Ishadi Lamathuba Okukhulelwa Ngokuya Ngeminyaka Nesikhathi Esingcono Sokukhulelwa

Ishadi lamathuba okukhulelwa ngokuya ngeminyaka lingamangaza abantu kakhulu lapho belibona okokuqala. Ngezinye izikhathi, kuminyene ukuthola ukuthi ukukwazi ukukhulelwa kungehla noma kukhuphuke masinyane kangakanani ngokuya kwesikhathi. Iminyaka ihlotshaniswa kakhulu nokukwazi umuntu ukukhulelwa kangangoba kuwukuphela kwezinto zokuqala abantu abavame ukuzihlola lapho behlela ukukhulelwa, noma ngisho nje bephupha ngezingane zesikhathi esizayo. Uma ubube ubuza mayelana nesigaba esingcono kakhulu sokwakha umndeni, noma ukuthi ukulinda kungase kwehlise amathuba akho, ngempela awuwedwa. Abantu abavela kuzo zonke izizinda babeka le mibuzo.

Ngezansi kunengxoxo eningiliziwe ehlanganisa amaqembu eminyaka ehlukene, ibheka nezinto ezithinta owesilisa, futhi inikeza nemibono yokudla okunomsoco.

Kungani Iminyaka Ibalulekile Ekukhulelweni

Iminyaka ngempela ithinta amahomoni, ikhwalithi yamaqanda, nawo wonke uhlelo lokuzala. Ngezinye izikhathi kulula ukukhohlwa ukuthi unyaka ngamunye ungayishukumisela ibhayoloji yethu ohlangothini olulodwa noma olunye. Isibonelo, ungase uzibuze ukuthi abesifazane bakhulelwa kakhulu baneminyaka emingaki ngoba uke wezwa ukuthi kusekuqaleni kunalokho abaningi abakucabangayo. Ngokuvamile, ukukwazi ukukhulelwa kuphezulu ekuqaleni kweminyaka yama-20 kuya emaphakathi nawo-20, nakuba abanye behlala benamandla okukhulelwa isikhathi eside kancane. Kodwa akuwona wonke umzimba ofunda izincwadi [1].

Njengoba umuntu ekhula, izinga lamahomoni athile liyanqunywa. Nempahla yamaqanda iyancipha. Lokhu kubalulekile uma uhlole amathuba okukhulelwa ngokuya ngeminyaka, ngoba indaba yakho yombelethisi ingase yehluke kweyomakhelwane wakho. Ukucindezeleka, ukudla, nezakhi zofuzo kuhlangana ndawonye. Okubalulekile ukuthi, njengoba ukhula, laba bafakwa ndawonye banganda, bethonya kokubili isikhathi sokukhulelwa nempilo yokukhulelwa okuzayo.

Okuthokozisayo, abantu abaningi baphendukela ku-zindaba ezindala zabesifazane ukuze bakhulelwe lapho bezama ukuba nomntwana. Kungaba ukudla ukudla okuthile, ukushintsha izikhundla zokulala, noma ngisho nokuma ngekhanda ngemuva kocansi, lezi zindlela zidluliselwe ezizukulwaneni ngezizukulwane. Nakuba isayensi ingase ingasekeli zonke zona, ezinye zingase zibe nencazelo emangalisayo enengqondo ngazo.

Ithiphu Eyinhloko: Gcina umqondo oguquguqukayo. Umngani oyedwa angakhulelwa masinyane emaphakathi nawo-30, kanti omunye angazama izinyanga eneminyaka yokuqala yawo-20.

Iminyaka Yokuzala Izingane

Lowomusho, iminyaka yokuzala izingane, uvame ukuhamba uhlangene nengxenye enkulu yempilo. Ngezinye izikhathi abantu bahlonipha iminyaka yokuzala izingane njengekusukela ekupheleni kweminyaka yobusha kuze kufike ekuqaleni kwama-40, nakuba lokho kungesona isiqiniseko esivamile kubo bonke. Ngendlela, incazelo iyahlukahluka kakhulu. Empeleni, ukukwazi ukukhiqiza zizalo kunamazinga ahlukene phakathi kwaleso sikhathi sonke [2].

Kukhona nokudideka okukhulu mayelana nokuthi yimuphi umnyaka ongakhulelwa kuwo. Uma sekuqale ukuya esikhathini, ngokomzimba, ukukhulelwa kungenzeka uma kwenzeka ukugobhoza kwamaqanda. Lokho kusho ukuthi abanye abantu bangakhulelwa besebusha, beseminyakeni yobutsha. Kodwa lokho kunconywa noma kufanele wonke umuntu? Akumelanga kube njalo kuwo wonke umuntu. Kanti uma ubheka ishadi leminyaka yokuzala, uzobona ukuthi umkhiqizo wokuzala uba semgqeni owehlayo ngemuva kweminyaka engaba ngu-30 kuya ku-35. Kodwa awukwazi ukuthembela kuphela kulelo shadi. Khumbula njalo ukuthi ishadi liyisithombe esibanzi, hhayi isiprofetho.

Ithiphu Eyinhloko: Uma uhlela ukuzala useneminyaka emikhulu, cabanga ngokwenza ukuhlolwa kwangaphambi kokukhulelwa. Kungakusiza ukwazi ukuthi impilo yakho imi kuphi.

Izimpawu Zokuchuma Ngokweminyaka

Ukuze uqonde ukuthi abesifazane bachuma kakhulu ngeminyaka emingaki noma ukuthi yimuphi umnyaka owesifazane achuma kakhulu kuwo, izimpawu ezincane zomzimba zingasiza. Imijikelezo ejwayelekile ivame ukuba uphawu lokuthi ukugobhoza kwamaqanda kuzinzile. Izinguquko kuhlonze (cervical mucus) nazo ziveza izinkomba ezinkulu zokuzala. Phakathi neminyaka ephambili (imvamisa maphakathi nawo-20 kuya ekuqaleni kwawo-30), abanye besifazane bathola kulula ukulandelela iphethini yokuvuthwa kwamaqanda ngoba imijikelezo ihleli ifana.

Kuleso sikhawu esihle, amathuba okukhulelwa ngokuya ngeminyaka angaba phezulu, ngoba amaqanda asemncane ngokuvamile abe nezinkinga ezimbalwa zamaschromosome. Akusilo iqiniso ngaso sonke isikhathi, kodwa yilokho okujwayelekile. Ngemuva kweminyaka engu-35, umkhiqizo wokuzala uqala ukuntenga ngokusobala kubantu abaningi, okuyilapho abantu beqala ukubuza ukuthi kwenzeka nini lapho owesifazane eyeka ukuba nokuzala okuqine. Akukhiyi ngokushesha lapho efika eminyakeni engu-35, kodwa umthambeka wokwehla uba mkhulu [3].

Ithiphu Eyinhloko: Ukuhlola izinga lokushisa komzimba eliyisisekelo njalo ekuseni kungakusiza uqinisekise ukuthi uke wakhulelwa. Le ndlela ayibizi kakhulu futhi ingakunikeza ukuthula kwengqondo.

Ukuqonda Ithuba Lokukhulelwa Ngokweminyaka

Ithuba lokukhulelwa ngokuya ngeminyaka akusona nje isibalo kumdwebo. Indlela yokuphila yomuntu ngamunye, izinga lengcindezi, ngisho nempilo yokuzivikela emzimbeni, konke kungakwazi ukuguqula amathuba. Nokho, uma uqoqa idatha eqoqweni elikhulu labantu, uzobona ukuthi amathuba okukhulelwa ngokuya ngeminyaka, isibonelo ukusuka ku-20 kuya ku-25, angaphakeme kakhulu kunaseminyakeni engu-35 kuya ku-40. Kodwa futhi, lokhu kumayelana namaphethini ajwayelekile nje.

Abanye abantu bavame ukufuna ulwazi lwamathuba okukhulelwa ngokuya ngeminyaka ngoba bafuna nje isithombe esisheshayo. Nakuba lokho kungakunikeza inani elijwayelekile, izindaba zangempela zingahluka. Ukungalingani kwamahomoni kungavela eseminyakeni emincane, kanti abanye bangadlula eminyakeni yawo-30 ngaphandle kwezinkinga nhlobo. NgasMeanwhile, izinguquko ezincane zendlela yokuphila, njengokudla okungcono noma ukuhamba nsuku zonke, zingase ziqondise umkhiqizo wakho wokuzala endaweni engcono [4].

Ithiphu Eyinhloko: Ungayibalekeli nempilo yengqondo. Ingcindezi engapheli ingaphazamisa umjikelezo wakho kakhulu ukwedlula njengoba ubucabanga.

Izinguquko eminyakeni yawo-20 nowo-30

Kwabantu abaningi, iminyaka yawo-20 iletha ubudala obuchumayo kakhulu kwabesifazane. Inani lamaqanda liphezulu, futhi umzimba uvame ukubuyela esimeni ngokuphawulekayo ngokushesha lapho ubhekene nengcindezi. Lokhu akusho ukuthi uma udlula unyaka ongu-25 ungakazali usuzophelelwa ithuba kamuva. Kodwa kugcizelela ukuthi kungaba lula ukukhulelwa kusenesikhathi. Amathuba okukhulelwa ngokuya ngeminyaka angahlala emnandi kakhulu kuze kube sekupheleni kweminyaka yawo-20.

Bese kufika iminyaka yama-30. Abanye babona ukwehla okuncane kwamandla okuzala ekuqaleni kweminyaka yama-30, kanti abanye abakwazisi ushintsho olukhulu kuze kusondele eminyakeni engu-35. Yingakho abanye abantu bevame ukukhathazeka ngamandla okuzala kowesifazane ngokuya ngeminyaka futhi bacela odokotela ukwenza izivivinyo zamahomoni lapho besondela eminyakeni engama-30. Kodwa alikho uhlelo olufanayo kubo bonke. Ngakho uma uzama ukukhulelwa useminyakeni yama-30, ukugxila endleleni yokuphila enesilinganiso, amavithamini, nokuphatha ingcindezi kungakusiza kwezinye izikhathi [5].

Izeluleko Ezibalulekile: Uma usekuqaleni kweminyaka yama-30 futhi ungakakhuleli ngemva kwezinyanga eziningana uzama, cabanga ukukhuluma nodokotela. Kungcono ukwazi kusenesikhathi uma kukhona okungahambi kahle.

Imibuzo Ngokuzala Ekupheleni Kweminyaka Yama-30

Abantu abaningi bahlala becabangisisa ngamathuba okukhulelwa ngokwemvelo uneminyaka engu-37 noma amathuba okukhulelwa uneminyaka engu-38. Ekupheleni kweminyaka yama-30 inani lamaqanda liyancipha, kodwa umbuzo wangempela ukuthi lingehla kangakanani. Abanye basakhulelwa kalula beneminyaka engu-37, kanti abanye balwelana nokwehla kwesitoreji samaqanda esibelethweni. Uma lokho kuyisimo sakho, kungaba usizo ukuya kochwepheshe wenze ukuhlolwa, okungase kuhlanganise nezivivinyo zamahomoni [6].

Kujwayelekile futhi ukuzibuza ngamathuba okukhulelwa uneminyaka engu-39 uma kuqhathaniswa nawu-40. Umehluko ungaba mncane, noma kwesinye isikhathi ubonakale kakhulu. Unyaka owodwa ungase ungabi ushintsho olukhulu emandleni okuzala, kodwa kwabanye abantu ungaba iphuzu lokwehla. Khumbula ukuthi izinto eziningi (njengemikhuba yansuku zonke, ifuzo, nesisindo) zithinta ithuba lakho lokukhulelwa ngokuya ngeminyaka. Ngakho awukwazi ukucabanga ukuthi umzimba wakho uzisebenza njengawo wonke amashadi owake wawabona.

Izeluleko Ezibalulekile: Cabanga ngemikhuba esekela ukuzala njengokuzivocavoca ngokulinganisela noma imultivitamin equkethe amavithamini abalulekile. Noma yisiphi isinyathelo esincane singaba nomthelela.

Ukungena eminyakeni yama-40 yokuqala

Ngesikhathi abantu sebefika eminyakeni yama-40, amathuba okukhulelwa uneminyaka engu-42 noma amathuba okukhulelwa uneminyaka engu-45 kuba yinto ecindezela ingqondo. Amathuba okukhulelwa ngokuya ngeminyaka kulesi sigaba angase angabonakali ephezulu kakhulu ngokwezibalo, kodwa lokho akusho uziro. Abanye bakhulelwa ngokwemvelo, yize kuvame ukudinga ukuhlela ngokuzimisela okukhulu.

Ngaleso sikhathi, ingozi yezinkinga zofuzo ingaba phezulu, futhi abantu bangase babhekane nokulahlekelwa ukukhulelwa kaningi. Empeleni, ukuqonda i-phesenti lokulahlekelwa ukukhulelwa emazingeni ahlukene eminyaka kungasinikeza ukuqonda ocacile ngezingozi ezingaba khona. Uma usola ukuthi amandla okuzala ehla ngokushesha kunalokho obukulindele, uchwepheshe wokuzala angakhuluma nga­macebo athuthukile noma okungenani ukuhlolwa olunzulu. Amasu ezindlela zokuphila angase asize kakhulu, okuhlanganisa ukudla okunempilo nokunciphisa ingcindezi, yize kungase kungakwazi ngokuphelele ukunqanda izinguquko zesimiso somzimba ezihambisana nokuguga [7].

Ithiphu Eyinhloko: Hlala uphuza amanzi anele. Kulula kodwa kusiza umzimba wakho usebenze kahle, okuhlanganisa nohlelo lokuzala.

Amathuba Ngemva Kweminyaka Engu-45

Abantu abaningi babuza ngamathuba okukhulelwa uneminyaka engu-45, ikakhulukazi uma bezizwa besebenza kahle futhi bephilile. Kodwa ngokomzimba, amathuba asehle kakhulu. Abanye bayakhulelwa ngosizo lwezindlela zokwelapha ukungabi nabantwana ezifana ne-IVF, kodwa akuwona wonke umuntu. Umbuzo ungaba lo: abesifazane bayeka uneminyaka emingaki ukukhulelwa? I-menopause ngokuvamile ifika ekuqaleni kweminyaka yama-50, ngakho akusona isicabha esivaleka masinyane eminyakeni engu-45. Kodwa nakanjani iwindi seliminyene kakhulu [8].

Abanye bakhetha ukungazami ukukhulelwa ngendlela yemvelo kuleso sigaba, kungaba ngenxa yezinkinga zempilo noma izimo zomuntu siqu. Uhambo ngalunye lwezokuzala luhlukile, ngakho uma uzithola uneminyaka engu-46 noma engu-47 ufisa ingane, khuluma nochwepheshe. Bangase bakhulume ngamaqanda abanikeli (donor eggs) noma ezinye izindlela ezahlukene.

Ithiphu Eyinhloko: Xoxa nodokotela ngazo noma yiziphi izifo onazo, ikakhulukazi uma usumdala. Izifo ezingapheli zingakwenza kube nzima kakhulu kunendlela ebezinjalo eminyakeni yakho emincane.

Ithebula 1: Ulinganiso Lwamathuba Okukhulelwa Umjikelezo Ngomjikelezo Ngokweminyaka
(Umthombo: American Society of Reproductive Medicine)

Ithebula 2: Amathuba Okukhulelwa Phakathi Kwezinyanga Eziyi-6 noma Eziyi-12
(Umthombo: Age and fecundability in a North American preconception cohort study, Am J Obstet Gynecol, 2017.)

Abesifazane Bayeka Nini Ukuba Bakwazi Ukukhulelwa?

Lo mbuzo othi, abesifazane bayeka nini ukuba bakwazi ukukhulelwa, uzungeza umqondo wokuthi amandla okukhulelwa ayaphela uma sekufike i-menopause. Kodwa inqubo iqala ngaphambi kwalokho. I-perimenopause ivame ukuqala eminyakeni eminingana ngaphambi kwe-menopause ephelele, okuholela emijikelezweni yokuvuthwa kwamaqanda engalindelekile. Ngakho uma ufuna ukwazi ukuthi yimuphi uneminyaka lapho owesifazane eyeka khona ukuba akwazi ukukhulelwa ngokusebenzayo, kungaba kusukela eminyakeni yokuqala kuya kweyasekupheleni kwama-40, kuye ngomuntu.

Akukho suku olulodwa ovuka ngalo “ungasebenzi ngokuphelele ekuzaleni.” Imvamisa kuba ukuhla kancane kancane. Abantu ababheka ishadi leminyaka yokuzala kwabesifazane bangabona ukuthi, ngokujwayelekile, ukwehla kugobile kakhulu ngemva kweminyaka engaba ngu-35. Kodwa kuhlale kukhona okuhlukile. Abanye bayaqhubeka nokuya esikhathini nasekuvuthweni kwamaqanda kuze kube eminyakeni yabo yama-40. Uma ungaqiniseki ukuthi umi kuphi, ukuhlolwa kwezokwelapha kungahlola inqwaba yamaqanda akho esibelethweni [9].

Ithiphu Eyinhloko: Uma usola i-perimenopause, landela imijikelezo yakho yokuya esikhathini ngokucophelela. Imijikelezo engajwayelekile ingase ibonise ukuthi amahomoni ayashintsha.

Imibono Yamadoda Ngemsebenzi Wokuzala

Nakuba izingxoxo zivame ukuzungeza iminyaka yokuzala kwabesifazane, amadoda nawo ayashintsha. Ikhwalithi yesidoda ingehla ngemva kweminyaka engama-40. Lokho kungase kuthinte ngendlela engenayo eqondile amathuba okukhulelwa ngokuya ngezibalo zeminyaka uma umlingani wesilisa emdala. Ukuntuleka kokunyakaza kahle kwesidoda noma ukwehla kwenani laso kungangeza ubunzima. Kanti futhi, i-stress, ukubhema, noma izinkinga zempilo ngokujwayelekile kungashesha sehlise lelo zinga.

Ngakho nakuba iminyaka yomfazi ibalulekile, ukuzala emadodeni akufanele kunganakwa. Amanye amadoda, ngisho naseminyakeni yawo yama-50, ayengababa bezingane ngaphandle kwezinkinga ezinkulu, kodwa lokho akusiqinisekiso. Ngezinye izikhathi imibhangqwana iyazibuza ngamathuba okukhulelwa eneminyaka engu-39 uma bobabili abangani sebendala. Ingxenye ngayinye ibalulekile. Uma unokukhathazeka, ukuhlaziywa kwesidoda kungakhanyisa ngezinkinga ezingaba khona [10].

Ithiphu Ephambili: Amadoda angasekela impilo yesidoda ngokuphuza amanzi amaningi futhi mhlawumbe ngokusebenzisa ama-supplement aqukethe i-zinc noma amavithamini. Kodwa kungcono ukubuzisisa uchwepheshe kuqala.

Ukusekelwa kwendlela yokuphila nokudla okunempilo

Nakuba ifuzo neminyaka kubonakala kukhulu, indlela yokuphila idlala indima ebalulekile ekuzaleni ngokweminyaka. Ukudla okulinganiselayo okugcwele amaprotheni, imifino enamaqabunga aluhlaza, namavithamini abalulekile kungathinta kahle ibhalansi yama-hormone. Abanye abantu bathanda ukwengeza i-ginger extract ngenxa yemiphumela yokulwa nokuvuvukala noma i-CoQ10 yamandla emaselula. Kukhona uhla olubanzi lwamavithamini namaminerali angasiza, kusukela ku-ayoni kuya ku-magnesium, yize imiphumela ihlukahluka [11].

Ukunciphisa ukuphuza utshwala nokuyeka ukubhema kungaletha umehluko omkhulu, nakho. Ngokugxila empilweni yakho yonke, ungakwazi ukukhulisa kancane indlela obheka ngayo ishadi leminyaka yokuzala kwabesifazane. Kodwa-ke, uma kunenkinga yezokwelapha okuyiyona ndawo yomthombo, usadinga ukunakekelwa kochwepheshe. Ukudla kahle kuphela kungenzeka kungaxazululi konke.

Ithiphu Ephambili: Hlola izinga lakho lokucindezeleka. Ngezinye izikhathi i-yoga, izivocavoca zokuphefumula ezilula, noma ukubhala kudayari kungagcina ingqondo yakho ithule, ngaleyo ndlela kusize umzimba wakho uthole ibhalansi.

Okubalulekile Ekugcineni

Uma sibheka amathuba okukhulelwa ngokweminyaka eshadini, lokho kusikhombisa ukuthi ukuzala kunesikhathi, kodwa akulukhuni kangangokuthi akukho ndawo yokuhluka komuntu ngamunye. Abantu bavame ukubuza ukuthi yimaphi iminyaka lapho abesifazane bekhula kakhulu noma abesifazane bayeka nini ukudla inzalo, befuna impendulo evamile, kodwa umzimba ngamunye uhlukile kancane. Iminyaka emincane ivame ukuba namathuba aphezulu okukhulelwa, kanti iminyaka emikhulu ingase idinge ukuhlela kakhulu noma ukungenelela, ikakhulukazi uma ufuna ukuqiniseka ukuthi uyakhulisa amathuba okukhulelwa uneminyaka engu-42 noma ngaphezulu.

Khumbula ukuthi zonke lezi zinombolo nezibalo zingukucaba nje. Ama-hormone, indlela yokuphila, ingcindezi, ukudla, ngisho nenhlanhla, kudlala indima ekutheni ukhulelwa masinyane noma udinge usizo. Noma ukuphi lapho ukhona, gcina umbono onempilo, cabanga ngohlolelo lokuqala, futhi uzame ukuvuleleka emiyalweni yobungcweti. Uma izinqumo zakho uzihlanganisa nokuhle kwakho uqobo, ungathola ukuthi lawa ma-curve ajwayelekile namashadi aba nje yindawo yokubhekisela kunokuba abe yinqubomgomo eqinile.

Imibuzo ejwayelekile

Ingabe ishadi leminyaka yokuzala liyakwazi ngempela ukubikezela ukuthi ngizokhulelwa yini?

Hhayi ncamashi. Ishadi leminyaka yokuzala libonisa izitayela ezibanzi, kodwa imiphumela yakho ingahluka. Impilo, ifuzo, nendlela ophila ngayo kungashintsha indlela yakho yesikhathi kakhulu.

Ingabe iminyaka ephakeme yokukwazi ukukhulelwa kwabesifazane ihlale imiwo-20 yokuqala kuphela?

Imvamisa yebo, kodwa akuhlali kunjalo. Abanye bathola ukuthi basenamandla amakhulu okuzala kuze kube maphakathi nawo-30, kanti abanye babona ukwehla kusasekuqaleni. Kuyithrendi ejwayelekile, hhayi umthetho oqinile.

Ingabe iminyaka yomlingani wami ingathinta amathuba ethu?

Yebo. Ukukwazi ukuzala kowesilisa nakho kungehla njengoba iminyaka iqhubeka, ngakho lokho kungathinta amathuba enu okuphela kokukhulelwa njengoba nobabili nikhula. Ukuhlolwa kungaveza imininingwane eyengeziwe.

Ingabe amathuba okukhulelwa eminyakeni engu-37 ngokwemvelo emancane kakhulu uma kuqhathaniswa no-35?

Angase ehle, kodwa akuwona ukwehla okusheshayo nokukhulu masinyane. Uhambo lokuzala lwawo wonke umuntu lwehluke. Abanye abaneminyaka engu-37 bakhulelwa masinyane, kanti abanye bangase babhekane nezinselelo.

Ngingayikhulisa yini imbewu (fertility) ngokusebenzisa ama-supplement kuphela?

Ama-supplement angasiza ukugcwalisa izikhala ekudleni okunomsoco, kodwa awona umuthi oyisimanga. Ukudla okulinganiselayo, ukuphuza amanzi anele, ukulala kahle, nokuholwa udokotela uma kudingeka, kuvame ukwakha indlela ephelele kakhulu.

Izinkomba

1. Broekmans, F. J., Knauff, E. A., te Velde, E. R., Macklon, N. S., & Fauser, B. C. (2007). Ukuguga kokuzala kowesifazane: ulwazi lwamanje nezitayela zesikhathi esizayo. Ijenali ethi Trends in endocrinology and metabolism: TEM. Available at: https://pubmed.ncbi.nlm.nih.gov/17275321/
2. American College of Obstetricians and Gynecologists. (2014). Ukwehla kokukwazi ukuzala okuhlobene neminyaka kowesifazane. Umbono weKomidi No. 589. Available at: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/03/female-age-related-fertility-decline
3. Broekmans, F. J., Soules, M. R., & Fauser, B. C. (2009). Ukuguga kwamaqanda esibeletho (ovarian aging): izindlela nemiphumela emitholampilo. Ijenali ethi Endocrine reviews. Available at: https://pubmed.ncbi.nlm.nih.gov/19589949/
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