A cikin ƙwayar in vitro (IVF)

In vitro fertilization (IVF) shine haɗuwa da kwan mace da na maniyyin mutum a cikin dakin gwaje-gwaje. In vitro na nufin wajen jiki. Yin takin yana nufin maniyyi ya hade kuma ya shiga kwan.

A yadda aka saba, kwai da maniyyi suna haduwa a jikin mace. Idan kwan da ya hadu ya lika a jikin mahaifar ya ci gaba da girma, ana haihuwar jariri kimanin watanni 9 daga baya. Wannan tsari ana kiran sa da mahaifa ko rashin samun juna biyu.

IVF wani nau'i ne na fasahar haihuwa (ART). Wannan yana nufin ana amfani da dabarun likita na musamman don taimakawa mace ta sami ciki. Mafi yawan lokuta ana gwada shi lokacin da wasu, dabarun haihuwa na ƙasa da ƙasa masu rauni.

Akwai matakai guda biyar na asali zuwa IVF:

Mataki na 1: Raɗaɗɗen motsa jiki, wanda ake kira super ovulation

• Magunguna, waɗanda ake kira magungunan haihuwa, ana ba mace don haɓaka ƙwai.
• A ka’ida, mace na samar da kwai daya a kowane wata. Magungunan haihuwa suna gaya wa ovaries su samar da ƙwai da yawa.
• A lokacin wannan matakin, mace za ta rinka yin gwaji na zamani don nazarin kwai da gwajin jini don auna matakan hormone.

Mataki na 2: Gano kwai

• Ana yin ƙaramin tiyata, wanda ake kira da fata, don cire ƙwai daga jikin mace.
• Ana yin aikin tiyata a ofishin likita a mafi yawan lokuta. Za a ba matar magunguna don kada ta ji zafi yayin aikin. Yin amfani da hotunan duban dan tayi a matsayin jagora, mai bada kiwon lafiyar yana saka wata allurar siriri ta cikin farji zuwa cikin kwayayen da jikkunan (follicles) dauke da kwan. An hada allurar da na’urar tsotsa, wacce ke fitar da qwai da ruwa daga kowane follic, daya bayan daya.
• Ana maimaita aikin don ɗayan kwan. Zai yiwu a sami ƙyanƙyashe bayan aikin, amma zai tafi a cikin kwana ɗaya.
• A wasu lokuta mawuyaci, ana iya buƙatar laparoscopy na pelvic don cire ƙwai. Idan mace ba ta haifa ko ba za ta iya yin ƙwai ba, za a iya amfani da ƙwai da aka ba da gudummawa.

Mataki na 3: Haɗuwa da takin zamani

• Ana sanya maniyyin mutum tare da mafi kyawon kwai. Ana kiran cakuda maniyyi da kwai insemination.
• Qwai da maniyyi sai a adana su a cikin ɗakin da ke kula da mahalli. Maniyyi mafi yawanci yakan shiga (haduwar) kwai 'yan sa'o'i kadan bayan haihuwar.
• Idan likita yana tunanin cewa damar yin takin ba ta da yawa, za a iya shigar da maniyyin kai tsaye cikin kwan. Wannan ana kiran sa allurar cikin maniyyi na intracytoplasmic (ICSI).
• Yawancin shirye-shiryen haihuwa na yau da kullun suna yin ICSI akan wasu ƙwai, koda kuwa abubuwa sun zama al'ada.

Mataki na 4: Al'adar tayi

• Lokacin da kwai ya hadu, sai ya zama amfrayo. Ma'aikatan dakin gwaje-gwaje za su duba tayi koyaushe don tabbatar da cewa yana girma yadda ya kamata. A tsakanin kwanaki 5, amfrayo na al'ada yana da ƙwayoyin halitta da yawa da suke rarraba sosai.
• Ma'auratan da ke da babban haɗarin wucewar ƙwayar cuta (gado) ga yaro na iya yin la'akari da ƙaddarar kwayar halitta (PGD). Ana yin aikin sau da yawa kwanaki 3 zuwa 5 bayan hadi. Masana kimiyyar dakin gwaje-gwaje sun cire kwaya daya ko sel daga kowane amfrayo kuma su tantance kayan don takamaiman rikice-rikicen kwayoyin halitta.
• Dangane da Americanungiyar Ba da Amfani da Magunguna ta Amurka, PGD na iya taimaka wa iyaye su yanke shawara game da ƙwayoyin halittar da za a dasa. Wannan yana rage damar wucewar cuta akan yaro. Dabarar tana da rikici kuma ba a bayar da ita a duk cibiyoyin.

Mataki na 5: Canza wurin Embryo

• Ana saka amfrayo a cikin mahaifar matar kwanaki 3 zuwa 5 bayan da aka gano ƙwan da ƙwai.
• Ana yin aikin a ofishin likita yayin da mace take a farke. Likitan yana shigar da siraran bututu (catheter) wanda ke ƙunshe da amfrayo a cikin farjin mace, ta cikin wuyan mahaifa, har zuwa mahaifar. Idan amfrayo ya manne a (abin da ake sanyawa) a cikin rufin mahaifar kuma ya yi girma, sakamakon ciki ne.
• Za a iya sanya tayi sama da ɗaya a cikin mahaifar a lokaci guda, wanda zai iya haifar da tagwaye, ‘yan uku, ko fiye. Adadin adadin amfrayo da aka canzawa abu ne mai rikitarwa wanda ya dogara da dalilai da yawa, musamman shekarun matar.
• Emwayoyin da ba a yi amfani da su ba na iya daskarewa kuma a dasa su ko ba da gudummawa nan gaba.

Ana yin IVF don taimakawa mace ta sami ciki. Ana amfani dashi don magance yawancin dalilan rashin haihuwa, gami da:

• Yawan shekarun mace (shekarun haihuwa masu zuwa)
• Lalacewa ko toshe tubes na Fallopian (na iya haifar da cutar kumburin kumburi ko tiyatar haihuwa)
• Ciwon mara
• Maɓallin rashin haihuwa na namiji, gami da rage ƙwayoyin maniyyi da toshewa
• Rashin haihuwa da ba'a bayyana ba

IVF ya ƙunshi yawancin ƙarfi da ƙarfi, lokaci, da kuɗi. Yawancin ma'aurata da ke fama da rashin haihuwa suna fama da damuwa da damuwa.

Mace mai shan magungunan haihuwa na iya samun kumburin ciki, ciwon ciki, sauyin yanayi, ciwon kai, da sauran illoli. Maimaita injections na IVF na iya haifar da rauni.

A cikin wasu lokuta, magungunan haihuwa na iya haifar da cututtukan hawan mahaifa (OHSS). Wannan yanayin yana haifar da tarin ruwa a ciki da kirji. Alamomin cutar sun hada da ciwon ciki, kumburin ciki, saurin samun kiba (fam 10 ko kilogram 4.5 cikin kwanaki 3 zuwa 5), ​​rage fitsari duk da yawan shan ruwa, jiri, amai, da karancin numfashi. Ana iya magance lokuta masu sauƙi tare da hutawa na gado. Mafi yawan lokuta masu tsanani suna buƙatar zubar da ruwa tare da allura kuma wataƙila asibiti.

Nazarin likitanci ya nuna ya zuwa yanzu cewa magungunan haihuwa ba su da nasaba da cutar sankarar jakar kwai.

Haɗarin dawo da ƙwai sun haɗa da amsawa ga maganin sa barci, zubar jini, kamuwa da cuta, da lalata tsarin da ke kewaye da ƙwarjin, kamar hanji da mafitsara.

Akwai haɗarin ɗaukar ciki da yawa lokacin da aka saka tayi sama da ɗaya zuwa mahaifar. Carauke da jariri fiye da ɗaya a lokaci guda yana ƙara haɗarin haihuwa da wuri da ƙarancin haihuwa. (Koyaya, koda ɗayan da aka haifa bayan IVF yana cikin haɗari mafi girma don tsufa da ƙarancin haihuwa.)

Babu tabbas ko IVF yana ƙara haɗarin lahani na haihuwa.

IVF yana da tsada sosai. Wasu, amma ba duka ba, jihohi suna da dokoki waɗanda suka ce kamfanonin inshorar lafiya dole ne su bayar da wasu nau'ikan ɗaukar hoto. Amma, yawancin tsare-tsaren inshora basa rufe maganin rashin haihuwa. Kudade don zagaye na IVF sun hada da farashin magunguna, tiyata, maganin sa barci, duban jini, gwajin jini, sarrafa kwai da maniyyi, adana amfrayo, da kuma canza wurin amfrayo. Matsakaicin adadin zagaye na IVF ya bambanta, amma na iya cin kuɗi sama da $ 12,000 zuwa $ 17,000.

Bayan an canza mata tayi, ana iya gaya wa matar ta huta har zuwa sauran ranar.Cikakken hutun gado ba lallai bane, sai dai idan akwai ƙarin haɗari ga OHSS. Yawancin mata suna komawa ayyukan su na gaba gobe.

Matan da ke yin IVF dole ne su sha hotuna ko kwayoyi na hormone progesterone na makonni 8 zuwa 10 bayan amsar amfrayo. Progesterone shine hormone ne da kwayayen ke samarwa ta hanyar halitta wanda ke shirya rufin mahaifa (mahaifar) don amfrayo ya iya haɗuwa. Progesterone kuma yana taimakawa amfanidin da aka dasa ya girma kuma ya zama ya zauna cikin mahaifa. Mace na iya ci gaba da shan kwaya na tsawon mako 8 zuwa 12 bayan ta sami ciki. Littlearamin progesterone yayin farkon makonnin ciki na iya haifar da zubewar ciki.

Kimanin kwanaki 12 zuwa 14 bayan amsar amfrayo, matar za ta koma asibiti don a yi gwajin ciki.

Kira mai ba ku sabis nan da nan idan kuna da IVF kuma kuna da:

• Zazzaɓi sama da 100.5 ° F (38 ° C)
• Ciwon mara
• Zuba jini mai yawa daga farji
• Jini a cikin fitsari

Kididdiga ya banbanta daga wannan asibitin zuwa waccan kuma dole ne a duba shi da kyau. Koyaya, yawan masu haƙuri sun bambanta a kowace asibiti, saboda haka ba za a iya amfani da ƙimar haihuwa a matsayin cikakken nuni na asibitin daya fi dacewa da wani ba.

• Adadin ciki yana nuna yawan matan da suka sami ciki bayan IVF. Amma ba duk juna biyu ke haifar da haihuwa ba.
• Yawan haihuwa a raye na nuna yawan matan da ke haihuwar ɗa mai rai.

Hangen nesa game da yawan haihuwa yana dogara ne akan wasu dalilai kamar shekarun mahaifiya, kafin haihuwar da rai, da kuma canza wurin tayi a lokacin IVF.

Dangane da ofungiyar Tallafin Haihuwa (SART), kimanin damar haihuwar jariri mai rai bayan IVF shine kamar haka:

• 47.8% ga mata 'yan ƙasa da shekaru 35
• 38.4% na mata masu shekaru 35 zuwa 37
• 26% na mata masu shekaru 38 zuwa 40
• 13.5% na mata masu shekaru 41 zuwa 42

IVF; Taimakon fasaha na haihuwa; FASAHA; Hanyar gwajin jariri; Rashin haihuwa - in vitro

Anna Katarina Tsarin ilimin haihuwa da rashin haihuwa. A cikin: Goldman L, Schafer AI, eds. Magungunan Goldman-Cecil. 26th ed. Philadelphia, PA: Elsevier; 2020: babi na 223.

Choi J, Lobo RA. A cikin vitro hadi. A cikin: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. M Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017: babi na 43.

Kwamitin Ayyuka na Americanungiyar (asar Amirka don Maganin Haihuwa; Kwamitin Ayyuka na forungiyar don Fasahar Haihuwa. Jagora kan iyakokin adadin amfrayo don canzawa: ra'ayin kwamiti. Taki Bakara. 2017; 107 (4): 901-903. PMID: 28292618 pubmed.ncbi.nlm.nih.gov/28292618/.

Tsen LC. In vitro hadi da sauran fasahar haihuwa. A cikin: Chestnut DH, Wong CA, Tsen LC, et al, eds. Ciwon Magungunan Chestnut's Obestetrics. Na 6 ed. Philadelphia, PA: Elsevier; 2020: babi na 15.