Kusadziletsa sikutanthauza chiganizo. Zikuganiza kuti mmodzi mwa amayi asanu omwe akukonzekera kukhala ndi mwana amakhala ndi vuto poyambira mimba. Koma ambiri a iwo amatha kupambana. Kulongosola bwino zamakono zamakono ndi chithandizo kumathandiza kuthetsa vuto ngati losabalalitsa kubereka ndi kusabereka.
Ndi liti kupita nthawi kwa dokotala?
Monga lamulo, mayi amabereka pakati pa chaka chimodzi chiyambireni kugonana nthawi zonse popanda kugwiritsa ntchito njira za kulera. Ngati nthawi sichikugwira ntchito (inu muli ndi zaka zoposa 30 ndipo simunatenge mimba, mwakhala mukukumana ndi mavuto kapena machitidwe achikazi m'mbuyomo), patatha nthawiyi, musazengereze kukaonana ndi mayi wa amayi omwe amadziwika bwino kuti amatha kuchiza. Pankhani ya atsikana achichepere, ulendo wotere ukhoza kusinthidwa kwa chaka chimodzi. Ambiri okwatirana amakhala makolo opanda chithandizo chamankhwala chaka chachiwiri chogwirizana kuti atenge mwana.
Kumbukirani kuti moyo umalengedwa palimodzi, choncho kwa dokotala muyenera kupita ndi mnzanuyo. Ngati mwamuna wanu akukulimbikitsani kuti muyambe kulankhulana nokha - kumuthandiza. Amuna ambiri amasankha kupita kwa dokotala kwambiri. Amaganizira za matendawa, akukhulupirira kuti izi ndizovuta. Malingana ndi akatswiri, anthu okwana 15% ali ndi mavuto ena oti akhale ndi pakati. Pali zifukwa zingapo za izi, ndipo nthawi zina zifukwa za onse awiriwa. Chifukwa chofala cha kulephera kwa mankhwala ndikulingalira pa vuto limodzi. Koma muyenera nthawi zonse kuyang'ana njira zatsopano popanda kuthana ndi zotsatira zothandizira. Nthawi imapita, ndipo zotheka zamoyo sizingathe.
Kusabereka kwa amuna ndi chifukwa cha pafupifupi theka la mabanja, ndipo malinga ndi akatswiri, zizindikiro izi zikukula mosalekeza. Kuzindikira kwa abwenzi kumafunika kupitilira limodzi. Zamoyo zowonongeka, njira yolakwika ya moyo zimapangitsa kuti zowonongeka zikuwonjezeredwa kwa oimira onse awiri.
Kodi ndingapeze kuti thandizo?
Mukhoza kupita kwa mayi wa zachipatala kuchipatala, ndipo ngati akufunikira, akutsogolerani. Chisankho chozindikira ndi kuchiza matenda osabereka amayamba kumatengedwa ndi azimayi ndi odwala matenda otchedwa endocrinologist, komanso katswiri wa matenda a mahomoni m'gulu la a andrologist (katswiri wa matenda opatsirana ndi abambo) kapena urologist (katswiri wa matenda a genitourinary system).
Ngati muli ndi mwayi (kuphatikizapo ndalama) - ndi bwino kupeza chithandizo chamankhwala chosabereka kuchipatala. Pali alangizi othandizira, ma laboratories ogwira ntchito komanso ogwira ntchito, onsewa m'malo amodzi. Kuzindikira ndi chithandizo chidzachitidwa mosamala kwambiri ndipo mudzasunga nthawi yochuluka. Mukapeza kuti ntchito yanu ndi yopanda phindu, mwinamwake mutha kuyendera limodzi kapena awiri pa mtengo wotsika wa misonkhano. Ngati pali vuto lalikulu, ndiye kuti adokotala wodalirika adzakutsogolerani kudera lonse la chithandizo mpaka kumapeto kokondweretsa.
Funso la kuthekera kwothandizira gawo limodzi la kafufuzidwe ndi chithandizo likupitilizidwanso muzipinda zapadera pamsonkhano woyenera ndi thumba. Zambiri zamtengo wapatali, kuphatikizapo malo abwino kwambiri ochiza matenda osagwira ntchito m'deralo komanso maganizo a madokotala omwe mungapeze mu Association of Treatment of Infertility.
Kumbukirani kuti nkhani yovuta ngati imeneyi ndiyo chithandizo cha kusabereka, ndikofunika kukhulupirira dokotala yekha woyenera. Kotero, chirichonse chiri chofunikira pano - ndi mayankho a odwala ena, ndipo ngakhale anu enieni oyambirira. Musazengereze kufunsa dokotala kuti atsimikizire ziyeneretso zake - izi ndizolondola.
Kodi chidziwitso cha mkazi chimaphatikizapo chiyani?
Akatswiri amasonyeza kuti palibe chifukwa choti kuyesa kubereka kwanu kukhale kwautali kuposa miyezi itatu. Pa nthawi yomweyi, ngati mukuchita ndi akatswiri, mukhoza kuona zonse ndikusankha zoyenera kuchita. Madokotala ambiri oyenerera amakambirana momasuka ndi amayi awo amtsogolo kuti akhale ndi maganizo oyenera pa vutoli. Izi sizikusintha mfundo yakuti intuition sikokwanira. Izi ndizofunika kukwaniritsa magawo akulu a matenda.
Kwa amayi, matendawa amaphatikizapo kufufuza kwa amayi, kuyeza kwa ultrasound za chikhalidwe cha ma falsipian tubes, laparoscopic. Wotsirizirayo amakulolani kuti muwone ngati chifukwa cha infertility ndi matenda ena opwetekedwa pambuyo pake - spikes kapena endometriosis. Ngati dokotala akuwona mavuto mu chiberekero cha uterine, monga mapuloteni, amatha kulangiza sonography kapena ultrasound atayambitsa jekeseni wa saline kudzera mu catheter. Kafukufukuyu ndi wotchipa ndipo alibe zopweteka.
Chinthu chofunika kwambiri cha matendawa ndicho kufotokozera nthawi ya ovulation ndi khalidwe lake. Maphunzirowa amawoneka otchuka kwambiri, koma zofunikira kwambiri ndi kufufuza kwa khola lachiberekero. Pachifukwachi, sizowonongeka zokhazokha, koma koposa zonse, kuyesedwa kwa mahomoni kuti aone momwe chithokomiro chimayendera. Makhalidwe a androgens, ntchito yowonongeka ndi ntchito yamagetsi yowonongeka imayesedwanso.
Kuyeza kwabakiteriya kumafunika. Matenda a bakiteriya ndi omwe amachititsa kuti anthu asabereke, komabe iwo saganiziranso m'dziko lathu. Ndikofunika kuchotsa matenda monga chlamydia. Kawirikawiri "smear" sikokwanira - mayesero apadera amafunika, omwe amatha kuyesa kusakaniza kwa mankhwala osokoneza bongo.
Kawirikawiri, maphunziro onsewa samapereka yankho zokhudzana ndi zomwe zimayambitsa kusabereka. Ngati inu ndi mnzanuyo muli ndi thanzi labwino, madokotala nthawi zina amapempha kuti apitirize kufufuza mayeso a majini ndi immunological. Mavuto amenewa amayamba nthawi ndi nthawi, kupeza zotsatira za kafukufuku ndi kovuta, ndipo mtengo wawo ndi wamtali. Koma zotsatira zake ndi zothandiza.
Zomwe zimachititsa kuti amayi asabereke
Kaŵirikaŵiri ultrasound ndi mayeso a magazi angathandize kuzindikira chomwe chimayambitsa kusabereka. Pakati pa 30-35%, amayi osabereka amakhala ogwirizanitsa ndi tubal occlusion, ndipo ena 25% amagwiritsidwa ntchito ndi matenda a hormonal. Choyambitsa matenda a tubal, monga lamulo, ndi tizilombo toyambitsa matenda omwe amachititsa matenda odyetsa, monga chlamydia kapena gonorrhea. Kutupa koopsa kapena kosatha kungayambitse kupangika kofiira, kupanga abscess komanso tubal atresia.
Kusokonezeka kwa mahomoni operekera kubereka kumakhudzana ndi kusowa kwa ovulation kapena ovulation zosayenera (follicle sizimaphulika, dzira silimasulidwa pa nthawi ya ovulation). Palinso zizindikiro za matenda obadwa ndi maina omwe amatchedwa polycystic ovary syndrome. Mu mazira ambiri, pali mahomoni amphongo ambiri, omwe amatsogolera ku imfa ya follicles ndi kupanga mapuloteni. Vuto lina ndi hyperprolactinemia (mkulu wa prolactin level), zomwe zingayambitse kutentha. Zikhoza kuthandizanso kwambiri kugonana kwa kugonana, kuchepetsa kutsekemera kwa progesterone mwa amayi, kuteteza chitukuko cha mimba.
Kusiyana kwa mahomoni kumabweretsa zinthu zambiri, zomwe zimagwirizana ndi moyo. Kuperewera kwa zakudya, kupitirira muyeso, kupanikizika, kumwa mowa mopitirira muyeso komanso masewera olimbitsa thupi angathe "kuyesa" kuyesayesa kwatsopano kuti akhale ndi mwana. Zotsatira zopweteka zimapangitsanso kusokonezeka kwa kayendedwe ka chithokomiro, ntchentche za pirusi ndi zozizira za adrenal.
Chotsatira cha kusabereka (kapena chinthu china chochepetsera kubereka) nthawi zina endometriosis. Matendawa amagwirizanitsidwa ndi kukhazikitsidwa kwa zidutswa za endometrium (mucous membrane ya chiberekero) kulowa mu ziwalo za m'mimba. Endometrium ili pamalo amenewo komanso mofanana ndi kusintha kwa chiberekero mu chiberekero. Ikulumpha, kuyambitsa kutupa ndi kupweteka. Zimakhala zovuta kwambiri kutenga mimba ngati matendawa ali okhudzana ndi ntchito ya mazira ochuluka kapena mazira oyenda.
Nthaŵi zina chifukwa cha kusabereka kwa kanthawi kochepa ndizogwiritsidwa ntchito pochiza matenda ambiri, makamaka matenda oponderezana, mahomoni, komanso antibiotics ndi analgesics. Zina mwa izo ndizo zomwe zilipo popanda mankhwala (monga aspirin ndi ibuprofen, ngati atengedwa pakati pa ovulation). Nthawi zina kusabereka kumayambitsidwa ndi mankhwala opatsirana pogwiritsa ntchito mankhwala osokoneza bongo omwe angawononge follicles.
Chifukwa china cha kusabereka kwa amayi, monga lamulo, ndizovuta zina popanga ziwalo zoberekera. Izi zimaphatikizapo zofooka zapachiberekero za chiberekero ndi umaliseche, komanso mitundu yonse ya fibroids ndi adheoperative adhesions m'mimba ndi m'mimba. Ndibwino kuti muyang'ane bwinobwino kachilombo ka HIV. Chomwe chimatchedwa chidziwitso cha kusabereka kwa amayi nthawi zambiri chimakhudzana ndi kusintha kwa thupi la chiberekero. Ambiri omwe amapezeka m'mimba mwawo amakhala ogwirizana ndi malo a chiberekero. Muzochitika zachilendo, izo zimalumikizidwa kumtunda wa kumbuyo kwa chiberekero. Kusintha kwa malo kumapangitsa kuti zikhale zovuta kuyanjana ndi umuna wamwamuna wa chiberekero.
Chifukwa cha kusabereka ndi nthawi zina kutupa kwa chiberekero. Zimakhudza katundu wa ntchentche, kuti akhale "mdani" weniweni wa umuna. Izi kawirikawiri zimaphatikizapo kusintha kwa acidity ndi kupezeka kwa opha umuna osiyanasiyana. Zotsatira zake, sakhala ndi mwayi wokwaniritsa cholinga chawo.
Nthawi ya chithandizo
Ndi nthano kuti madokotala pafupifupi nthawi zonse amapereka ana kuchokera ku chubu. Njira iyi imalingaliridwa ngati yowonongeka kwambiri. Mapiritsi omwe amagwiritsidwa ntchito kawirikawiri amapangidwa kuchotsa matenda a mahomoni, kapena kumenyana ndi matenda. Nthaŵi zina chithandizo cha opaleshoni n'chofunika: kawirikawiri chimapangitsa kuti mankhwalawo asamalire, amachititsa ngakhale kuchiza mazira kapena chiberekero, khansara yam'mimba, kapena kuchotsa njira ina yoberekera.
Pamene matenda a "kuperewera kwa ntchito yobereka" sangathe kufotokoza zomwe zimayambitsa kusabereka, ndipo chikhalidwe chothandizira ndi chofunikira (mwachitsanzo, pamene chiberekero chachisawawa chimafooka chifukwa cha ukalamba) - ndiye zowonjezereka zimayenera. Nthawi zambiri muyenera kupita kukaonana ndi dokotala kuti muwone momwe ntchitoyo ikuyendera. Ngati palibe chothandiza, njira zamtengo wapatali zilibe mphamvu - mukhoza kulankhula za kufunika kwa IVF.
Panthawiyi, madokotala ena amati njira yodzipangira insemination. Kujambulidwa kwa umuna kwa wokondedwa kumapangidwa pogwiritsa ntchito catheter yapadera, mchiberekero. Ndikopa mtengo kwambiri kusiyana ndi in vitro, ndipo ndizowona ngati muli ndi vuto la chiberekero ndi umuna wa wokondedwa. Pa nthawi imodzimodziyo, tiyenera kukumbukira kuti mphamvu zake, ngakhale m'maphunziro opindulitsa kwambiri, siziposa 15%.
Njira ya IVF
Chigamulo chogwiritsa ntchito mu vitro feteleza chiyenera kukhazikitsidwa mwachindunji. Ngati nthawi yothandizira nthawi yayamba yoposa chiwerengero chovomerezeka cha abwenzi, komanso m'mabanja omwe ali ndi zaka zoposa 35, poopseza kuthera kwachisawawa. Kawirikawiri, njira ya IVF sivomerezedwa kwa amayi ocheperapo zaka 35 osabereka komanso osabereka.
Njirayi imachokera ku chisankho cha ma laboratory ovules osapangidwira komanso chiyambi cha chiberekero. Choncho mwana wosabadwa amaikidwa mu chiberekero, kupyola magawo onse a feteleza. Kupambana kwa njirayi kumakhala pafupifupi 30% poyerekeza ndi njira yachikhalidwe yobereka.