ICSI - amadlozi. ICSI - le nkqubo. Yintoni yahlukile kwi-IVF IVF + ICSI?

Inani elikhulu nakwizibini ongachumiyo babenokuba abazali elide ilindelwe baby Bulelani kuqaliswa ubuchwepheshe ekuzaleni. Artificial in vitro fertilization (IVF) - indlela kakhulu progressive. Le zibonisa ukuba ukusetyenziswa kwayo iintlobo-ntlobo iinkunzi zombini ababhinqileyo kunye abangamadoda. Kuxhomekeka ukusebenza iinkqubo ngezifo unako ukufikelela-50% nangaphezulu. ICSI-ivundiswe - eyongeziweyo lobeko eliphezulu-ukusebenza IVF.

A incinane

Kuba ngqa indlela vitro wasetyenziswa eNgilane ngo-1976. Kodwa ke, ngelishwa, le ukukhulelwa kwaba ethunjini (noMesheki). Kodwa sele ngo 1978 kwikliniki enye wazalwa Bourn Hall - wokuqala umntwana "uvavanyo-IVF". Unina - Luizy Braun - lisusiwe tubes. Yaye ngowe-1993, owokuqala lwenzelwa e Belgium ICSI-kokukhulelwa. Ukuphonononga yenkqubo, ngokuba ubukhulu becala, ukusebenza eliphezulu le ndlela. Kodwa kwimeko nganye yahlukile, yaye, ke, ukuba inkolelo ngokuqinileyo zombini iziphumo ezintle nezimbi unako.

Indlela yokwenza kwi inkqubo vitro?

Okokuqala, kufuneka bangenele uviwo ngugqirha ngokucokisekileyo. Ekubeni le nkqubo wenziwe "in vitro", umzimba bomfazi umntu zivela iiseli lwegciwane. Ukuze wenze oku, esebenzisa iziyobisi umama elizayo ukukhuthaza indlela eya ivuthwa amaqanda kunye nokulungiselela endometrium ukuba ukukhulelwa. Emva kokuba inkqubo efunekayo, ngenxa okuhlatywa of kweqanda ovarian etsalwe. Ukuze kwenzeke kwezichumiso, bebekwe kwityhubhu kuvavanyo kunye kwamadlozi, apho iimeko iyafana zendalo. Emva kweentsuku ezintathu ukuya ezintlanu, imibungu ezinokuphila bathuthwayo kuloo ndawo ibinomthwebeba zesibeleko. Ngokuqhelekileyo athwale imibungu abathathu okanye abane, njengoko bambi agatywe umzimba ababhinqileyo yaye ziza kuphuhlisa omnye kuphela. Kodwa ngenxa yokuba IVF unako ukuza kunye nokukhulelwa ezininzi.

Yintoni yahlukile kwi-IVF IVF + ICSI?

In yemveli iqanda IVF senye obekwe kwindawo eyodwa apho kwezichumiso ngakumbi yindlela yendalo (kukho intshayelelo eyahlukileyo amadlozi ukuba kukho icytoplasm beqanda). ICSI-nkqubo Kubandakanya injecting amadlozi iqanda ngokusebenzisa isitofu microneedle. Of umgangatho isidoda ukukhulelwa nezihlandlo livela, njengoko umthetho, musa ukuthembela. Kuba nkqubo, kufuneka ukuba ubuncinane omnye umgangatho yobudoda.

Njani na inkqubo ye ICSI?

Emva kokugqiba zonke izigaba zokuzilungiselela (as in eqhelekileyo IVF): ukuvuselela ovarian, okuhlatywa yobudoda unyango ukuqokelelwa kwaye iqala amalungiselelo ukuze kwakheke iqanda. Ukuza kuthi ga ngoku, le kweemveku usebenzisa reagent ezizodwa ususa maleko zokukhusela. Phantsi neemicroscope, wathabatha isidoda kakhulu esebenzayo. Zombini iiseli zibekwe kwindawo ekhethekileyo engenazintsholongwane kunye lobushushu ezifunekayo. Emva koko, usebenzisa micropipette iqanda ekhethekileyo fixed ngu amadlozi umsila wahlulelwa kwaye ibekwe microneedle. Kweemveku usebenzisa zabantu ngononophelo egqithiseleyo, ebukele le ndawo ngokuthi neemicroscope kunye nokulawula ukuhamba yazo zonke sazisa amadlozi eqandeni. ICSI-nkqubo ngoku ngokupheleleyo. Ngoku ke kufuneka ukuba ulinde de emva kokukhulelwa kunye kwicandelo iseli kuqala. Yintoni yahlukile kwi-IVF IVF + ICSI ukongeza inkqubo kwesisu? Ngokwenene, eli mahluko kunye nesiphelo. Emva kokuba impumelelo kokukhulelwa, lo mfazi uya kuba phantsi kweliso lomgadi oogqirha kwakunye emva IVF.

Ziziphi iimeko ezibonisa inkqubo ICSI?

Ekukhulelweni ngu ICSI wenziwe phantsi kwe ntlobo ngokuqatha ukungachumi eyindoda, untreatable. Umzekelo:

• Azoospermia - ukungabikho epheleleyo amadlozi kwi ejaculate.

• Teratozoospermia - ubukho spermatozoa ukuba uqwalaselo eziqhelekileyo, kukho imali engaphantsi kwe-14%.

• Oligozoospermia - inani elingonelanga ngamadlozi.

• ukungabikho azalwa ngayo Umbobho yobudoda.

• Imeko emva vasectomy.

Ukongeza, indlela ICSI isetyenziselwa ukusebenza abaziintsizana ubume ubunjani kunye ubungakanani yobudoda, libya "unfrozen" sperm amalinge zangaphambili akuphumelelanga ka-IVF, ukungachumi imvelaphi othile.

Indlela ukulungiselela le nkqubo?

Phambi kokuba inkqubo, ICSI umfazi kwaye umntu kufuneka kudlule uthotho lweemvavanyo:

• uhlobo lwegazi, RH factor;

• negcushuwa;

• AIDS;

• hepatitis C no B.

Iziphumo wohlalutyo asemthethweni kwiinyanga ezintathu ezizayo.

Umfazi kufuneka enze izifundo ezifana:

• Uhlalutyo igazi emzimbeni (FSH, LH, prolactin, estradiol, testosterone, dlala, TTG, DHA-S);

• kwasala ukusuka iphecana angasese lwezifo efihliweyo kunye nezifo ezosulela ngesondo;

• Uhlalutyo igazi ezinto eziphilayo;

• urinalysis jikelele;

• Smear phezu nezihluma;

• analysis coagulation.

Njengoko kulungiselelwa ICSI ibandakanya thethwano inyanzelekile kunye ugqirha ukuba Izimo kunokwenzeka.

Kuba abantu, uphando ibalulekileyo ukulungiselela inkqubo ibizwa yobudoda. Kungenxa hlalutyo ixhomekeke ukukwazi womntu ukukhawula. Uhlalutyo amadlozi utyhila iimpawu ubuninzi nobulunga madlozi, kwakunye njengelungu zophando zilandelayo:

• spermotest - analysis of ukukwazi amadlozi ukugcina ukushukumiseka kwityhubhu uvavanyo;

• yokuqingqa inani le leucocytes ku yobudoda ;

• nokuchongwa kwezifo;

• Mart-test;

• Uhlalutyo smear namabala.

Ngosuku yomfazi kweqanda okuhlatywa Akuvunyelwe ukuba adle, asele kuphela emva kokuba imvume kagqirha. Indoda iintsuku ezintathu okanye ezine phambi kokuba inkqubo kukukuzila ukulalana iintsuku eziliqela zange ukusela utywala.

ukusebenza kwenkqubo

ICSI-kwezichumiso kukhokelela akhawulwe 30-60% yamatyala. Kuxhomekeke ngobume okuzala, bobabini abasetyhini kunye namadoda (mhlawumbi omnye wabo uphethe anomaly yemfuza), kwakunye kweemveku emfundo owenze lomgaqo (ngexesha kwinkqubo iqanda nokuba yonakele). Ukuba ekukhulelweni kuye kwenzeka, amathuba ukuba iiseli elalisandul 'ukusekwa iza kuphuhlisa imbumba esesesiswini nempilo 90-95%. Kufuneka kuqatshelwe ukuba iziphumo ezakhayo zokukhulelwa ezininzi angaphantsi kwe oluqhelekileyo. Ukuba iziphumo nenkqubo iimbumba eziliqela zingafumaneka mazenziwe ulondolozo lwabo besebenzisa nitrogen engamanzi. imibungu ezinjalo abayi kuphulukana iipropati kwayo emva kweminyaka emininzi.

Ezinokuchaphazela iziphumo nenkqubo?

yimpumelelo ICSI-kokukhulelwa Oku kuxhomekeke kwizinto ezahlukeneyo:

• ubudala Partner;

• ebangela yokungabi nenzalo;

• iiklinikhi;

• izenzo gqirha kwabaphilileyo, lifuneka

• wombuso iqanda.

Ngenxa yoko entle inkqubo ifuna spermatozoa esebenzayo oyindoda isidoda namabhinqa oocytes ezikumgangatho ophezulu. Ukuba umntu lowo uthe akaba amadlozi esebenzayo, amathuba ukukhulelwa kunciphisa.

Ukhetho madlozi physiologically abaqolileyo

factor Iduna inempembelelo enkulu kuphuhliso mbungu. Ngokufuthi unobangela ukungachumi oyindoda isebenza inani elikhulu amadlozi bezingekavuthwa kwi ejaculate. Isidoda oqolileyo ukubophelela hyaluronic acid. Oku kusekelwe kule ndlela uze ukhethe iiseli ezinqwenelekayo. embriologist Gqirha ukhetha biochemically amadlozi elifanelekileyo ezinxulumene ne gialorunanom. Kuyinto ezi seli physiologically aqolileyo aza kusetyenziswa ICSI.

ICSI-kokukhulelwa: ixabiso inkqubo

Yonke imihla, abaninzi abafazi abanomdla ukusebenza, ixabiso le nkqubo, elinde ekliniki ilungileyo le nkqubo. ERashiya, ukuzama esondele ixabiso omnye-ICSI kwezichumiso yi 150-200 amawaka engange. Phesheya, ixabiso nkqubo ngasentla. KwaSirayeli - malunga idlelo-2. EUnited States, eJamani, Switzerland - ngamaxesha 3-4.

ubungozi kunokwenzeka

Nangona izinto ezininzi, ICSI, ukuqhamisa It has ethile enye ezinkulu - factor zivunywa ayisebenzi apha. Oku kubaluleke ngakumbi xa amadoda kunye ukubakhona kwezifo yemfuza (umz, Klinefelter engqondweni, kunye nabanye) ukuba akanako kumitha ngaphandle ukusetyenziswa kobuchule encedisayo. izifo ezinjalo yimfuzo kwaye kwenzeka iminyaka emininzi. ugqwidizo Genetic kubantwana elizayo musa ukuphuhlisa ngenxa inkqubo IVF siyazilayita. Noko ke, abazali nenzalo kuchaphazela impilo yenzala. Ukuze ukubona chromosomal kunokwenzeka nabanezinto ezingaqhelekanga ngokwemfuzo ndiseyimbumba ngamnye, kucetyiswa ukuba aphumeze pre-umzila kokuxilongwa. Oku kungenziwa eqongeni phezu blastomeres ezintandathu.

Ziziphi ezinye iindlela neqanda?

SIPHO - oocytes kunye amadlozi (gametes) zigqithiselwe ityhubhu Imibhobho, ukuba ubuncinane omnye eziluncedo kwabo.

Zefta - oocytes aqhamileyo (zygotes) bathuthwayo kwi ityhubhu Imibhobho.

OD - ECO kweqanda zomzimba , kulandele ngokuthutha ndiseyimbumba kungena retsipientki isibeleko. Le ndlela isetyenziswa kungekho zamaqanda kwabasetyhini kunye nokuhluthwa nemisebenzi yabo, ukuphazamiseka ngokwemfuzo unina, koku- yendalo.

I 'umama ngokwesivumelwano "- imibungu abazali yemfuza ukuba ethwele umntwana zidluliselwa kwi isibeleko wankazana yimbi wena. Isizathu sokuba oku kuba ukungabikho okanye ukunganeli isibeleko yomguli, kodwa ukugcinwa umsebenzi ovarian.

inkqubo IVF Kakade ke, kukho imali eninzi nexesha elide, izixhobo eziyimfuneko ukuze enze amadlozi, bangenayo kuzo zonke iikliniki ukuze ufumane ugqirha abaqeqeshiweyo nalo kunzima kakhulu. Nangona kunjalo, le nkqubo ivumela izibini ezininzi engenabantwana ukwazi uvuyo kakhulu ngumama nokuba ngubaba.