Ingabe nawe unamaqanda ambalwa kuma-ovari akho? Ake sixoxe nge-Diminished Ovarian Reserve!

Ingabe ubulokhu uzama ukukhulelwa isikhathi eside? Kuvamile ukuzizwa udangele futhi ukhathazekile uma ungatholi imiphumela ngokushesha njengoba ubucabanga. Udokotela wakho kungenzeka ukuthi ukutshelile ukuthi ama-ovari akho ane-egg reserve ephansi, isimo esibizwa ngokuthi i-Diminished Ovarian Reserve . Yilokho esizokhuluma ngakho namuhla. Ungakhathazeki, ukuqonda lokhu kahle kuzokusiza kakhulu.

Kuyini i-Diminished Ovarian Reserve?

Kalula nje, i-Diminished Ovarian Reserve yilapho inani lamaqanda kuma-ovari akho lehla khona uma kuqhathaniswa nabanye abantu abaneminyaka yakho. Lokhu ngezinye izikhathi kubizwa ngokuthi "inani lamaqanda eliphansi." Uyazi, ukuze ukhulelwe, udinga iqanda (kanye nesidoda). Ngokuvamile, inani lamaqanda lawo wonke umuntu liyancipha njengoba ekhula. Kungokwemvelo. Kodwa-ke, kwabanye abantu, lokhu kwenzeka ngokushesha kunokulindelekile. Yilapho lesi simo sivela khona.

Ukuthola umntwana kungaba nzima kakhulu uma i-egg reserve yakho iphansi. Udokotela wakho angakuqinisekisa ukuthi unalesi simo ngokwenza ukuhlolwa okubizwa ngokuthi i-Ovarian Reserve Testing .

Into ebalulekile ukuthi lokhu akusho ukuthi awusoze waba nomntwana. Kodwa-ke, kungaba nzima kakhulu, noma kungadingeka usebenzise izindlela zokwelapha ukuzala.

Mangaki amaqanda okufanele sibe nawo ngokuvamile kuma-ovari ethu?

Cabanga ngakho, lapho thina mantombazane sizalwa, sithola wonke amaqanda esiwadingayo impilo yethu yonke. Ngemva kwalokho, awekho amaqanda amasha akhiqizwayo. Ubudala bakho yisona sici esiyinhloko esinquma ukuthi unawo amaqanda amangaki. Izifundo zikhombisile ukuthi ngemva kweminyaka engu-35, izinga lokulahlekelwa amaqanda liyanda kakhulu.

Nakuba lezi zinombolo zingahluka kumuntu nomuntu, nansi umbono wenani elimaphakathi lamaqanda esinawo kukho konke ukuphila kwethu:

• Ekuzalweni: Amaqanda aphakathi kwesigidi esisodwa kuya kwezimbili.
• Ngesikhathi sokuthomba: Amaqanda aphakathi kuka-300,000 no-400,000.
• Cishe eminyakeni engama-40: Amaqanda angaba ngu-25,000.
• Ngesikhathi sokunqamuka kokuya esikhathini: Amaqanda angaphansi kwe-1,000.

Kodwa-ke, udokotela wakho kuphela ongakutshela ukuthi mangaki amaqanda onawo, ngemuva kokubukeza imiphumela yokuhlolwa kwe-Ovarian Reserve okukhulunywe ngakho ngenhla.

Ingabe akunakwenzeka ukuba nomntwana ngoba unamaqanda ambalwa?

Awukwazi ukuthi cha! Usengaba nomntwana noma ngabe unenani elincane lamaqanda. Kodwa-ke, kufanele futhi uqonde ukuthi amathuba okukhulelwa angase abe mancane kancane ngenxa yenani eliphansi lamaqanda. Cabanga ngakho, okudingayo ukuze uthole umntwana iqanda elihle nelinempilo, akunjalo?

Futhi, akulona nje inani lamaqanda elithinta amathuba okukhulelwa kwengane. Ikhwalithi yamaqandaZiningi izinto ezithinta lokhu, njengekhwalithi yesidoda somlingani wakho, impilo yesibeletho sakho kanye nama-fallopian tubes (noma ama-ovari).

Ziyini izimpawu zalesi simo?

Iningi labantu alibonisi zimpawu ezithile. Okuwukuphela kwento ukuthi abakwazi ukukhulelwa ngemva kwezinyanga, mhlawumbe iminyaka, beya ocansini (ngaphandle kokusebenzisa noma yiziphi izindlela zokuvimbela inzalo).

Abanye besifazane bangase baqale ukuya esikhathini ngaphambi kwesikhathi esijwayelekile, okusho ukuthi imijikelezo yabo iba mifushane kanye nenani lezinsuku liyancipha.

Uma une -Primary Ovarian Insufficiency , isimo lapho ama-ovari engasebenzi kahle, ungase ube nezimpawu ngesikhathi sokuya esikhathini . Lokhu kufaka phakathi:

• Ukujuluka okungazelelwe nokuzizwa ushisa (ukushisa okukhulu).
• Ukuya esikhathini okungajwayelekile (kusenesikhathi, sekwephuzile, noma ukuphuthelwa izinyanga).
• Ukoma kwesitho sangasese sowesifazane, okungadala ukungakhululeki ngesikhathi socansi.

Kungani lokhu kwenzeka? Yiziphi izizathu zalokhu?

Ukuguga kuyimbangela eyinhloko nengokwemvelo yokuncipha kokubekelwa amaqanda. Kuvamile kuwo wonke umuntu. Kodwa-ke, ngezinye izikhathi akukho sizathu esicacile esingatholakala.

Kunezinye izizathu ezingathinta lokhu:

• Izimo zofuzo: Izinkinga zofuzo, ikakhulukazi lezo ezihilela i-chromosome X.
• Ukwelashwa komdlavuza: Ukwelashwa ngemisebe noma ngamakhemikhali okwelapha umdlavuza kungalimaza ama-ovari futhi kubhubhise amaqanda.
• Ukuhlinzwa okwenziwa kuma-ovary: Okunye ukuhlinzwa kudinga ukususwa kwengxenye yama-ovary.
• Uma iqanda elilodwa noma womabili esusiwe: Lokhu kungadingeka ngenxa yesimo sempilo.
• Izimo zokuzivikela komzimba: Lokhu kwenzeka lapho amasosha omzimba wethu ehlasela ama-ovari ethu.

Ingabe ukucindezeleka kuyakuthinta lokhu?

Cha, ukucindezeleka akunciphisi ngokuqondile ukubekelwa amaqanda. Abantu abaningi banombono ongalungile ngalokhu. Kodwa-ke, ngokusho kwe-American Society of Reproductive Medicine, ukubhema nokusetshenziswa kwemikhiqizo kagwayi (ugwayi, ama-bidis, njll.) yizona kuphela izici zokuphila ezitholakale zinciphisa ukubekelwa amaqanda.

Yiziphi izivivinyo ezitholakalayo zokuthola lokhu?

Odokotela basebenzisa iqembu lezivivinyo elibizwa ngokuthi i-Ovarian Reserve Testing ukuze bathole umbono oqondile wokuthi mangaki amaqanda asele kuma-ovari akho.

Kodwa-ke, lezi zivivinyo azikwazi ukukutshela ukuthi uzokwazi ukuba nabantwana isikhathi esingakanani, noma ukuthi uzokwazi yini ukukhulelwa ngokwemvelo (ngaphandle kokwelashwa). Lezi zivivinyo zibheka kakhulu i-Kumayelana nendlela ama-ovary akho asabela ngayo emithini yama-hormone enikezwa ngesikhathi sokwelashwa kokuzala njenge-IVF (In Vitro Fertilization), noma ukuthi amathuba akho okukhulelwa ngaphandle kokwelashwa aphansi yini.

Kubaluleke kakhulu ukuqaphela ukuthi noma ngabe lezi zivivinyo ziqinisekisa ukuthi unamaqanda aphansi agciniwe, akusho ukuthi awukwazi ukuba nomntwana ngokwemvelo. Lezi zivivinyo azilinganisi ukuzala kwakho kwemvelo.

Ukuhlolwa Kwe-Ovarian Reserve kuvame ukufaka:

• Ukuhlolwa kwegazi: Lokhu kuhilela ukuthatha isampula yegazi lakho nokuhlola amazinga ama-hormone abizwa ngokuthi (i-Anti-Mullerian Hormone - AMH) , (i-Follicle-Stimulating Hormone - FSH) , kanye (i-Estradiol) . La mazinga ama-hormone anganika udokotela wakho umbono wokuthi ama-ovary akho asabela kanjani emithini yokuzala.
• I-Ultrasound Yesitho Sangasese Sowesifazane: Lokhu kuhilela ukufaka idivayisi encane yokuskena ngesitho sangasese sowesifazane ukuze kulinganiswe ubukhulu bama-ovari. Kuphinde kulinganiswe nenani lama-follicle amancane ngaphakathi kwama-ovari angaqukatha amaqanda. Lokhu kubizwa nangokuthi i-Antral Follicle Count (AFC) .
• Kukhona ukuhlolwa okubizwa ngokuthi i-Clomiphene Citrate Challenge . Lokhu kuhilela ukuthatha umuthi womlomo wokuzala (i-Clomiphene Citrate) izinsuku ezimbalwa, bese ulinganisa amazinga ama-hormone bese ubona ukuthi umzimba usabela kanjani kuwo. Kodwa-ke, lokhu kuhlolwa akusasetshenziswa njalo.

Labo abane-ovarian reserve ephansi bavame ukuba namazinga aphezulu e-hormone (FSH) kunabanye aneminyaka yabo, amazinga aphansi e-hormone (AMH), kanye naphansi (AFC). Futhi, lokhu kuhlolwa kulinganisa kakhulu ukuthi ama-ovaries akho asabela kanjani emithini yama-hormone, hhayi ikhono lakho lokukhulelwa ngaphandle kwemithi.

Yini engenziwa njengokwelashwa?

Lena yinto ebaluleke kakhulu okudingeka siyiqonde kuqala: Ngokwesayensi yezokwelapha yamanje, ayikho indlela yokuguqula ukwehla kwamaqanda agciniwe noma ukudala amaqanda amasha kuma-ovari.

Uma udokotela wakho esola lesi simo, uzokhuluma nawe ngokucophelela futhi akusize wakhe uhlelo lokwelashwa oluzokusiza ukufeza iphupho lakho lokuba nomntwana. Lapho edala lolu hlelo lokwelashwa, udokotela uzokubuza imibuzo efana nalokhu:

• Ungathanda ukuba nomntwana isikhathi esingakanani?
• Bangaki abantwana ofuna ukuba nabo?
• Anjani amakhono akho ezezimali? (Ezinye izindlela zokwelapha zingabiza kakhulu)
• Ingabe ufuna ingane ehlobene nawe ngokwezakhi zofuzo , noma uzimisele ukucabanga ngezinye izinketho?

Izinketho zokwelapha zinqunywa ngokucabangela zonke lezi zici. Izinketho eziyinhloko yilezi:

• Ukuqandisa amaqanda akho ukuze uwasebenzise esikhathini esizayo.
• Ukuzama ukukhulelwa ngokwemvelo (kungathatha isikhathi).
• (IVF - Ukuvundiswa Kwe-In Vitro)Ukwelashwa - Ungasebenzisa amaqanda akho, noma ungasebenzisa amaqanda anikelwe (amaqanda atholwe komunye umuntu).

Uma usebenzisa amaqanda akho...

Ukuqandisa amaqanda kuyindlela enhle yokugcina ukuzala kwakho. Ikakhulukazi uma udokotela wakho ecabanga ukuthi usengozini enkulu yokuba nenani eliphansi lamaqanda, bangase basikisele ukuthi uqandise amaqanda akho ngaphambi kokuba abe mancane kakhulu.

Okwenzekayo ukuthi, unikezwa imijovo yama-hormone ukuze ukhuthaze ama-ovari akho ukuthi akhiqize amaqanda amaningi ngangokunokwenzeka ngesikhathi esisodwa. Ngemuva kwalokho, la maqanda avuthiwe ayatholwa ngenqubo encane yokuhlinzwa bese eqandisiwe ngendlela ekhethekile yokwelashwa kwe-IVF esikhathini esizayo.

Ngezinye izikhathi, udokotela wakho angase asikisele ukudala ama-embryo (amangqamuzana okuqala akheka lapho iqanda nesidoda kuhlangana). Lokhu kusho ukuthi amaqanda avuthiwe ayathathwa, avundiswe elebhu ngesidoda somlingani wakho noma ngesidoda somnikeli (isidoda esivela komunye umuntu), bese ama-embryo aphumayo eqandisiwe ukuze asetshenziswe esikhathini esizayo. Noma, angadluliselwa esibelethweni sakho bese efakwa ngokushesha.

Uma usebenzisa amaqanda e-donor...

Uma ikhwalithi kanye/noma ubuningi bamaqanda akho buphansi kakhulu, okusho ukuthi amathuba okukhulelwa okuphumelelayo usebenzisa amaqanda akho mancane kakhulu, udokotela wakho angase asikisele ukusebenzisa amaqanda anikelayo (amaqanda anikelwe ngomunye wesifazane onempilo).

Kulesi simo, iqanda elivela kumnikeli livundiswa elabhorethri ngesidoda somlingani wakho (noma isidoda somnikeli). I-embryo ephumayo ibe isifakwa esibelethweni sakho. Ingane edalwe ngale ndlela ngeke izuze izakhi zofuzo zakho, kodwa ingase izuze izakhi zofuzo zomlingani wakho (ngaphandle kokuthi kusetshenziswe isidoda somnikeli).

Enye indlela ukuqandisa umbungu. Lokhu kuhilela ukufaka umquba emaqandeni akho (noma amaqanda anikelayo) ngesidoda, ukudala umbungu, nokuwuqandisa ukuze usetshenziswe esikhathini esizayo.

Ingabe i-folic acid iyathuthukisa ikhwalithi yamaqanda?

Kunamavithamini akhethekile okufanele uwathathe ngesikhathi sokukhulelwa (amavithamini angaphambi kokubeletha), aqukethe ivithamini ebizwa ngokuthi i-Folic Acid . Lokhu (i-Folic Acid) kubaluleke kakhulu ekugcineni ikhwalithi yamaqanda.

Uma unethemba lokuba nomntwana, udokotela wakho cishe uzokutshela ukuthi uqale ukuthatha i-vitamin yokukhulelwa. Kungcono ukuqala ukuyithatha okungenani izinyanga ezintathu ngaphambi kokuba uhlele ukukhulelwa . Lokhu kungenxa yokuthi kuthatha cishe izinyanga ezintathu ukuthi iqanda livuthwe ngokugcwele.

Ukudla kwakho, ukuzivocavoca umzimba, nezinye izici zendlela yokuphila (njengokungabhemi) kungathinta impilo, noma ikhwalithi, yamaqanda akho. Kodwa-ke, azithinti inani lamaqanda onawo noma indawo yakho yokugcina amaqanda (isimo esibizwa ngokuthi i-Diminished Ovarian Reserve).

Yini esingayenza ukuze sinciphise le ngozi?

Ngempela, akukho ongakwenza ukuvimbela ukunikezwa kwamaqanda akho ekwehleni. Njengoba sesixoxile ngaphambili, kunezinto eziningi ezithinta lokhu, okuhlanganisa nezinto ezingaphezu kwamandla ethu (njengokuguga kanye nofuzo).

Noma kunjalo, kunezinto ezithile ongazenza ukusiza ukugcina ikhwalithi yeqanda lakho lihle ngangokunokwenzeka. Isibonelo:

• Ukugcina isisindo somzimba siphilile.
• Ukuzigcina kude ngokuphelele nemikhiqizo kagwayi njengogwayi.

Nakuba lezi zinto zingeke zandise inani lamaqanda, zizosiza ekugcineni ikhwalithi yamaqanda atholakalayo.

Ukwelashwa nge-IVF kuphumelele kangakanani kulabo abanamaqanda aphansi agciniwe?

Impumelelo yokwelashwa nge -IVF (In Vitro Fertilization) iyahlukahluka kakhulu kumuntu nomuntu. Kuncike ezintweni eziningi, okuhlanganisa imbangela yokubalwa kwamaqanda akho aphansi, inani lamaqanda onawo, ikhwalithi yalawo maqanda, kanye nendlela umzimba wakho osabela ngayo emithini yokuzala.

Kunzima ukunikeza izibalo eziqondile ngesilinganiso sempumelelo ye-IVF kulabo abanamaqanda aphansi, njengoba kuncike ezintweni eziningi.

Kodwa abacwaningi bayazi ukuthi, njengokukhulelwa ngokwemvelo, izinga lempumelelo ye-IVF liyancipha ngokuguga. Lokhu kuyiqiniso ikakhulukazi kulabo abanamaqanda aphansi agciniwe. Uma ukhula, i-IVF yakho ingase ingabi nempumelelo kangako.

Uma ukuhlolwa kubonisa ukuthi ukutholakala kwamaqanda akho kuphansi, cishe ngeke usabele kahle emithini yama-hormone (evuselela ama-ovari). Lokhu kusho ukuthi ungase ungakwazi ukuqoqa amaqanda amaningi ngendlela obungathanda ngayo ngesikhathi se-IVF. Kodwa-ke, i-IVF ingaba yindlela engcono kakhulu kuwe. Kufanele nakanjani ukhulume nochwepheshe wezakhi zofuzo (udokotela ophatha ukungazali) ngalokhu bese unquma ukuthi yini engcono kakhulu kuwe.

Ingabe ukwehla kwe-ovarian reserve kusho ukuthi ukunqamuka kokuya esikhathini sekusondele?

Kunzima ukusho ngqo ukuthi kuzoqala nini ukunqamuka kokuya esikhathini (isikhathi lapho ukuya kwakho esikhathini kunqamuka ngokuphelele). Ukugodla okuncane kwama-ovari kusho ukuthi inani lamaqanda akho liyehla. Nakuba kungaba uphawu lokunqamuka kokuya esikhathini, akunakwenzeka ukubikezela ukuthi kuzokwenzeka ngokushesha kangakanani.

Ekugcineni, kukhona okufanele ukucabangele...

Uma uzwa kudokotela wakho ukuthi une-ovarian reserve enciphile, ungase uzizwe udumele kakhulu, udabuke, futhi ukhathazekile ngokuthi ikusasa liphetheni. Lokhu kujwayelekile kakhulu, futhi akudingeki uzizwe kabi ngakho.

Kodwa, into ebaluleke kakhulu ukukhumbula ukuthi kusengenzeka ukukhulelwa naphezu kwalesi simo. Ngakho ungadikibali noma ulahle ithemba.

Udokotela wakho angacabangela inani lamaqanda osele nawo, iminyaka yakho, kanye nempilo yakho, bese edala uhlelo lokwelashwa olungcono kakhulu oluzokusiza ukufeza iphupho lakho lokuba nomntwana. Kukhona nezinye izinketho, njengokwelashwa kokuzala kanye, uma kudingeka, ukusebenzisa amaqanda anikelayo.

Ungalilahli iphupho lakho lokuba nomntwana ngoba nje amaqanda akho ephansi - ngokuqinisekile kunezindlela zokwelapha nezindlela zokukusiza. Khuluma ngokukhululekile nodokotela wakho bese ukhetha okulungele wena.

Ama - ovari, ukuphelelwa yiqanda, ukungabi nabantwana, ukukhulelwa, impilo yabesifazane, i-IVF, ukuzala