Ukungazali Kudokotela: Indima Yodokotela Bezokuzala Ekwelashweni

Ukungabi nenzalo yisimo lapho izithandani zingakwazi ukuthola umntwana ngemuva konyaka wezocansi ojwayelekile ongenazo izivikeli-zocansi. Le nkinga ekhathazayo ithinta cishe u-15% wezithandani emhlabeni jikelele, kanti izimbangela zayo zingaba yinoma yini. Lokho kwenza kubaluleke ukuthi kufunwe usizo lwezokwelapha uma ukukhulelwa kubambezeleka. Odokotela bokuzala, abaziwa nangokuthi reproductive endocrinologists, bangasiza. Laba dokotela abakhethekile bangasiza ekuxilongeni nasekwelapheni ukungabi nenzalo, benikeza ithemba ezithandani eziningi ezifuna ukukhulisa imindeni yazo. Udokotela onguchwepheshe ku-“doctor infertility” angakwazi ukwenza ukuhlolwa okuqondiswe ngokukhethekile ukuze athole izimbangela eziyinhloko futhi ahlele ukwelashwa okusebenzayo kulowo nalowo mbhangqwana.

Yini Okubizwa Ngokuthi Doctor Infertility?

“Doctor infertility” libhekisela emiyalelweni, ekuxilongweni nasekwelashweni okunikezwa ochwepheshe bezokwelapha abakhethekile kwezokuzala. Laba ochwepheshe bezempilo basebenzisana nabesilisa nabesifazane ukulungisa izinkinga zokuzalana. Ngokuphambene nalokho okuningi abakukholwayo, ukungabi nenzalo akusona isinkinga sabesifazane bodwa. Ngokwe idatha yokungabi nenzalo, phakathi kwecala eliphelele lokungabi nenzalo, amadoda ayimbangela ku-30% yawo. Uma kuqhathaniswa, abesifazane benza elinye u-30%, kanti u-40% osele ubangelwa yizinto ezihlangene noma ezingachazwanga.

Udokotela wezokuzala fertility physician usiza bobabili abalingani ngokuhlola impilo yabo yokuzala, ebona izimbangela ezingaphansi zokungabi nenzalo, futhi encoma ukwelashwa ngokuya ngezidingo zomuntu ngamunye.

Yini Ebanga Ukungabi Nenzalo?

Akukho sizathu esisodwa esiqondile sokungabi nenzalo ngoba kunezinto eziningi ezibamba iqhaza elibalulekile ekuzaleni. Ukungabi nenzalo kuvela kokubili kubesilisa nakubasifazane, kanti ezinye izinkinga ezivamile zingaba lezi:

1. Izimbangela Zokungabi Nenzalo Kwabesifazane

• Izinkinga zokuchama iqanda (ovulation disorders): Izinkinga zokuchama iqanda zingezinye zezimbangela ezivame kakhulu zokungabi nenzalo kwabesifazane. Izinkinga ezifana ne-polycystic ovary syndrome (PCOS) noma ukuphela kokusebenza kwamaqanda kusenesikhathi (premature ovarian failure) zingaphazamisa ukuchama iqanda okuvamile. Ngamazwi alula, lezi zifo yiziphazamiso ekukhiqizweni kwamaqanda [1].
• Imithambo yokuzala yabesifazane evalekile: I-hydrosalpinx noma ukuvinjelwa kwe-fallopian tube kwenzeka lapho ingxenye yokuguma yomthambo wokuzala kowesifazane ivuvukele futhi igcwele uketshezi. Ukuvinjelwa okubangelwa izimo ezifana ne-endometriosis noma isifo sokuvuvukala esiswini (pelvic inflammatory disease) nakho kuvimbela isidoda ukuthi sifinyelele eqandeni [2].
• Ukungezwani kwesibeletho: Iningi lezinkinga zokuzalwa kwesibeletho alinazimpawu nhlobo. Futhi nakuba ezinye izifazane zikhulelwa ngendlela evamile yize zinezinkinga zesibeletho, akuhlali kunjalo. Izinkinga ezifana nama-fibroid noma izibazi zingaphazamisa ukunamathela kombungu, kuholele ekungazalweni kowesifazane. [3].
• Ukungalingani kwamahomoni: Lena mhlawumbe imbangela evame ukudala ukuthi izithandani eziningi zihluleke ukukhulelwa. Umzimba wakho udinga ukuba namazinga amahomoni alinganiselayo ukuze kube nokukhulelwa okunempilo. Ukungajwayelekile ekukhiqizweni kwamahomoni kungaphazamisa ukuvuthwa kwamaqanda (ovulation) futhi kwehlise ikhono lokuzala. [4].

2. Izimbangela zokungazali emadodeni:

• Inani eliphansi lesidoda: Lena ingenye yezimbangela ezivame kakhulu zokungazali emadodeni. Inani elijwayelekile lesidoda liphakathi kwezigidi ezingu-15 nezigidi ezingu-200 zesidoda ku-millilitre ngayinye yesidoda. Noma yini engaphansi kwezigidi ezingu-15 ibhekwa njenge-oligospermia (inani eliphansi lesidoda). [5].
• Ukunganyakazi kahle kwesidoda: Ukunyakaza kwesidoda (sperm motility) ikhono lesidoda sakho sokunyakaza ngokushesha nangempumelelo ukuze sifinyelele iqanda. Uma isidoda sakho sinzima ukufinyelela iqandeni nokulisemina, kufanele ubone udokotela wezokungazali ngokushesha.
• I-Varicocele: Lesi simo, lapho imithambo esikhunjeni sezende ivuvukele, singathinta kabi ukukhiqizwa kwesidoda. Ngokuvamile emadodeni, ukukhiqizwa kwesidoda yikho okunquma ikhono lakho lokuzala. Ngakho-ke noma iyiphi inkinga enomphumela omubi ekukhiqizeni isidoda ibangela ukungazali. [6].

Indima kadokotela okhethekile kwezokuzala

Udokotela okhethekile kwezokuzala uqeqeshwe ngokukhethekile ukuze axilonge futhi aphathe ukungazali emadodeni nasemakhosikazini. Nansi indlela abasiza ngayo:

1. Ukuxilongwa

Udokotela wakho wezokungazali uqala ngokuqoqa umlando onemininingwane wezempilo nowocansi kubo bobabili ozakwenu. Angase enze izivivinyo eziningana ukuze athole imbangela yokungazali, njengokuhlolwa kwesidoda, ukuhlolwa kwamahomoni, noma izivivinyo zokubona ngaphakathi njenge-ultrasound noma ama-hysterosalpingogram (HSG) ukuze kubhekwe kahle impilo yezitho zokuzala.

2. Izinketho Zokwelashwa

Uma imbangela isiyaziwa, udokotela wezokungazali uzophakamisa izindlela zokwelashwa ezihambisana nesimo salelo bapho. Lezi zingabandakanya:

• Izinguquko zesitayela sokuphila: Lokhu kungahlanganisa ukuphatha isisindo, ukuyeka ukubhema, noma ukunciphisa ukucindezeleka, konke lokhu okungathinta ukuzala. Uma ubuzama ukukhulelwa kodwa usenezindlela zokuphila ezinganempilo, sekuyisikhathi sokuzishintsha.
• Imithi: Imithi yokuzala, efana ne-Clomid noma i-Letrozole, ingasiza ukuvuselela ukukhishwa kwamaqanda kwabesifazane. Kwabesilisa, kunganconywa imithi ekhuphula i-testosterone noma ebhekana nenkinga yokungabi namandla ocansi (erectile dysfunction).
• Ukuhlinzwa: Ngezinye izikhathi kudingeka ukuhlinzwa, njengokulungisa amathumbu ama-ovari avaliwe (ama-fallopian tubes) noma ukulungisa ama-varicocele kwabesilisa.

3. Ubuchwepheshe Bokuzalana Obusiziwayo (Assisted Reproductive Technology \- ART)

Uma izinguquko zendlela yokuphila noma imithi kungasebenzi, i-ART ingase inconywe. Lokhu kungabandakanya:

• Ukufakelwa isidoda esibelethweni (Intrauterine insemination \- IUI): Isidoda sibekwa ngqo esibeleni (uterus), kukhuliswe amathuba okukhulelwa.
• Ukukhuleliswa ngamaqanda ngaphandle komzimba (In vitro fertilization \- IVF): Ama-ova athathwa ema-ovari bese akhiqizwa inzalo (afakelwa isidoda) elabhorethri. Uma i-embryo seyakhiwe, ibuyiselwa esibelethweni.
• Ukufakwa kwesidoda ngaphakathi kweseli leqanda (Intracytoplasmic sperm injection \- ICSI): Isidoda esisodwa sijovwa ngqo eqandeni phakathi nenqubo ye-IVF.

Kufanele Ubone Nini Udokotela Wezokuzala?

Udokotela wezokuzala ngokuvamile ubuzwa uma umbhangqwana esehlale ezama ukukhulelwa iminyaka eyodwa ngaphandle kwempumelelo. Nokho, uma owesifazane eseneminyaka engaphezu kwengu-35, kunconywa ukufuna usizo ngemva kwezinyanga eziyisithupha. Ngaphezu kwalokho, uma omunye wozakwenu enenkinga yezempilo esivele yaziwa ethinta ukuzala (njengokungajwayelekile kokuya esikhathini noma ukuhlinzwa ngaphambilini kwezitho zokuzala), kuhlakaniphile ukuvakashela udokotela kusenesikhathi.

Umthelela Wemizwa Nezindlela Zokubhekana Nawo

Umthelela wengcindezi emoyeni ngenxa yokungabi namandla okukhulelwa ungaba mkhulu kakhulu futhi ube nzima. Imibhangqwana ivame ukubhekana nokukhathazeka, ukudikibala nokudabuka ngesikhathi idlula ezinhlelweni zokwelashwa zokuzala. Yisikhathi lapho bobabili ababambisene bengasizana kakhulu. Kubalulekile ukufuna ukwesekwa ngokwelashwa kwengqondo (therapy) noma amaqembu okusekela ukuze kulawulwe uhlangothi lwemizwa mayelana nokungabi namandla okukhulelwa.

Odokotela bezokuzala bangabuye banikeze isiqondiso sokuthi ungabhekana kanjani nokuguquguquka kwemizwa phakathi nenqubo yokwelashwa. Amaklinikhi amaningi anikeza izinsizakalo zokwelulekwa, kanti abanye abaguli bathola induduzo ngokuxhumana nabanye ababhekene nezinselelo ezifanayo.

Amazwi okugcina

Ukungabi namandla okukhulelwa (infertility) yinkinga evamile ethinte imibhangqwana eminingi, kodwa akusho ukuphela kwendlela. Udokotela okhethekile kwezokuzala angasiza ukuthola imbangela yenkinga futhi anikeze uhla lwezindlela zokwelapha ezandisa amathuba okukhulelwa. Kusukela ezinguqukweni zendlela yokuphila kuya kubuchwepheshe besimanje bokuzalela, laba odokotela badlala indima ebalulekile ekusizeni imibhangqwana ifinyelele iphupho layo lokuba nabantwana. Uma ubhekene nokungabi namandla okukhulelwa, ukubonana nodokotela okhethekile kwezokuzala kuyisinyathelo sokuqala ekutholeni isixazululo. Ungaze uzizwe unganqikazi ukuxhumana nodokotela onguchwepheshe kwezokungabi namandla okukhulelwa ongakuhola ezinyathelweni ezifanele ezisekelwe olwazini lwezokwelapha nasezinhlanganisweni eziveziwe ukuthi ziyasebenza.

Imithombo

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573907/
2. https://www.medicalnewstoday.com/articles/321419
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8911320/
4. https://www.parents.com/getting-pregnant/infertility/treatments/hormone-imbalance-and-pregnancy/
5. https://www.mayoclinic.org/diseases-conditions/low-sperm-count/diagnosis-treatment/drc-20374591
6. https://www.ncbi.nlm.nih.gov/books/NBK448113/

Thenga imikhiqizo yokukhulelwa ku-inthanethi kwa-Conceive Plus, uphawu lokuzala oluthembelwe yimibhangqwana nochwepheshe bezempilo emazweni angaphezu kuka-70! Oda izithasiselo ezisezingeni eliphezulu zokukhulelwa kuwebhusayithi yethu namuhla, amakhithi okukhulelwa angcono kakhulu athengiswayo emibhangqwaneni ezama ukukhulelwa (TTC).