Varombo Vakapomerwa, Vakarambidzwa Egg Retrieval, uye Vakaderedzwa Kuberekwa Kwemubhedha
Kuvhiringidzika kweVIV kushandiswa kunowanzoreva apo nhamba yakaderera ye follicles inokura mumapapiro omukati panguva yekusimudzira chikwata chekurapa, uye kuwanikwa kweii kuri kubviswa. Vakadzi vane mazai avo havaiti mazai akakwana (kana follicles) panguva yekurapa vanonzi "varombo vanopindura." Pakati pe5 ne35 muzana yevakadzi varombo vanopindura .
Kunyange zvazvo kukundikana kukura zvakakwana follicles zvakakodzera yekudzoka kweiyo chikonzero chimwe chekuregererwa kweVF kufambisa, kutenderera kwako kunogona kuderedzwa, kunonoka, kana kukundikana kukwaniswa kune zvimwe zvikonzero zvakare.
Mimwe mimwe mienzaniso inosanganisira kuva vashoma kusvika mazai mazai akadzorerwa, kusakwanisa kwemazai kusvina, kusagadzikana kwemazai kukura kazhinji, kana kuti panjodzi yekuita mavari maitiro ekurwisa . (Zvimwe zvinokonzera IVF kupedzisa kuporesa kana kunonoka zvakanyorwa pasi apa.)
Kuva neAVF yako yakakanganiswa kana kunonoka kunogona kushungurudza. Nenguva ino, iwe wakaisa nguva, simba rekunamata, uye mari inokosha. Kusati kuenda kune embryo kuendesa mberi kunogona kurwadza.
Izvozvo zvakati, kana kubviswa kamwe chete kana kukanganisa kupoteredza hakureve kuti inotevera inotenderera inofanirwa kuve yakafanana kuguma kusingaperi. Uye, dzimwe nguva, iwe unogona kukwanisa kupfuurira nehutenderedzwa pasinei nekurudzirwa kuregera kana zviratidzo zvekutsvaga kwakashata.
Hezvino izvo zvaunoda kuziva kuti unzwisise kuregererwa kweVVF nekuita zvisarudzo zvakajeka.
Chikonzero Nei Zviratidzo Zvako Zvese Zvingave Zvarambidzwa, Zvideredzwa kana Zvisingakwanisi Kuzadzisa
Anenge anenge munhu wese anotanga chirwere cheVVF anoziva kuti kuberekwa uye kuberekwa kurarama hakuzivikanwi.
Asi vazhinji vanoshamisika kana vasingakwanisi kuitisa kumbrus transfer.
Heano zvimwe zvikonzero zvinogona kuitika kuti IVF yako inenge yakanonoka, yakanatswa, kana kuti inokundikana kusvika kuhutachiona hwekutengesa.
Baseline ultrasound kana basa reropa rakaoma : Pakutanga kwekuvhara kwe IVF (kana kuti chero chirongwa chekurapa kwekubereka ), basa rekutanga re ultrasound uye neropa rinorayirwa.
Izvi zvinonyanya kuitwa kutsigira apo hapana ma cysts pane mavha mavari. Kana cyst inowanikwa, kurapa kunogona kudikanwa kunonoka.
Aya ma-cysts anowanzobata uye anozoenda pasina kuwedzerwa kuwedzerwa. Kana ikasarudzwa, unogona kutanga utange IVF mushure mekurumidza kunonoka, kana kuti inogona kuendeswa kune imwe mwedzi.
Hazvina kukwana follicles iri kukura : Yakataurwa kare, iyi ndiyo apo mavha mavari haapinduri pamwe chete uye anotarisirwa kumishonga inobereka . Ingani "isina kukwana" follicles? Tsanangudzo ye "yakadzika kwazvo" inopesana pakati pechiremba, asi kazhinji, katatu kana mashoma follicles inotungamirira pakuregererwa. Vamwe vanachiremba vachabvisa chirwere kana kune vashoma kupfuura mashanu follicles.
Kana iwe usina hutano hwakakwana, mazai evha anogona kubviswa nekliniki yako, kana kuti chiremba wako anogona kukurudzira kuregererwa asi anokubvumira kuti uite foni yekupedzisira pamusoro pokuti ungaenderera mberi sei. Chiremba wako angangodaro akakurudzira kuti iwe ugadzire kusarudzwa kwekutsvaga kwekutsvaga pane zvaunofunga kuti mune remangwana rekurapa.
(Izvi zvose, nenzira, inofunga kuti une chirwere chinowanzoitwa IVF chirwere.) Kana iwe uri "wepanyama" IVF, kana "mini-IVF" , kuratidzira imwe chete kana zvishoma zvinyorwa zvinotarisirwa uye zviri mukati chokwadi chiri chinangwa.)
Low estrogen levels : Kana iserogen mazinga akaderera kudarika kutarisirwa panguva yeivulatory kukurudzira chikamu chekufamba kwako, izvi zvinogona kuratidza matambudziko nehutano hwekunyora.
Bhuku rinowanzoregererwa chete nekuda kwezinga rezasi-kupfuura-raunoda estrogen-kazhinji, ichisarudzo chakaitwa kubva pane izvi uye kuti ndeapi follicles unazvo.
Estrogen mazinga akakwirira kwazvo : Sezvo zvichiita kuti usapindira-kubata pamishonga yekubereka, zvinogona zvakare kukanganisa. Izvi zvinogona kutungamirira ku ovarian hyperstimulation syndrome (OHSS) , mamiriro ezvinhu kuti kana akasara asina kutorwa anogona kuva nengozi. Mumatambudziko makuru, zvisingawanzoitiki, zvinogona kukonzera kurasikirwa kwekubereka uye kunyange rufu.
Kana yako yeserogen mazinga akakwirira zvikuru, kutenderera kwako kunogona kubviswa. Izvi zvinogona kuitika musati wambotanga kupfura, mazai asati atora, kana mushure mokunge mazai atora. Kana kuregererwa kunoitika mushure mokutora mazai, uye mamwe mazai ane utano anowanikwa mubasa racho, iyo mazai angangodonhwa. Vanogona kunonoka kuchinjwa uye kutamirwa kuburikidza nechando chisina kuvhara, kana FET.
Zvinogona kuva nengozi kutumira mazai kana iwe uri kukura nyaya yakaipa yeHSSSS. Kuberekwa kunogona kuita kuti zvive zvakaoma kupora kubva kuHSSSS. Zviri nani kumirira kune imwe nzira uye kuita FET.
Mune ramangwana, chiremba wako anogona kukwanisa kushandisa madhigirii mashoma emishonga inobereka kana kuti prototi yakasiyana yekudzivisa imwe ovarian kugadzirisa kupindura.
Zvisingatarisirwi kuderedza isrogen mazinga : Zvimwe zvirongwa zveVFF zvinotarisirwa kudonha muestrogen pamberi peii rinotora nguva. Iyi haisi dambudziko, maererano nekutsvakurudza.
Zvisinei, kana estrogen levels dzinodonha zvisatarisirwe vasati vadzoka mazai, izvi zvingava chiratidzo chakaipa. Chiremba wako anogona kukurudzira kuti udzize maitiro ekudzorera mazai, kuchengetedza mari uye simba rekunetseka pakuenderera mberi kwendangariro iyo isingagoni kubudirira.
Kwete kutora hCG / trigger kupfura panguva yakakodzera : Kuberekwa kwechirwere hCG inotorwa nemurojekiti anenge maawa makumi matatu maawa asati adzoka. Nguva yejojo iyi inokosha. Kana ikatorwa panguva isina kukodzera, mazai anogona kuvhara pamberi pekuita kwako. Kana kamwe mazai akasunungurwa mukati memapapiro, haagoni kuwanikwa zvakare nokuda kweVIVF.
Chiremba wako achakupa nguva chaiyo kuti uzvipe mujoyi uyu. (Mamwe makiriniki achaita kuti varwere vavo vauye kuchipatara kuti vawane pfuti nokuti nguva yakakosha.) Kana iwe uchiitora panguva isina kunaka, zvakadaro, kutenderera kwako kunogona kuregererwa.
Hapana mazai akadzorerwa : Inoretically, kila follicle inofanira kuva neii. Asi hazvishandi zvakadaro. Dzimwe nguva, follicles hazvina chinhu. Iwe unogona kuva nenhamba yakanaka ye follicles, asi usatora chero mazai kubva kwavari.
Kana pasina mazai, kubereka hakugoni kuitika. Kurongeka kunopera pano.
Progesterone mazingawo akakwirira : Progesterone inonzi hormone inokura mushure mekuvhara. Iyo inobatsira kugadzirisa michina yekumetometrial , iyo inonzi embbryo inotarisira kuisa, uye inobatsira kuchengetedza kubata pamuviri. Progesterone haifaniri kutanga kusimuka kusvikira mushure mokutora mazai (kana kuvhara).
Zvisinei, vamwe vakadzi vachaona huwandu hweprogesterone huchiwedzera pazuva rekuwana mazai. Zvimwe zvidzidzo zvakawana kuti kutama kwemashure panguva iyoyo inenge isingagoni kutungamirira pakuzvitakura kubudirira.
Kana izvi zvikaitika kwamuri, chiremba wenyu anogona kukurudzira kubvongororwa kwevamwe mazai uye kuronga pane imwe nguva zuva rakasvibiswa kuendeswa kwemazamu. Kumirira kunogona kuva kwakaoma, asi kunogona kuvandudza maitiro ekubudirira kwehutano.
Hapana mazai okutama : Dzimwe nguva, kunyange mushure menguva yakawanda mazai akadzorerwa, kubereka hazviitiki. Izvi zvinoreva kuti hapazovi nemambrus kuti adzokere.
Uyewo, dzimwe nguva, mazai anozadza asi mazai ayo anoguma ari varombo mune utano kana kuti "kusungwa" mukubudirira vasati vatumirwa. Chimwe chikonzero iwe unogona kunge usina mazamu kuendesa kana PGS / PGD genetic kuongorora zviitiko zvinoratidza ma embro ane matambudziko emagetsi kana chromosomal.
Kuratidza zviratidzo zveHSSSS njodzi : Sezvataurwa pamusoro apa, ovarian hyperstimulation syndrome inogona kuva yakakomba zvikuru kana isina kusiyiwa isingateereri. Kana zviratidzo zvako, ultrasound, kana basa reropa zvichiratidza dambudziko guru reHSSSS, kutenderera kwako kunogona kubviswa kana kusarudzwa.
Izvi zvinogona kuitika musati wawana mazai kana kuti mushure mekuwanazve asi musati mambakwedza.
Chirwere chisingaenderani neVIV : Kana mumwe munhu aine chirwere chakakomba mukati mekurapa, chirwere chacho chinogona kubviswa kana kuchetwa. High fever inogona kukanganisa zvinokonzera mbeu.
Iva akatendeseka nachiremba wako kana iwe une fever yakakura kana uri kuuya pasi nechimwe chinhu mukati mako mwedzi wekurapa. Zvinogona kuvhiringidza kuti unoda kubvisa kana kunonoka kurapwa, asi zvimwe zvirwere zvinogona kuderedza maitiro ako okubudirira uye zvingatowedzera hutano hwako huri pangozi kana huchibatanidza nehutano hwepanyama.
Iwe Unogona Kuenda Nemaawa Anogadziriswa Kunyange Nemavhiki Mashoma / Mifananidzo?
Mwana wekutanga weVIVF akaberekwa nehana imwe chete yakatsvaga. Muzvinhu zvakasikwa uye mini-IVF mishonga, imwe kana kuti mashoma follicles anoda. Saka, sei usina kungoenderera mberi nekai yezveii panguva yakatarwa IVF kunyange kana iwe uchinge uine zvishoma zviduku zvinowedzera?
Iyi inharo inopesana. Kune vamwe vanachiremba vanoda uye vanogona kukukurudzira iwe kuti uende mberi neii rinotora. Mune mamwe mamiriro ezvinhu, ichi ndicho chiitiko chakanakisisa chemukadzi uyu. Kana iye akaderedza mazai evhaari uye haadi kushandisa maii evha , achifamba nemhepo yakatowanikwa kunyange nechepasina matanho ekubudirira angaramba achiri mikana yakanakisisa yekubata pamuviri.
Zvisinei, zvakakosha kuziva kuti kupindura kwakashata pamishonga yekuita mishonga hakusi mamiriro akafanana nemumwe munhu akangoti akurudzirwa kukura imwe kana maawa mashomanana ekudzorera. Ichokwadi kuti huwandu hwemasero ehomoni hwakanga husina kukwana kuti hurumidze kukurudzira mazai ega inoratidza kuti mazai evha haana urombo.
Kwete chiremba wose achakupa chisarudzo chekuenderera mberi neii kutora kana yako follicle nhamba yakanyanya. Vamwe vachakupa maonero avo pane zvaunofanira kuita kunze kwekusiya chisarudzo chokupedzisira mumaoko ako.
Heano mamwe maverengi ekukubatsira kuita sarudzo:
- Maererano nedzidzo dzakasiyana-siyana, "varombo vanopindura" vanoenda neayai kutora vari pakati pe7,6 kusvika ku17,5 mukana wekuwana kubata pamuviri (zvichienzaniswa ne25.9 kusvika 36.7 mukana yevaya vanopindura kazhinji).
- Paunenge uchitarisa dhesi yacho yose, vaparidzi vanotambura vane hafu yekana yekutora pamuviri kana vakayambuka neii rinotora.
- Nhau dzezera. Varombo vashoma avo vaiva nemakore makumi matatu nemaviri kana vaduku vakanga vane mimba yemukati pakati pe13 ne35 muzana. Vaparidzi vashoma vava nemakore makumi matatu nemaviri uye zvichikwira zvishoma zvakanyanya kubudirira kwehutano : pakati pe5,5 ne12,7 muzana.
- Nhamba yehuremu. Vakadzi vane BMI vakanga vanopfuura 30 vakanga vasingakwanisi kutora pamuviri kana vachienzaniswa nevarombo vanopindura pamutengo wekureruka.
- Vakadzi vakanga vawedzera mazinga eFSH vakanga vasingakwanisi kutora pamuviri mushure mokunge varatidzirwa, kana vachienzanisa nevarombo vakapindura vane maitiro akazara eFSH. (High FSH vakadzi vaiva ne4 muzana yehupamuviri hwekuita, vachienzanisa ne14,8 muzana kune avo vane maitiro akanaka eFSH asi mhinduro isina kunaka.)
Nhamba chaiyo ye mazai inotora zvinhu, uye maawa mashomanana anotungamirira kudzikira kwepamuviri. Zvidzidzo zvitatu zvakatarisa pamuviri mazinga zvichienderana nenhamba yamaoocyte.
- Vakadzi vane dhi rimwe chete vakadzokorora vakave nemitengo yekuzvitakura pakati pe 0 ne 2.3 muzana.
- Vaya vaiwana mazai maviri akadzorerwa vaiva nezviyero pakati pe4.3 ne15.2 muzana.
- Chimwe chidzidzo chakawana kuti vakadzi vane maoocyte mashanu vakabviswa vaine mimba yehutombwe pa 22 muzana.
Kuchinja kubva kuIVF kusvika kuIUI Mid-Cycle
Chimwe chingaitwa nachiremba wako ndechekushandura kufamba kwako kubva kuVIV kusvika kuIUI . Izvi, zvechokwadi, zvaizongova chete kana mazai enyu asina kupindura sezvakanaka sezvakavimbwa. Iwe haungadi kuchinja kuIUI purogiramu kana maovari ako hyper-apindurwa.
Kunyangwe ichi ichi chisarudzo chakanaka iwe uchavimba nemari, zvikonzero zvako zvekusabereka, uye ndeupi mukomana nenyaya dzenyaya dziri kutamba.
Somuenzaniso, kana wakavhara fallopian tubes , IUI haisi kuzosarudza. Kana uwandu hwemurume wako huri pasi , kana IVF ne ICSI inodiwa, kuchinja kune IUI chirongwa hazviitike.
Dzimwe nguva, kune mashoma mashoma eVF asi asi akawanda kwazvo kune IUI. Kuva nemafuta matatu kusvika mashanu kunoreva, neIUI, uri pangozi yekutora pamuviri nekatatu, quadruplets, kana kunyange quintuplets . Izvi zvinogona kuisa hutano hwako uye chero mimba yekuberekwa vana hutano huri pangozi.
Chii Chinotevera? Unofanira Kuedza zvakare Mushure mekuvhara IVF Kuchenesa here?
Mushure mokufungidzira kwakanyanya uye mari yekutsvaga mari , kuita kuti kutenderera kwako kuregere kunogona kukusiya iwe unetseka-iwe unofanira kuedzazve here?
Uyu mubvunzo hausi nyore kupindura uye unobva pane imwe mamiriro ako. Muzviitiko zvizhinji, hongu, kana iwe une nzira yezvemari, zvakakosha kuti uedze zvakare. Chiremba wako angadzidza nzira yekuvandudza zviri nani yako inotevera inobva pane zvakakanganisika nguva yekutanga.
Semuenzaniso, kana iwe ukapfuura-wakapindura pamishonga yekubereka, chiremba wako anogona kuderedza dhizi kana kushandisa shanduro yakasiyana nenguva inotevera. Kana pasina mazai akaberekwa, chiremba wako anogona kuedza IVF ne ICSI nguva inotevera. Kunyange munyaya yekupindura kwakashata, pangave pane protocol yakasiyana inogona kubatsira.
Chimwe chidzidzo chakawana kuti makumi mashanu kubva kuzana kubva kuzana kubva kuvakadzi vevakadzi vaiva nemhinduro shoma mune imwe IVF yakaenderera mberi vakapindura nenzira yakajeka mune imwe inotevera. (Zvakakosha, zvisinei, kuratidza kuti kubata pamuviri kubudirira kwaive kuchiri kurutivi rwezasi muchidzidzo ichi: chete 10.1 muzana nepamuviri yehutachiwana mumutambo unotevera-kupindura.)
Mune zvimwe zviitiko, kukanganiswa kwekukanganiswa kunotyisa. Dzimwe nguva kuberekwa kwekuberekwa kunofanotaura kupindura kwakashata . Dzimwe nguva mimwe miedzo inoita zvakanaka uye zvinhu hazviendi sezvinotarisirwa.
Muzviitiko izvi kunyanya, imwe nzira ingave yakakosha. Kutsvakurudza kwakawana kuti vasingatarisiri varombo vanopindura vane huwandu hwekutora pamuviri kubudirira kwe 25.9 kusvika 47% pavanotarisa matambudziko anopfuura matatu eVF maitiro akabatanidzwa.
Kune, zvisinei, dzimwe nguva apo mhinduro shoma, pamwe chete nezvimwe zvinhu, chiratidzo chaunofanira kufamba nacho. Zvichienderana nechinetso, izvi zvinogona kureva kuenda kune IVF ne mazai emubatsiri, IVF nevana vanopa, kana kufunga nezvekugamuchirwa kana kurarama kwemwana .
Shoko Rinobva Kunyanya
Hapana munhu anopinda muIVF achitarisira kuti arege kuitisa kuburikidza nehutachiona hwekutengesa. Zvakajairika kuti uwane kusuruvara, kuora mwoyo, uye kunyange kutsamwa. Izvi zvinonyanya kuitika kana iwe unogona kungoita mari chete kuedza kamwechete.
Iva nechokwadi chokuti kunyange mararamiro akaregererwa haasi dongo. Chiremba wako ane tariro yekukwanisa kushandisa data yakagadzirwa kuti abatsire kuita chiitiko chinotevera kana chivakwa chemhuri chifambe zviri nani. Kunyange kana chirongwa chisina kukanganisa chisingaiti kunze kwekusimbisa iwe unofanirwa kufunga nezveVIV neine mucheki weii, kana kuti uende mberi kwezvokurapa kwekuberekwa , iyi ndiyo mashoko iwe usina kumbove nawo.
Yeuka kuti yako yekutanga yekutanga haisi chiratidzo chekuti zvichazoitika sei, uye iwe unogona kugara uine pfungwa yechipiri.
Tsvaka rubatsiro kubva kune shamwari nemhuri . Taura nachiremba wako pamusoro pepurogiramu yakakanganiswa, teerera mazano ake, uye sarudza-mushure mokunge iwe uine nguva yekufunga nezvechiitiko-zvinotevera matanho ako.
> Sources:
> Az-Azemi M1, Kyrou D, Kolibianakis EM, Humaidan P, Van Vaerenbergh I, Devroey P, Fatemi HM. "Yakakosha progesterone munguva yevhivari yekusimudzira IVF. "Kuzvidza Zvinyorwa Online. 2012 Apr; 24 (4): 381-8. doi: 10.1016 / j.mangarirai.2012.01.010. Epub 2012 Jan 24.
> Fisher S1, Grin A, Paltoo A, Shapiro HM. "Kudonha mazinga eesradiol semugumisiro we > nekuda > kuderedzwa kwegonadotrophin dose hakubatanidzi nemigumisiro yakashata yeVIV, asi kuerekana uchinge kuwira isradiol mazinga kunokonzera kushandiswa kwekliniki yekudzivirira pamuviri. "Hum Reprod. 2005 Jan; 20 (1): 84-8. Epub 2004 Oct 15.
> Oudendijk JF1, Yarde F, Eijkemans MJ, Broekmans FJ, Broer SL. "Murombo anopindura mu IVF: ndizvo zvinoreva nguva dzose zvishoma? "Hum Kudzosera. 2012 Jan-Feb; 18 (1): 1-11. doi: 10.1093 / humupd / dmr037. Epub 2011 Nov 10.