Ukuqandisa isidoda kwandisa amathuba okuba ngubaba ngemva kokwelashwa kwe-Hodgkin lymphoma

Amadoda anomdlavuza wegazi obizwa ngokuthi i-Hodgkin lymphoma abafuna ukuba ngoyise ngemva kokwelashwa umdlavuza banamathuba andile kakhulu okufeza lokho uma bengagcina futhi befriza izampula ze-semen kusenesikhathi, ngokusho kwemagazini ohamba phambili eYurophu kwezokuzala, i-Human Reproduction.

Ocwaningweni lokuqala ukuhlola umthelela ekubeni nobuntwana wokufriza i-semen ngaphambi kokwelashwa umdlavuza, abacwaningi babuze amadoda angu-902 asinde ku-Hodgkin lymphoma emazweni amahlanu aseYurophu (iFrance, iBelgium, iThe Netherlands, i-Italy neSwitzerland) bathola ukuthi phakathi kwabo-334 abafuna ukuba nezingane, ukuba ne-semen efriyiwe kuphindwe kabili ithuba labo lokuba nezingane uma kuqhathaniswa namadoda angenzanga ukufriza i-semen yawo.

UDkt. Marleen van der Kaaij uthi, "Ucwaningo lwethu lubonisa ukuthi ukugcinwa kwe-semen ngokuyifiriza ngaphambi kokwelashwa umdlavuza kunomthelela omkhulu: 1 kwezi-5 zezingane ezizalwe ngemva kokwelashwa i-Hodgkin lymphoma yazalwa kusetshenziswa i-semen ebigcinwe ifriziwe. Phakathi kwabaphunyukile abafisa ukuba ngoyise ngemva kokwelashwa, ukutholakala kwe-semen egcinwe ngokuyifiriza kuphindwe kabili amathuba okulokhu kuphumelela ekubeni ngoyise."

Uthe le miphumela igcizelela ukubaluleka kokugcinwa kwe-semen ngokuyifiriza. "Ukugcinwa ngokuyifiriza kufanele kuhlale kunikelwa kuzo zonke iziguli zobulili besilisa ezizoya ekwelashweni komdlavuza - ngisho nasezimeni lapho ukwelashwa kufanele kuqale ngokuphuthumayo noma lapho ukwelashwa kwokuqala kungabi yingozi kakhulu ekuzaleni. Odokotela kufanele babone umthelela omkhulu walenqubo eshibhile futhi elula."

Ukwelashwa kwe-Hodgkin lymphoma Kungalimaza Ukuzala

Ukwelashwa kwe-Hodgkin lymphoma kuncike ekutheni isifo sesithuthuke kangakanani. Kokubili i-radiotherapy ne- chemotherapy kungasetshenziswa, kodwa lapho i-radiotherapy ingaqondiswa endaweni ethile yomzimba, i-chemotherapy iyindlela yokwelapha esebenza emzimbeni wonke. I-chemotherapy ejwayelekile yaleli gciwane ingasebenzisa ama-alkylating agents - imishanguzo elimele i-DNA yamaseli - noma imishanguzo engeyona i-alkylating.

I-alkylating chemotherapy isetshenziswa kabanzi ezigulini zesigaba esithuthukile futhi ingabangela ukungazali kwesikhathi eside infertility kubantu besilisa abangaphezu kuka-80%. Kodwa-ke, izinhlelo ze-chemotherapy ezingasebenzisi ama-alkylating agents cishe zibangela ukungazali ngaphansi kuka-10% wamadoda, futhi lezi zinhlaka zivamise ukusetshenziswa ezigabeni zokuqala zesifo.

Ucwaningo Olusha Lwabasayensi Abavela ku-European Organisation for Research and Treatment of Cancer (EORTC) kanye ne-Groupe d'Étude des Lymphomes de L'Adulte (GELA).

Kuze kube manje, bekunolwazi oluncane mayelana nesibalo seziguli zomdlavuza ezifriza i-semen ngaphambi kokwelashwa; kube nezifundo ezimbalwa ezivela ezikhungweni ezilodwa zokuzala ezinezinga elilinganiselwe lokulandela iziguli. Lolu cwaningo lusekelwe ezigulini ezingu-3399 zamadoda anomdlavuza i-Hodgkin lymphoma ezivela ezivivinyweni ezingu-13 zokwelashwa komdlavuza ezenziwa ngokungahleliwe phakathi kuka-1974 no-2004. Ngo-2008 abacwaningi bathumela imibuzo kubasindile abangu-1849 futhi bathola izimpendulo ezingu-902 eziqukethe ulwazi abaludingayo. La madoda abeneminyaka ephakathi kuka-15 no-69, kanti iminyaka ephakathi (median) yayingu-31. Inani eliphelele lamadoda angu-363 kwangu-902 (40%) abenefriza i-semen yawo ngaphambi kokuqala ukwelashwa komdlavuza. Kula madoda angu-363, angu-78 (21%) ayisebenzisa ngemva kokwelashwa kwawo.

Phakathi kwamadoda angu-334 abefuna ukuba nezingane ngemva kokwelashwa kwawo, angu-206 (62%) aba ngoyise ngaphandle kosizo lwezokwelapha, kodwa angu-128 (38%) abangenelanga ukuthola ukukhulelwa okuzenzakalelayo ngaphandle kosizo futhi badinga usizo lwezokwelapha. Phakathi kwalawo madoda, u-77% wayene-semen efriyiwe ayitholayo. Kubantu abangu-99, angu-78 basebenzisa i-semen efriyiwe futhi angu-48 baphumelela ekukhiqizeni ingane eyodwa noma ezingaphezu kweyodwa. Kulabo abangama-30 abasele, abangama-27 bahluleka ukuzala izingane futhi abathathu baba nengane ngokuzimela ngaphandle kokusebenzisa i-sperm efriyiwe.

UDkt. van der Kaaij uthi: "Amadoda angama-23% angenakukwazi ukukhulelisa owesifazane ngokwemvelo abengenayo i-semen egcinwe ngokuyifiriza futhi awakwazanga ukuba ngoyise. Kanti-ke, phakathi kwamadoda asebenzise i-semen egcinwe ngokuyifiriza sithole izinga lempumelelo elingu-62% futhi amadoda amaningi ayesesezinhlanganweni zokwelashwa ukungazali ngesikhathi kwenziwa lolu cwaningo. Lokhu kugcizelela ukubaluleka kokwazisa nokunikeza ukufinyelela emoyenisini wokugcinwa ngokuyifiriza lwe-semen ezigulini zomdlavuza."

Ukutholakala kwe-sperm kungathuthukisa ukuzala, nokuvimbela inzalo

Ukukhulisa Ukufinyeleleka Kokugcinwa Ngokuyifiriza

Abacwaningi bathole ukuthi amadoda aphathwe nge-chemotherapy abe kathathu kuya kokune amathuba okufuna ukufriza i-semen yawo, futhi aphindwe kabili amathuba uma ethola ukwelashwa kwesigaba sesibili ngenxa yokuhamba phambili kwesifo noma ukubuyela kwaso, okungaba yimishanguzo ye-alkylating. Amadoda afundile kakhulu abe nama-60% amathuba amaningi okufriza i-semen yawo, kanti amadoda aneminyaka engaphezu kwengu-30 abe mancane amathuba okufuna ukufriza i-semen kunamadoda angaphansi kwengu-30. Amadoda aphathwe ngemva kuka-1994 abe kathathu kuya kwezilishumi nanye amathuba amaningi okufriza i-semen.

Kunezizathu eziningana ezingenzeka ezenza amadoda abe maningi amathuba okufuna ukugcina i-semen ngokuyifiriza ngemva kuka-1994, kusho uDkt. van der Kaaij, "Lokhu kubandakanya ukwanda kwezikhungo zokugcina i-semen ngokuyifiriza kanye nokuqwashisa nolwazi ngezinketho ezikhona, okuyinto ekhule kancane kancane kusukela ngeminyaka yawo-1970; amasu okuvikela ukuzala (fertility preservation techniques) aqale ukufakwa njengengxenye yezinqubo zokwelashwa ezijwayelekile kusukela ngeminyaka yawo-1990 kuya phambili; odokotela sebejwayele kakhulu nokuphakamisa ukugcinwa kwe-semen ngokuyifiriza ezigulini; ulwazi ngemiphumela engase ibe yinhlekelele yokwelashwa komdlavuza ekukhiqizeni inzalo selukhule kusukela maphakathi nawo-1980; kanti nemibono kodokotela ishintshe isuka ekugxileni ekusindeni kuphela iye ekufakeni izici zekhwalithi yokuphila nezinye izinto ezigxile kakhulu ezigulini."