Imijovo Yokukhulelwa: Asebenza Kanjani Nokuthi Ungakulindela Ini

Imijovo yokuzala (ezaziwa nangokuthi imijovo yokuzala ingane) ingesinye sezindlela ezivame kakhulu zokwelapha ukungabi nenzalo ezinconywa odokotela. Le mijovo iqukethe ama-hormone asiza ukukhuthaza ukuvuthwa kweqanda noma ukulungisa umzimba ukwelashwa kokuzala njenge-IVF. Zibamba iqhaza elibalulekile ekwelashweni kokuzala, ikakhulukazi kulabo abangaphumelelanga ngemithi yomlomo noma abahlanganyela kubuchwepheshe bokuzala obusizwa (ART) njengokuchanyushelwa kwembryo ngaphandle komzimba (IVF).

Yini Imijovo Yokuzala?

Imijovo yokuzala yimijovo yama-hormone eklanyelwe ukukhuthaza izikhunji zamaqanda ukuthi zikhiqize amaqanda, ilungise ukuvuthwa kweqanda, noma ilungise ulwelwesi lwesibeletho ukukhulelwa. Le mijovo ivamise ukunconywa kwabesifazane abanenkinga yokuvuthwa kweqanda ngokwemvelo noma abalungiselela ukwelashwa kokuzala njenge-IVF noma i-IUI (intrauterine insemination).

Kukhona izinhlobo ezahlukene zemijovo yokuzala, ngayinye inomsebenzi othile:

• Ama-gonadotropins: Le mijovo iqukethe ama-hormone afana ne-follicle-stimulating hormone (FSH) noma i-luteinizing hormone (LH), asiza ukuvuthisa amaqanda amaningi ngaphakathi ezikhunjeni zamaqanda [1].
• I-human chorionic gonadotropin (hCG): Lo mjovo uvusa ukuvuthwa kweqanda ngokukhuthaza ukukhululwa kweqanda elivuthiwe esikhunjeni samaqanda. Uvame ukunikezwa ngesikhathi amaqanda esesilungele ukukhiwa noma ukufakelwa isidoda.
• Imijovo ye-progesterone: Ngemva kokuvuthwa kweqanda noma ukudluliselwa kwembryo ku-IVF, imijovo ye-progesterone isiza ukujiya ulwelwesi lwesibeletho nokulungisa umzimba ukukhulelwa [2].

Ubani Odinga Imijovo Yokuzala?

Imijovo yokuzala ngokuvamile zinconywa lapho eminye imithi, njengemithi yokuzala etholakala ngaphandle kukadokotela (OTC), ingasebenzi. Le mithi, ehlanganisa imithi yomlomo efana ne-Clomid noma i-Letrozole, ivame ukunconywa kuqala kwabesifazane abanenkinga yokuvuthwa kweqanda. Kodwa-ke, odokotela bokuzala basebenzisa imijovo uma le mithi ingaphumeleli.

Imijovo yokuzala ilusizo ikakhulukazi kulezi zimo:

• Imijikelezo ye-IVF: Udokotela wakho okhethekile kwezokuzala uzokhipha amaqanda amaningi ukuze achanyushelwe esebenzisa le mijovo [3].
• IUI: Le mijovo iqinisekisa ukukhishwa kweqanda ngesikhathi ukuze kwenziwe i-insemination.
• Izinkinga zokukhishwa kweqanda: Kwabesifazane abanezimo ezifana ne-polycystic ovary syndrome (PCOS) noma i-hypothalamic amenorrhea, imijovo yokuzala ingavuselela ukukhishwa kweqanda lapho imithi ephuzwayo ingakwazi.

Indlela Imijovo Yokuzala Esebenza Ngayo

Inqubo iqala ngokubonisana nodokotela esikhungweni sokuzala. Udokotela uzohlola umlando wakho wezokwelapha futhi anqume uhlelo lokwelashwa olufanele. Ngemva kwalokho, imijovo inikwa kuhambisane nomjikelezo wakho wokuya esikhathini. Imijovo eminingi yokuzala uzizijova ekhaya. Ungalandela imiyalelo kadokotela wakho ukuyisebenzisa esiswini noma ethangeni ekhaya [4].

Le mijovo ihlose ukuvuselela ama-ovary akhiqize amaqanda amaningi, inqubo eyaziwa ngokuthi ukuvuselelwa ngokulawulwa kwama-ovary (controlled ovarian hyperstimulation, COH). Ukugadwa nge-ultrasound kanye nokuhlolwa kwegazi kuqinisekisa ukuthi ama-ovary ayaphendula ngendlela efanele nokuthi amaqanda avuthwa. Uma amaqanda eselungele, kunikwa umjovo we-hCG trigger ukuze akhululwe, bese kuba nenqubo yokukhipha amaqanda noma yokufaka isidoda (insemination).

Imiphumela Emibi Engase Ibonakale

Imijovo yokuzala ngokuvamile iyabekezeleleka kahle, kodwa njengayo yonke imithi, iza nemiphumela engemihle engase yenzeke. Le miphumela ingaba lula noma ibe nzima kakhulu, kuye ngokuthi umzimba wakho uyiphendula kanjani. Imiphumela emibi ejwayelekile ifaka phakathi:

• Ukugobhoza esiswini
• Ukuguquguquka kwemizwa noma izinguquko ezingokomzwelo
• Ukubuhlungu kwamabele
• Ukungakhululeki okuncane endaweni yomjovo

Imiphumela emibi emibi kakhulu, njengokugula kokuvuselelwa ngokweqile kwama-ovary (ovarian hyperstimulation syndrome, OHSS), yenzeka lapho ama-ovary ephendula ngokweqile emithini, kubangele ukubamba kwamanzi nokuvuvukala. Izigameko ezinzima ze-OHSS zingase zidinge ukungenelela kwezokwelapha.

Imithi Yokuzala Ye-Over-the-Counter (OTC) vs. Imijovo Yokuzala

Kukhona umehluko phakathi kwemithi yokuzala ye-OTC nemijovo yokuzala. Imithi yokuzala ye-OTC iyimithi engenasidingo sokubhaliselwa, ngokuvamile ama-supplement noma imithi ephuzwayo eklanyelwe ukusiza ukukhishwa kweqanda.

Izinketho ezidume kakhulu zifaka phakathi:

• Clomid (Clomiphene Citrate): Ukwelashwa kokuqala okuvame ukusetshenziswa ukuvuselela ukukhishwa kweqanda.
• Letrozole: Elinye ikhambi eliphuza ngomlomo elisetshenziselwa ukuvuselela ukukhishwa kweqanda kwabesifazane ababa nobunzima bokukhulelwa.

Imijovo yokuzala inikeza umthamo omkhulu wamahomoni nokuvuselelwa kwama-ovary okulawulwe kangcono. Ngokungafani nemithi ye-OTC, imijovo yokuzala idinga ukuthi igadwe eduze udokotela ukuze kuqinisekiswe umthamo nesikhathi esifanele.

Amazinga Empumelelo Nokulindelwa

Impumelelo yemijovo ye-fertility incike ezintweni eziningana, okuhlanganisa iminyaka yomuntu wesifazane, izinkinga ayinazo zokuzala, nohlobo lokwelashwa olwenziwayo (isb. IUI noma i-IVF). Ngokuvamile, imijovo ye-fertility isebenza kakhulu ekukhuthazeni i-ovulation, ikakhulukazi kwabesifazane abanokuphazamiseka kwe-ovulation noma abenza i-IVF.

Kubaguli be-IVF, imijovo ye-fertility ibalulekile ekukhiqizeni amaqanda amaningi azokhishwa, okwandisa amathuba okukhulelwa ngempumelelo. Nokho, amazinga empumelelo angahluka kuye nge-clinic, izinga lamaqanda akhishiwe, nezinye izici zomuntu siqu. Kubalulekile ukuba nokulindela okunengqondo nokuba nesineke kulo lonke leli nqubo.

Isifinyezo Esiyinhloko

Imijovo ye-fertility iwukwelashwa okusebenza kahle futhi esetshenziswa kabanzi kubantu abalwelana nokungazali. Le mijovo inikeza ukulawulwa okunembile kwe-ovulation futhi idlala indima ebalulekile empumelelweni yezinqubo ezifana ne-IVF. Noma imithi ye-fertility ye-OTC ingase isebenze kwabanye, imijovo ye-fertility inikeza izinga eliphezulu lokungenelela, ikakhulukazi kulabo abenza ukwelashwa okuthuthukile kwe-fertility. Uma ucabangela imijovo ye-fertility, xoxa nodokotela wakho wezokuzala ukuze uhlole izinketho ezingcono kakhulu esimweni sakho futhi ukhulise amathuba akho okukhulelwa.

Imibuzo Evame Ukubuzwa Ngemijovo Ye-Fertility

1. Ingabe imijovo ye-fertility iyabuhlungu?

Iningi labantu lizwa ubuhlungu obuncane kuphela emijovweni ye-fertility. Umjovo ngokuvamile mncane, futhi i-clinic yakho ye-fertility izokunikeza imiyalelo yokuthi uwunikwe kanjani ukuze kube nobuhlungu obuncane. Uma kudingeka, ungabeka ipakethe yeqhwa ukuze udedele indawo ngaphambi kokujova.

2. Ngingayithenga emtholampilo noma ekhemisi ngaphandle kadokotela imijovo ye-fertility?

Cha, imijovo ye-fertility itholakala kuphela ngemithi ebhalwe udokotela futhi kumele inikwe ngaphansi kokuqondiswa udokotela wezokuzala. Uma ufuna imithi ye-fertility ye-OTC, kukhona izinketho ezifana ne-Clomid noma i-Letrozole, kodwa azinamandla njengemijovo ye-fertility uma kukhona izinkinga ezinzima zokungazali.

3. Imijovo ye-fertility ihlala isikhathi esingakanani ohlelweni lomzimba wakho?

Ama-hormone avela emijovweni ye-fertility ngokuvamile ahlala isikhathi esifushane ohlelweni lomzimba wakho, cishe amahora angu-24 kuya kwangu-36 emijovweni evusa i-ovulation efana ne-hCG. Imijovo ye-progesterone, esetshenziselwa ukusekela ukukhulelwa kwasekuqaleni, ingase inikwe nsuku zonke amasonto amaningana ngemva kokufakelwa.

Imithombo

1. https://www.uptodate.com/contents/infertility-treatment-with-gonadotropins-beyond-the-basics/print 
2. https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716 
3. https://my.clevelandclinic.org/health/treatments/22457-ivf 
4. https://www.sciencedirect.com/science/article/abs/pii/S0277539523001486