Okumele ngikwenze uma ngikwazi ukukhulelwa kodwa ngiqhubeka ngiphuphunyelwa yisisu

Ngiyakwazi ukukhulelwa kodwa ngihlale ngilahlekelwa ukukhulelwa. Lokho kuzwakala kuyadumaza futhi kubuhlungu kakhulu ngokomzwelo. Imibhangqwana eminingi ikhuluma ngokuthi ijabula kangakanani, bese ibhekana nokulahlekelwa okungazelelwe. Abanye abantu badlula ekulahlekelweni okukodwa noma ngisho okungu-2 kulandelana bezizwa bengazi lutho ngemvelaphi yenkinga. Abanye bangabhekana nokulahlekelwa ukukhulelwa okungu-3 kulandelana baze bazibuze ukuthi bazoke bayibambe yini ingane ezandleni zabo. Ngezinye izikhathi impendulo itholakala ekuhlolweni kwezokwelashwa noma ekulungisweni kwendlela yokuphila, kodwa uhambo lungaba nzima. Ngezansi kunolwazi oluwusizo ongakwazi ukuluhlanganyela.

Ukuxazulula Udideko Ngemuva Kokulahlekelwa Kaningi

Ukukhulelwa kungaba nzima kakhulu. Ezinye imindeni elahlekelwe ukukhulelwa kabili kulandelana iyakwazi futhi ukukhulelwa ngokwemvelo futhi, kodwa ukulahlekelwa okuqhubekayo kusalokhu kunzima ukukubhekana nakho. Izizathu zalezi zilahleko zivame ukuhluka. Izakhi zofuzo, amahomoni, ukwakheka kwesibeletho, noma ngisho nezinto ezifana nengcindezi (stress) nokudla (diet) kungaba nendima. Kufana nocezu lwephazili, kuqoqwa imikhondo okuvela ekuvakasheni kudokotela, ekuhlolweni kwegazi, nasemlandweni wezokwelashwa, nethemba lokubona isithombe esicacile.

Kunoma ubani ongabazayo ukuthi enzeni ngemva kokulahlekelwa ukukhulelwa okungu-2 kulandelana, ukuhlolwa okup Thorough kungathola izinkinga ezifihlekile ze-thyroid, izifo zomzimba ezihlobene nokuzivikela ezingakahlonzwa, noma ezinye izimbangela [1]. Noma imiphumela yokuhlolwa ibuya ijwayelekile, lokho akusho ngokwemvelo ukuthi ukukhulelwa kusho ukuthi ingane ayisatholakali; kungadinga nje isikhathi sokuthola indlela esebenzayo.

Icebiso eliyinhloko: Uma imiphumela yokuhlolwa ingacaci, cabanga ukuhlolwa izifo zokunqwabelana kwegazi noma ukungalingani okuncane kwamahomoni okungenzeka kudlulwe.

Izinkinga Zofuzo nempilo yesidoda

Abaningi bacabanga ukuthi ukulahlekelwa ukukhulelwa kwenzeka kuphela ngenxa yezinkinga emzimbeni wowesifazane, kodwa lokho akulona iqiniso ngaso sonke isikhathi. Ukungajwayelekile kwamachromosome kungaqhamuka kunoma ubani kubalingani bobabili [2]. Imininingwane ebonakala ingeyona inkinga, njengokushintshana kwamachromosome okufanisanayo (balanced translocation), ingaba yona imbangela. Uma umbungu uthola izinto zofuzo ezengeziwe noma ezilahlekile, ukukhulelwa kungaphela kusenesikhathi. Impilo yesidoda ibalulekile futhi ngoba ukuphazamiseka okukhulu kwe-DNA esidodeni kungandisa ingozi yokulahleka kokukhulelwa, noma ukuhlaziywa okujwayelekile kwesidoda kubonakale kukahle.

Lesi simo sivame ukuholela ezingxoxweni nochwepheshe bezofuzo. I-karyotyping ingadalula ukushintshaniswa okungenzeka kwamachromosome. Kwezinye izimo, ukuhlolwa kofuzo lwembungu ngaphambi kokufakwa kungaba inketho, ikakhulukazi uma ukulahlekelwa ukukhulelwa okuqhubekayo kuhlotshaniswa namachromosome angajwayelekile [3].

Ithiphu ebalulekile: Uma inani lesidoda lomlingani livamile kodwa ukuphuphunyelwa yisisu kuqhubeka kwenzeka, ukuhlolwa okujulile kwe-DNA yesidoda kunganikeza imininingwane ebalulekile evame ukunganakwa.

Indima Yesakhiwo Sesibeletho

“Isibeletho esingavamile” singavimbela ukufakwa kahle kombungu. Isibeletho esine-septate, ngokwesibonelo, sinendwangu efana nodonga esihlukanisa isibeletho ingxenye noma sonke. Ama-fibroid noma ama-polyp nawo angavela futhi aphazamise ukukhulelwa. Kulabo ababhekene nendlela yokuhlala bekhulelwe emva kokuphuphunyelwa yisisu kaningi, ukungajwayeleki kwesakhiwo kungase kuhlotshiswe ngqo nale nkinga. I-saline ultrasound noma izivivinyo ze-X-ray zingathola amanxeba noma izimila, futhi ukuzikhipha kwesinye isikhathi kusiza. Nokho, akuwona wonke amatholomali adala izinkinga; amanye mancane.

Kukhona futhi amathuba okuba kube nokungakwazi ukuvala kahle kwesibeletho, okusivule kusenesikhathi ekukhulelweni bese kuholela ekulahlekelweni ukukhulelwa esigabeni sesibili sokukhulelwa. Ukufakelwa umthungo esibelethweni noma imithi yamahomoni kungaba yikhambi [4]. Abaningi abaze baqaphele ukuthi inkinga yesakhiwo sangaphakathi ingase ibe imbangela yokulahlekelwa ukukhulelwa.

Ithiphu ebalulekile: Buza udokotela okhethekile ngobukhulu nendawo yama-fibroid noma ama-polyp uma etholakala. Akuzona zonke izimila ezikhuphula ingozi yokuphuphunyelwa yisisu, ngakho ukwazi ukuthi yiziphi ezibalulekile kubalulekile.

Ukungebalansi Okungenzeka Kwezinhlelo Zama-Endocrine

Amahomoni adlala indima enkulu ekukhulelweni. Ukungahleleki okukodwa ekukhiqizweni kwama-hormone kungabangela izinkinga ezinkulu. I-hypothyroidism (indlu yegilo engasebenzi kahle) noma i-hyperthyroidism (indlu yegilo esebenza ngokweqile) kungakhulisa ingozi yokuphuphunyelwa yisisu. Izimo ezifana ne-Polycystic Ovary Syndrome (PCOS) nazo ziphazamisa ukuvuthwa kweqanda. Ukumelana ne-insulin kubonakala kuhlotshaniswa nokulahlekelwa ukukhulelwa kaningi kakhulu [5]. Ukuhlolwa kwegazi okulula kuvame ukuqinisekisa noma kukhiphe lezi zinkinga.

Noma ubani obhekene nalokho okuthi ngiyakwazi ukukhulelwa kodwa ngihlale ngiphuphunyelwa yisisu uvame ukuba nokuhlolwa kwendlala yegilo kuqala. I-TSH, i-T3, i-T4, noma ama-antibody endlala yegilo kungalinganiswa. Nezinga likashukela egazini lingahlolwa isifo sikashukela noma i-prediabetes. Imithi kanye nezinguquko ekudleni zingasiza uma imiphumela ikhombisa ukungalingani.

Ithiphu ebalulekile: Imijikelezo yokuzila iyokuya okungaqondakali ingase ibe uphawu lokungalingani kwamahomoni; kunconywa ukuthi uyikhulume nodokotela, ikakhulukazi uma iqhubeka izinyanga eziningi.

Izifo Zamasosha Omzimba Nezokubumbana Kwegazi

Izifo zokuzivikela komzimba kwesinye isikhathi zingabangela ukuphindaphinda kokulahleka kokukhulelwa. Isifo i-antiphospholipid, ngokwesibonelo, sidala “igazi elinamathelayo” elingaphazamisa ukugeleza kwegazi liye embungwini. Lokhu kwesinye isikhathi kuchaza ukuhushulwa kwezisu okuvame ukwenzeka kusenesikhathi, futhi i-aspirin yomthamo ophansi noma imijovo ye-heparin kungaba usizo. Ukuhlolwa kubalulekile, ngoba akuwona wonke umuntu onezisu ezihushulwa kaningi onenkinga yokujiyeka kwegazi [6].

Ngenkathi abanye becabanga ukusebenzisa imithi yokuqanda ukujiya kwegazi “ukuze baziphephe nje,” ukuqinisekisa isifo sangempela kubalulekile. Ukusetshenziswa okungafanele kungaba nemiphumela emibi. Abanye bahlola izici zokuzivikela komzimba, njengamaseli okubulala emvelo, nakuba ubufakazi busamele buhlangane ngokuphathelene nezinye izindlela zokwelapha.

Ithiphu ebalulekile: Ngemihlololwazi yokuzivikela komzimba noma yokujiyeka kwegazi, qinisekisa ukuthi yenziwa elabhorethri ethembekile, ngoba umehluko omncane emiphumeleni ungadida ukuxilongwa.

Izici Zokudla Ezibalulekile

Ukuzala nokudla kuvame ukuhambisana lapho kukhulunywa ngokuphumela ekukhulelweni ngempumelelo ngemva kokuhushulwa kwezisu kabili kulandelana. I-Folic Acid yaziwa kabanzi ngokwehlisa ubungozi bokukhubazeka kwemigudu yengqondo yomntwana. I-Myo-Inositol ikhankaswe ngokuthuthukisa ukumelana ne-insulin nekhwalithi yamaqanda, ikakhulukazi nge-PCOS. I-CoQ10 kukholakala ukuthi iqinisa ukuthuthukiswa kwamaqanda futhi yehlise ukucindezeleka kwe-oxidative. I-Calcium ne-Magnesium zivame ukuvela ezifakeni zokuzala, ngenhloso yokusiza ukusebenza kwemisipha nokunciphisa ukucrampa.

I-Zinc ivame ukukhulunywa kakhulu emadodeni, isekela ukukhiqizwa kwesidoda esinempilo. I-L-Arginine ngezinye izikhathi iyelulekwa ukuze ikhuthaze ukugeleza kwegazi esibelethweni, kanti i-L-Carnitine ingathuthukisa ukunyakaza kwesidoda [7]. Ezinye izinqubo nazo zifaka impande ye-Maca noma i-Ginseng, okuyizingxenye zemifino ezitholakala kwezinye izingxube zokukhulisa ukuzala. Abanye bakhetha ukudla okugcwele okuphelele okunezimifino eluhlaza enamaqabunga, izithelo, okusanhlamvu, namaprotheni anganamafutha amaningi ukuze bahlangabezane nezidingo zokudla.

Ithiphu ebalulekile: Qaphela imikhawulo yokudla kwansuku zonke enconywayo, ngoba ukweqisa amanye amavithamini—njenge-Iron noma i-Vitamin A—kungaba yingozi.

Ingqikithi Ye-Lubricant Enobungane Kokuzala

Ama-lubricant ajwayelekile kwesinye isikhathi angavimba ukunyakaza kwesidoda, okungenza umehluko kulabo abahlangabezana nokuthi ngiyakwazi ukukhulelwa kodwa ngihlale ngihushulwa isisu noma abalinganisela ngokunembile isikhathi sokulala ngokocansi. Ngikhulelwe ngisebenzisa ama-lubricant aphephile ekuzaleni, aqanjwe ngendlela ecabangela isidoda, futhi avame ukubandakanya ama-ion e-Calcium noma e-Magnesium ukuze agcine imvelo efanele yesidoda [8]. Le mikhiqizo ayiqinisekisi ukutheleka kwesisu kodwa isiza imibhangqwana edinga umswakama owengeziwe ukuthi igweme ukulimaza isidoda.

Umhlahlandlela Omkhulu: Izinkinga zokoma zenza kubaluleke kakhulu ukugwema ama-lubricant anamakhemikhali aqinile noma amakha anganciphisa ikhono lesidoda lokuphila. Amalebula abhalwe ukuthi “fertility-friendly” avame ukuba engcono kakhulu.

Izinguquko Zendlela Yokuphila Nezinto Ezibangela Ukucindezeleka

Indlela yokuphila ingaba nomthelela omkhulu emiphumeleni yokukhulelwa. Ukubhema kwaziwa ngokwandisa ingozi yokuphelelwa yisisu. Utshwala nokudla i-caffeine eningi kungalimaza imizamo yokukhulelwa. Ukulawula imikhuba enjalo kungasiza ukugcina ukukhulelwa. Ukufinyelela isisindo somzimba esinempilo nakho kuyasiza ngoba ukukhuluphala ngokweqile nokuba mncane kakhulu kokubili kuthinta ukulawulwa kwama-hormone [9].

Ukucindezeleka kungesinye isici, futhi kuvame ukukhula lapho kuphindaphinda ukuphelelwa yisisu. Abantu abafuna ukuthi bangahlala kanjani bekhulelwe ngemuva kokuphelelwa yisisu izikhathi eziningi bangagcwala ukukhathazeka. Amasu afana nokuzivocavoca kancane, ukuphefumula ngokucabangisisa, noma imihlangano yokwelashwa kwengqondo anganciphisa lowo mthwalo. Ukukhuluma nabanye abake babhekana nezimo ezifana nale kungasiza futhi.

Umhlahlandlela Omkhulu: Ukulandelela imikhuba yansuku zonke—ukulala, ukudla, amazinga okucindezeleka—encwajaneni encane kungasiza ukubona amaphethini avimbela noma asize.

Ukusondela Osizweni LoChwepheshe

Ngezinye izikhathi imindeni ihlangabezana nokuphelelwa yisisu kabili kulandelana noma idlulele phambili ibe kathathu kulandelana. Uma lokho kwenzeka, ukubona uchwepheshe wokuzala kungaba indlela engcono kakhulu. Udokotela we-endocrinology yokuzala angahlinzeka nge-ultrasound esezingeni eliphezulu, ukuhlolwa kofuzo, noma aphakamise izindlela zokuzala ezifana ne-IVF enokuhlolwa kofuzo. Uhlelo lungaba lulula njengokulawula amazinga e-thyroid, noma lube olunzulu njengokuhlela ukuhlinzwa okuncane ukulungisa ukungajwayeleki esibelethweni.

Kwezinye izimo, yonke ukuhlolwa kubonakala kujwayelekile, kanti ukulahlekelwa okuqhubekayo kubhekwa njengokuthi “akuchazeki.” Lokhu kungakhathaza kakhulu. Noma kunjalo, imibhangqwana eminingi ekugcineni iyakwazi ukuthwala ingane ize ifike esikhathini sokubeletha ngokugadwa ngokuseduze ngesikhathi sokukhulelwa. Ukuhlola okungeziwe kwamazinga ama-hormone noma ukunikezwa i-progesterone kwesinye isikhathi kuyasiza [10].

Umhlahlandlela Omkhulu: Ukufuna ukwelulekwa noma usizo lwezempilo yengqondo kungaba usizo lapho ukuphindaphinda kokulahlekelwa kuthwala umthwalo osindayo ngokomzwelo.

Okubalulekile Okungaqondwa Ukuze Ube Nethemba

Ukusho ukuthi ngiyakhulelwa kodwa ngihlale ngiphelelwa yisisu kungadida futhi kukhandaze kakhulu. Imininingwane yezofuzo, izinkinga zama-hormone, noma ukungahleleki kahle komzimba kungase kube nesandla, kodwa zikhona izixazululo. Ukuhlolwa okuphelele kunconywa uma uphelelwa yisisu kabili kulandelana noma ngaphezulu. Ukuhlolwa kungathola izimo ezifana nezifo ze-thyroid, izinkinga zamasosha omzimba, noma ukushoda kokudla okunomsoco [11]. Uma konke kuphuma kujwayelekile, kusenokwenzeka ukuba nokukhulelwa okunempilo. Ukuqapha kusenesikhathi kungasiza ukunikeza isiqiniseko nokuthola noma yiziphi izinkinga.

Ukudla okunomsoco okulinganiselayo kuvame ukufaka izithasiselo ezisiza ekuzaleni ezihlanganisa i-Folic Acid, i-Myo-Inositol, noma i-CoQ10. I-lubricant ehambisana nesidoda nayo ingasiza uma ukoma kuyinkinga. Noma ngabe akukho sizathu esitholakalayo, abantu abaningi bagcina bekhulelwe ngempumelelo ngemva kokuphuphunyelwa yizisu okungu-2 okulandelanayo. Izingxoxo eziqhubekayo nochwepheshe bezempilo nokugxila ezintweni zokuphila okunempilo kungalulula indlela eya ekubeni ngabazali. Uhambo lomuntu ngamunye luyahlukahluka, futhi kukhona ithemba ngomphumela ojabulisa kakhulu.

Okubalulekile Ekugcineni

Ukubhekana nesimo sokuthi "ngiyakhulelwa kodwa ngihlale ngiphuphunyelwa yizisu" kuletha ukunyuka nokwehla okukhulu kwemizwa. Nokho, ulwazi, ukuhlolwa okuphelele, nezinguquko ezincane kuvame ukuguqula indlela izinto ezibonakala ngayo. Ukuhlolwa kofuzo kungadalula ukungajwayeleki okufihlekile, kanti ukungalingani kwamahomoni okutholakele kungalawulwa ngemithi. Ukubuyekeza ukudla noma ukuphenya ama-fibroid noma ama-polyp nakho kungenza umehluko. Ingxoxo evulekile nochwepheshe bezokwelapha, ukugxila kuma-nutrient abalulekile, nokunaka impilo yokomoya nakho kuyasiza. Inhlanganisela yokusekelwa ngendlela efanele kwezokwelapha nezinyathelo zokuzinakekela njalo inikeza ithemba langempela kulabo abakulungele ukwamukela usana olusha.

Imibuzo evame ukubuzwa

Kushesha kangakanani umuntu angazama ukukhulelwa ngemva kokuphuphunyelwa yisisu?

Abaningi batusa ukulinda amasonto amabili ukuze kwehliswe ingozi yokutheleleka, kodwa ukuzama masinyane kungamukeleka kwabanye abazizwa belungele ngokomzwelo nangokomzimba. Ukuholwa udokotela kuhlala kuyindlela engcono kakhulu.

Ingabe ukulahlekelwa okunye kuqinisekisiwe ngemva kokuphuphunyelwa yizisu okungu-2 okulandelanayo?

Akusona isidingo njalo. Inani elingatheni labantu liyakhulelwa ngempumelelo okwesikhathi esilandelayo. Ukucubungula izimbangela ezingaphansi kungase kwehlise ubungozi besikhathi esizayo.

Ingabe i-lubricant enobungane ekuzaleni iyasiza ngempela ekukhulelweni?

Kungasiza uma ukoma kuyinkinga noma uma ama-lubricant ajwayelekile ephazamisa ukunyakaza kwesidoda. Akusona isixazululo sabo bonke, kodwa kusiza ukususa okungenani isithiyo esisodwa esingaba khona.

Ingabe ukuhlolwa kofuzo okuthuthukile kubalulekile ngemva kokuphuphunyelwa yisisu kanye kuphela?

Ukuhlolwa okujulile kuvame ukwenziwa kulabo abelokhu belahlekelwa yizisu kaningi. Nokho, umlando womndeni noma okukhethwa umuntu mathupha kungathinta lesi sinqumo.

Ingabe ukudla kuphela kungaxazulula ukuthi umuntu angahlala ekhulelwe kanjani ngemva kokuphuphunyelwa yizisu izikhathi eziningi?

Ukudla okuyikho kuyinto ebalulekile, kodwa ngokujwayelekile kuyisigaxa esisodwa kuphela sephazili. Ukuhlanganisa ukudla okunomsoco okulinganiselayo nokuhlolwa kwezokwelapha kunikeza uhlelo oluphelele olunamandla kakhulu.

Izincaphuno

1. Practice Committee of the American Society for Reproductive Medicine (2012). Ukuhlola nokwelapha ukulahlekelwa ukukhulelwa okuphindaphindayo: umbono wekomidi. Ukuzala nokungachumi. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/22835448/
2. Stephenson, M., & Kutteh, W. (2007). Ukuhlola nokuphatha ukulahlekelwa kokuqala kokukhulelwa okuphindaphindayo. I-clinical obstetrics and gynecology. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/17304030/
3. Rubio, C., Bellver, J., Rodrigo, L., Castillón, G., Guillén, A., Vidal, C., Giles, J., Ferrando, M., Cabanillas, S., Remohí, J., Pellicer, A., & Simón, C. (2017). Ukufakelwa umbungu ngaphandle komzimba (i-in vitro fertilization) ngokuhlolwa kofuzo kwangaphambi kokufakelwa ukuze kutholakale ama-aneuploidy kubomama abaneminyaka emikhulu yokuzala: ucwaningo oluqokwe ngenhlanhla nolulawulwayo. Ukuzala nokungachumi. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/28433371/
4. Drakeley, A. J., Roberts, D., & Alfirevic, Z. (2003). Ukuthunga umlomo wesibeletho (cerclage) ekuvimbeleni ukulahlekelwa ukukhulelwa kwabesifazane. I-database yeCochrane yokubuyekezwa okuhleliwe. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/12535466/
5. Palomba, S., de Wilde, M. A., Falbo, A., Koster, M. P., La Sala, G. B., & Fauser, B. C. (2015). Izingqinamba zokukhulelwa kwabesifazane abanesifo se-ovary esinama-cyst amaningi (polycystic ovary syndrome). Ukubuyekezwa kwezokuzala komuntu. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/26117684/
6. Empson, M., Lassere, M., Craig, J. C., & Scott, J. R. (2002). Ukulahlekelwa ukukhulelwa okuphindaphindayo okunama-antiphospholipid antibody: ukubuyekezwa okuhleliwe kwezivivinyo zokwelashwa. I-obstetrics and gynecology. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/11777524/
7. Agarwal, A., & Said, T. M. (2004). Ama-carnitine nokungachumi kwabesilisa. I-reproductive biomedicine online. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/15149558/
8. Mackenzie, S. C., & Gellatly, S. A. (2019). Ama-lubricant esitho sangasese sowesifazane emibhangqwaneni ezama ukukhulelwa: ukuhlola izincomo zochwepheshe bezempilo nomthelela emsebenzini wesidoda ngaphandle komzimba (in vitro). I-PloS one. Kutholakala ku: https://pmc.ncbi.nlm.nih.gov/articles/PMC6516666/
9. Boots, C., & Stephenson, M. D. (2011). Ukuthi ukukhuluphala ngokweqile kwandisa yini ingozi yokulahlekelwa ukukhulelwa ekukhulelweni okuzenzakalelayo: ukubuyekezwa okuhleliwe. Izifundo ezikwezokuzala kabusha. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/22161463/
10. Coomarasamy, A., Harb, H. M., Devall, A. J., Cheed, V., Roberts, T. E., Goranitis, I., Ogwulu, C. B., Williams, H. M., Gallos, I. D., Eapen, A., Daniels, J. P., Ahmed, A., Bender-Atik, R., Bhatia, K., Bottomley, C., Brewin, J., Choudhary, M., Crosfill, F., Deb, S., Duncan, W. C., … Middleton, L. J. (2020). I-progesterone ekuvimbeleni ukulahlekelwa ukukhulelwa kwabesifazane abopha igazi esigabeni sokuqala sokukhulelwa: ucwaningo lwe-PRISM RCT. Ukuhlolwa kobuchwepheshe bezempilo (Winchester, England). Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/32609084/
11. Jaslow, C. R., Carney, J. L., & Kutteh, W. H. (2010). Izici zokuxilonga ezikhonjwe kwabesifazane abangu-1020 ababenokulahlekelwa ukukhulelwa okuphindaphindayo kabili uma kuqhathaniswa nokulahlekelwa kathathu noma ngaphezulu. Ukuzala nokungachumi. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/19338986/