Anodhonza Sei?
Chinangwa chokurapa ndeye mwana ane utano, imwe panguva. Ichi ndicho chiitiko chakanaka kune amai nevana. Iwe unogona kufungidzira izvo zvinoreva chete embryo imwe inofanira kuendeswa kumativi ose, pasinei nemamiriro acho ezvinhu, asi haisi nyore. Chero bedzi nokuti une mwana mucheche, izvo hazvirevi kuti uchawana pamuviri.
Izvi zvinonyanya kuitika apo mazai aya haasi "akakwirira" uye mumadzimai ane makore 37 kana kupfuura .
Iyo yekutanga yeVIV yakagadzirirwa mwana yakanga isina kuberekwa. Asi iyi yakanga isiri iyo protocol inowanikwa mumakore ekutanga. Rubatsiro rwekuberekwa kwekombiki rwakanga ruchiri kuwedzera, uye mikana yekuve nepamuviri kubudirira nemumwechete embryo kuendesa yakanga yakaderera.
Izvi zvaireva kuti vanachiremba vaiwanzoendesa mazai matatu uye kunyange mana panguva imwe. Tariro iri kuti munhu aizoramba "akasungirira."
Kunyange zvazvo kuendesa huwandu hwemasvosve hwakakonzerwa nehuwandu hwakakonzerwa nekuita pamuviri, hwakatungamirirawo kune hutatu uye huwandu hwakawanda huwandu hwekuita pamuviri apo vamwe kana mazamu ose akaendeswa "vakatora." Sezvo teknolojia yakagadziriswa, yakabva yakwanisika kutumira "chete" embryos maviri muhutano hwakanaka hwevarwere uye vachiri kuwana hutano hwakanaka hwekuzvitakura. Iyo inozivikanwa sekudzivirirwa kwemaviri embryo (DET), ichi chakava chinowanzosarudzwa chisarudzo chakasarudzwa navanachiremba nevarwere.
Kunyange zvakadaro, kutengesa kwemaviri embryo kunoreva kuti maitiro ekuwana mimba mapatya akanga akakwirira, kunyanya kune avo vaiva nemukana wakanaka wokubudirira. VIV varwere vanowanikwa makumi maviri nemakumi maviri emikana yekuwana mimba mapatya kune vanhu vakawanda. Mumakore gumi adarika, IVF yakasvika pamwe nekuwedzera mukubudirira kwayo uye kukwanisa kusarudza mazai akanaka. Izvi zvakakonzera kusundira kukurudzira kushandiswa kwemukomana kamwechete.
Ikoko kune mamiriro ezvinhu apo kutumira maviri maviri, matatu, uye kunyange mazai mana chisarudzo chakanaka. Kune vakadzi vanopfuura makore makumi mana nemasikirwo akanaka ane urombo, izvi zvinonyanya kuitika. Asi chisarudzo ichi hachifaniri kuiswa pachena.
Uri Mudiwa Akanaka weSET?
Kana zvakakodzera, American Society for Reproductive Medicine inokurudzira vanachiremba nevarwere kusarudza kusarudzwa kwemashure embryo.
Vakagadzira kutsvakurudza-based guidelines kuti vabatsire nyanzvi dzekubereka dzichasarudza kana iri sarudzo yakarurama.
Kusarudza imwechete embryo kuendesa kunogona kunge iri sarudzo yakakodzera kwauri kana ...
Kurongeka kwako kunobereka zvinopfuura imwechete yakanaka yembryo . Zvechokwadi, kana iwe ukangotora mucheche mumwe chete kuti uende, haugoni kusarudza imwe yemubereki kutama. Iwe unongova nechimwe chete chokutumira.
Zvisinei, munyaya iyi, izvo zvavanoreva ndezvokuti kune imwe yakakwirira yepamusoro embryo yakaguma panguva yekugadzirwa kwehuwandu hweVF. Kuwana zvinopfuura imwechete yepamusoro embryo chiratidzo chiratidzo chako chakanaka chakanaka.
Icho chinoreva zvakare kuti iwe unofanira kuva nekamwe kana mamwe mazai kuti aite cryopreserve (kana kupisa).
Izvi zvinokonzerwa nemakumbo anokwanisa kunyoreswa uye kutamirwa panguva inotevera, kana iri inotevera (kana pamuviri hazviitiki panguva ino) kana munguva yemberi (apo uchiedza mumwe mwana).
Iwe uri nemakore makumi matatu kana makumi matatu . IVF kubudirira kwamazinga yakakwirira kune vakadzi vane makore makumi matatu nemashanu kana vaduku, kazhinji vachitaura. Zvechokwadi, zvichienderana nechinokonzerwa nekushaya vana, izvi hazvisi nguva dzose. Chiremba wako anogona kukupa humwe hutungamiri pamusoro pekuti mamiriro ako akasiyana.
Iwe uri kushandisa mazai ekupa . Mupi weiyo IVF anopa zvakanakisisa zvibereko zvekuberekwa zviripo zvekurapa. Ichi ndechokuti vanopa mazai vakanyatsosarudzwa. Mazai anopa IVF ane mukana wakanaka wekutungamirira pamuviri kune chirevo chakanakisisa chechirwere cheVIV chinoshandisa mazai ake.
Iwe une rimwe kana mamwe mazamu emvura, zvisinei kuti uri nemakore mangani. Chirwere chinoputika chine nhamba chaiyo yechromosomes. Iza ine utano uye hupenyu hune hupenyu humwe hunoita ma 23 chromosomes, zvichiita kuti pave nemakromosomes makumi mana (kana kupatsanurwa kwemajeri kuchienda zvakanaka).
Mucheche ane nhamba isiri yema chromosomes inonzi aneuploidy. Kuparadzana kunowanzoitika apo mucheche ane aneuploidy. Downs syndrome inokonzerwa nenhamba dzisina kukwana dzekromosomes.
Vakadzi vanopfuura makore makumi matatu nemaviri vashoma kuti vawane IVF kubudirira, asi izvi zvinonyanya kukonzerwa nekusaita kwechromosomal. Zvisinei, kuburikidza nekuongorora, kana mukadzi ane makore makumi matatu nemaviri anowanikwa ane mazamu euploid, chirevo chekubudirira chiripamusoro. Kuenda kune imwe mubereki kune imwe nzira inogona kushandiswa, kunyange zvazvo makore avo angave akave asina kuvadzivisa.
Kusarudza Yakanakisisa Embryo
Kuendeswa kwemashure embryo kunosarudzwa kana uine huwandu hunopfuura embryo. Asi chiremba wako anogadzirisa sei kana mucheche "unhu hwakanaka?"
Kune dzimwe mbiri nzira huru:
- kutarisa pane morphology (kana chimiro) chemu embryo
- kuita Comprehensive Chromosome Screening (CCS) ye embryo
Kwenguva refu, kutarisa mazai aiva emhando yakakwirira yainyanya kuitwa nekucherechedza morphology yekukura mumbryo mubazi. Iyi nzira ine zvikanganiso zvayo. Imbuyo inogona kutarisa huru pasi pe microscope asi ichiri chromosomally isina kujairika. Izvo zvinogona zvakare kuti mucheche uone "zvishoma pane zvakakwana" uye uve chromosomally yakanaka.
Iyi ichiri nzira yekutanga yekugadzira ma embrusi ayo akakwirira uye izvo zvisiri. Inowanikwa nehutano hweVF.
Zvisinei, imwe nzira yakarurama yakasarudzwa yekusarudza yakakura yembrush yakakwana ine Comprehensive Chromosome Screening, kana CCS. Iyi inyanzvi yekuongorora zvigadzirwa zvemagetsi inobvumira mudzidzisi kuti averenge ma kromosomes ose (uye ona kana embryo iripo). CSS inogonawo kukuudza mazita ehutano hwemazwi embryo. CSS haisi yakazara sepakutangarirwa kwema-genetic diagnosis / screening (PGD / PGS), asi nekuda kweizvi, haifaniri kuva.
CCS haisipo pane imwe kliniki yekubereka. Uyezve, zvinoreva kuwedzera mari yekuwedzera kurapwa kweVF. Izvozvo zvakati, CSS yakaongororwa mazai anowanzoita kuti ave nepamuviri, zvisingaiti kuguma mukupererwa pamuviri, uye inogona kukubatsira kusarudza imwe yembramu kuendesa nekutenda kwakanyanya.
CSS kuedza kune njodzi uye hazvina kunaka kune munhu wose. Ichi chinhu chinokurukura nachiremba wako.
Iwe Unogona Zvishoma Here Kuwana Mucheche neSET?
Uyu ndiwo mubvunzo wemamiriyoni. Mhinduro ndeyekuti yakaoma ... asi ichivimbisa.
Kana iwe uchifananidza imwe sarudzo imwe yemukomana yekufambisa kuenda kune imwe yepamusoro inonzi embbryo kuenderera mberi, kliniki yekubata pamuviri yakakwirira yepamusoro pekudzivirirwa kwemukati embryo. Zvisinei, kuenzanisa kusina kururama.
Chienzanidzo chakakosha ndechokuenzanisa kutora kwekuita kwechimwe chepachiviri chekuberekwa kwemuviri kutama kusvika kune maviri asina kuberekwa kutenderera maitiro. Mune mamwe mazwi, pamwe chete nemumbryo kuendesa maitiro, imwe inenge iri mutsva mutsva uye, kana izvozvo zvisingabvi pakuberekwa, eSET yechipiri yaizoitwa uchishandiswa kuberekwa kwechirwere kubva kune yakapfuura mutsva.
Apo mimba yemukomana inofananidzwa seyizvi, mhinduro yacho yakasiyana zvikuru.
Mukuongorora kwemasvondo gumi nemana, izvo zvaisanganisira vakadzi vanodarika 2 000, vatsvakurudzi vakawana kuti kaviri kuwedzerwa kubudirira kwehuwandu hwekubudirira kwakanga kusiri zvakasiyana nekusarudza imwe yembramu kuwedzerwa kwehuwandu pawakatarisa vaviri kusvika matatu musati mava embryo maitiro pamwe chete. Chidzidzo chacho chakawana kuti kana kukanganisa kwekuberekwa kwakararama kwaive makumi mana kubva muzana nekodzero yekufambisa embryo, iyo inenge iri pakati pe30 ne42 muzana uye inodzokorora kushandiswa kwema embryo.
Vatsvakurudzi vakawana zvakare kuti avo vaive nekudhinda kwemaviri embryo vaiva 15 muzana vanogona kuva nepamuviri yakawanda, vachienzanisa pakati pe1 ne4 muzana zvinopesana nemusana wekuberekwa kwemukomana. Izvi zvidzidzo, zvisinei, zvakatongesa mazamu ehutano akavakirwa pane morphology. Chii chinoitika apo CSS genetic kuongorora kunoshandiswa? Maitiro ekubudirira anotarisa zviri nani.
Muchidzidzo chakasiyana, mararamiro ekuberekwa ari kurarama akatarisa, achienzanisa kusarudzwa kwemajeri embryo kuendesa (kuongororwa achishandiswa CSS) kuti isabatanidzwe kaviri kuwedzerwa kwema embbryo. Kusiyana nechidzidzo chepamusoro, maitiro akaenzaniswa mumwechete. (Mune mamwe mazwi, rimwe denderedzwa nechisarudzo chimwechete chinonzi embryo cycle kana ichienzaniswa neyemuviri wekudzivirirwa kwechimbaridzo.)
Vakaona kuti kubudirira kwehuwandu kwakanga kusiri kwakasiyana zvikuru. Vakatorawo kuti njodzi yekuzvarwa yakawanda yakanyanya kuderera (0 muzana yakaenzaniswa ne48 muzana) neCSS yakarongedzwa isina kuvharwa kwema embryo, uye njodzi dzezvinetso zvakadai sokutanga kwekuberekwa, kuberekwa kwechiremu, uye nguva muNICU yakanga yakasiyana zvikuru.
Imwe yemumbryo yekuendesa vana vakange vari hafu yenguva inogona kuberekwa zvakanyanya kare, chechitatu chekuita sechepasi-kuberekwa uremu, uye zvishoma kudarika hafu inogona kupedza nguva muchikwata chekuchengetedza zvakanyanya pakuberekwa.
Asi Hasi Mapatya Anogona Kuva Akanakisisa Kupfuura 1 Mwana Chete Here?
Kana vakabvunzwa navanachiremba kana vachida kugadzirira kutora mwana ari oga, kuti varege kubata pamuviri mapatya, vazhinji vakaroorana vanobvunza kuti nei vasingadi mapatya sechisarudzo chavo chikuru. Pashure pemakore ekuedza kuve nemuviri, uye mari yemutoro wekuongororwa uye kurapwa, tarisiro yekuwana vana vaviri mumuedzo mumwe chete inonzwika zvakakwana.
Asi hazvisi. Mapatya anouya ane ngozi kune amai nevana vasina kuberekwa .
Kubata pamuviri uye kuberekwa kunowanzoita kuti:
- ruzivo rwekuzvitakura kunetseka
- berekwa kuburikidza neC-chikamu
- uzvarirwe nguva isati yakwana
- unoberekwa pakuberekwa kunorema
- shandisa nguva muNICU, kana kuti mucheche unoberekwa
Kurera nekutarisira mapatya kunogonawo kuoma. Vabereki vemapatya vanogona:
- vane dambudziko rakawanda rokuyamwisa
- kutarisana nekuneta mupfungwa uye mupfungwa mumakore ekutanga
- vane mari yakakwirira yekuchengetedza (haisi "mbiri kune imwe chete")
Kuva nemwana mumwe pane imwe nguva ndiyo nzira yakanakisisa.
Zvakadini Nezvinodhura Zvokurapa Zvokudya?
Chimwe chikonzero vanhu vanobatana nekushaya vana vanogona kunge vasingadi kusarudza kuberekwa kwevana vasina kuberekwa ndiyo mari yezvokurapa . Munyika umo IVF yakafukidzwa nehutano inshuwarheni, mukana wekusarudza imwe embryo kuendeswa kune yakakwirira zvikuru.
Heano zvimwe zvinhu zvekuchengetedza mupfungwa:
- Izvo zvinodhura zvekudzivirira imwe embryo kutengesa uye yechipiri kupera ne thawed, cryopreserved embryo haisi yakangofanana neyese, yakazara IVF maitiro. Iyo embryo-kutengesa-chete inenge yakadhura.
- Kunyange kana iwe ukachengetedza mari pane mamwe maitiro eVF, mapatya angadhura. Iwe haungagoni kuchengetedza mari munguva yakareba.
- Mamwe makiriniki anopa zvipo zvemari kukurudzira vakaroorana kuti vasarudze sarudzo imwechete yekutengesa kuberekwa, kusanganisira mapurogiramu ekubhadhara mari uye zviduku. Bvunza kliniki yako zvavanogona kukuitira.
- Kuenda kwemashure embryo neCSS kuongorora kunodhura, asi iwe hauna kukanganisa uye unogona kuva nepamuviri hwakanaka nekuberekwa.
Shoko Rinobva Kunyanya
Chisarudzo chekusarudza kusarudzwa kwekuberekwa kwemukomana kunofanira kuitwa pamwe chete nechirongwa chechiremba wako, uye funga nezvehutano hwako, mari, uye kubereka.
Mamwe emashoko anodiwa kugadzirisa haazovipo kusvika pakati peVIVF, shure kwekucheka kweii nekugadzira. Kusvikira kliniki yako yakaratidza kuti une mazai ane utano akakodzera kubhadharwa kuberekwa, iwe haugoni kuziva kana zvakakunakira iwe.
Hapana chisarudzo "chakaipa" pano. Mababa maviri anogona kuva mugumisiro wakanaka. Nepo kune njodzi, njodzi haisi chivimbo. Ichokwadi, IVF inobereka mapatya haisi pangozi yakawanda-inokonzerwa nezvinetso kupfuura maruva akazvarirwa nemapatya, zvichida nekuda kwekuwedzera kurapwa kwakapiwa kuvata pamuviri weVIV.
Zvisinei, kuita chisarudzo ichi nokukurumidza hakurudzirwi. Kurukurai mukana wekusarudza imwe embryo kuendesa nemumwe wako uye chiremba usati watanga IVF. Nenzira iyi, haungamanikidzi kusarudza kana dambudziko rakanyanya uye iwe uri pasi pedambudziko rekurapa .
> Sources:
> Kusarudza Single-Embryo Kudzingwa . Komiti Yedzimiro yeSosaiti Yekubatsira Kunobatsira Kubudirira Kwekombiki uye Komiti Yedzidzo yeAmerican Society yeRecductive Medicine.
> Forman, Eric J .; Scott Jr., Richard T. "Euploid Single-Embryo Transfer: IWIV Paradigm?" Contemporary OB / GYN . July 1, 2014.
> Kuohung, Wendy; Ginsburg, Elizabeth S; Racowsky, Catherine. "Nzira dzekugadzirisa huwandu hwehutano hwakanaka huwandu hwemasikana. "UptoDate.com.
> Pandian Z1, Marjoribanks J, Ozturk O, Serour G, Bhattacharya S. "Nhamba yemambrus ekutsvaga mushure mokuraira in vitro fertilization kana intra-cytoplasmic chirwere chemuviri. "Cochrane Database Syst Rev. 2013 Jul 29; (7): CD003416. doi: 10.1002 / 14651858.CD003416.pub4.
> Practice Komiti yeAmerican Society yeRecductive Medicine; Komiti Yedzimiro yeSosaiti yeBatsiro Rokuberekesa Kubereka Technology. "Kutungamirirwa pamiganhu yenhamba yemambrus kuendesa mberi: maonero emukomiti." Fertil Steril. 2017 Apr; 107 (4): 901-903. doi: 10.1016 / j.fertnstert.2017.02.107. Epub 2017 Mar 11.
> Imba imwechete yekudhonza. Rubatsiro Rwakabereka Dzidzo. Chirwere Chetachiona Chetachiona.