Ukungazali Okwesibili — Kuyini Nokuthi Uqhubekela Phambili Kanjani

Ukungazali okwesibili kungesinye sezinselelo zokuzala ezinzima kakhulu ngokomzwelo futhi ezivame ukungaqondakali umndeni ongase ubhekane nazo. Kubhekisela ekungakwazini ukukhulelwa noma ukuthwala ukukhulelwa kuze kube sekupheleni ngemva kokukwenzile lokho ngaphambilini — okuvame ukushiya imibhangqwana ididekile, izolile, ingazi ukuthi ingabheka kuphi usizo. Ngokungafani nokungazali kokuqala, ukungazali okwesibili kuphethe isisindo sakhona esiyingqayizivele ngokomzwelo: usizi luyiqiniso, kodwa abangani abaningi, amalungu omndeni, ngisho nabelaphi bangase bangalibonisi uqobo lolu bunzima, becabanga ukuthi uma uke wakhulelwa kanye kuzohlala kulula njalo ukukhulelwa.

Iqiniso liyinkimbinkimbi kakhulu. Ukungazali okwesibili kuthinta cishe u-11% wemibhangqwana e-United States, okwenza kube cishe kujwayeleke njengokungazali kokuqala. Ukuqonda izimbangela, ukuqaphela umthelela wengqondo, nokwazi ukuthi yiziphi izinyathelo ongazithatha kungaletha umehluko omkhulu — kokubili empilweni yakho yokuzala nasenhlalakahleni yakho yengqondo. Lo mhlahlandlela uchaza konke okufanele ukwazi mayelana nokungazali okwesibili: ukuthi kuyini, kungani kwenzeka, nokuthi ungaqhubekela kanjani phambili ngokucaca ngethemba.

Kuyini Ukungazali Okwesibili?

Ukungazali okwesibili kuchazwa ngokwezokwelapha njengokungakwazi ukukhulelwa noma ukugcina ukukhulelwa kuze kufike esikhathini sokubeletha ngemva kokubeletha ngempumelelo ngaphambilini. Ochwepheshe bezokwelapha ngokuvamile batusa ukuhlolwa uma umbhangqwana ongenakaze abe neminyaka engaphezu kwengu-35 ezame ukukhulelwa izinyanga ezingu-12 ngaphandle kwempumelelo, noma izinyanga eziyisi-6 uma omunye wabo eseneminyaka engaphezu kwengu-35. Lesi sikhathi sisebenza ngokulinganayo nakulabo abahlangabezana nokungazali okwesibili.

Kubalulekile ukuqaphela ukuthi ukungazali okwesibili akusho ukuthi umuntu wayenenzalo enhle ngaphambili. Imizimba iyashintsha, ubudlelwane buyaguquka, nezici zempilo ziyanyakaza — noma yikuphi kwalokhu kungathinta amandla okukhulelwa. Iminyaka idlala indima ebaluleke kakhulu, njengoba ukuzala kwabesifazane kwehla kakhulu ngemva kweminyaka engu-35, futhi ikhwalithi yesidoda emadodeni nayo iyashintsha ngokuhamba kwesikhathi. Umbhangqwana owakhulelwa kalula eneminyaka engu-28 angase abhekane nesimo sokuzala esihlukile kakhulu eneminyaka engu-34 noma engu-38.

Ukungazali okwesibili kuhlukile nokulahleka kokukhulelwa okuvame ukuphindaphinda, yize lezi zimo ezimbili zingase zihlangane. Abanye abantu bangakwazi ukukhulelwa kodwa bese behlale bephuphunyelwa yizisu — iphethini elibuhlungu kakhulu eliwela esigabeni salo sezinselelo zokuzala kodwa elihlanganyela izimbangela eziningi eziyisisekelo.

Ukungazali Okwesibili Kuvamile Kanganani?

Yize ivamile, ukungazali okwesibili kuvame ukungaqondakali. NgokweZikhungo Zokulawulwa Nokuvikelwa Kwezifo (CDC), cishe u-11% wabesifazane abaneminyaka engu-15–44 e-United States babhekana nokungazali okwesibili. Ezinye izifundo zibonisa ukuthi leli nani lingase libe phezulu kakhulu, njengoba imibhangqwana eminingi ibambezele ukufuna usizo — icabanga ukuthi izokhulelwa ngokwemvelo ngoba yake yakwazi ukukhulelwa ngaphambilini.

Umbiko wangonyaka ka-2012 we-World Health Organisation (WHO) wathola ukuthi ukungabi nenzalo kwesibili kubala ngaphezu kwengxenye yawo wonke amacala okungabi nenzalo emhlabeni jikelele. Lokhu kusho ukuthi iningi labantu abahlushwa ukungabi nenzalo emhlabeni selivele laba nengane okungenani eyodwa — iqiniso eliqokomisa ukuthi isimo sisaqondwa kancane emphakathini.

Izifundo ezishicilelwe kumajenali okuhlanganisa i-Human Reproduction ne-Fertility and Sterility zikhombise ngokungaguquki ukuthi izimbangela zokungabi nenzalo kwesibili zehluke kwezenzalo yokuqala, futhi ukuthi imibhangqwana elinda isikhathi eside ngaphambi kokuhlolwa ingaphuthelwa amafasitela abalulekile okwelashwa. Ukuhlolwa kusenesikhathi kubalulekile, ikakhulukazi kwabesifazane abaneminyaka engaphezu kuka-35.

Izimbangela Ezivamile Zokungabi Nenzalo Kwesibili

Ukungabi nenzalo kwesibili kungadalwa izinguquko empilweni yokuzala yanoma yiliphi iphathi kusukela ekhulelweni kokugcina. Ukuqonda izimbangela ezingaba khona kuyisinyathelo sokuqala ekwelashweni okuqondiswe ngqo enkingeni.

Izimbangela Zabobulili Besifazane

• Ukwehla kwekhwalithi yamaqanda ngenxa yobudala: Isitoreji samaqanda owesifazane siyancipha ngokwemvelo njengoba eseguga. Ngemva kweminyaka engu-35, inani nekhalithi yamaqanda kwehla ngokushesha okukhulu. Ngisho nesikhawu seminyaka emi-3–5 phakathi kokukhulelwa singathinta kakhulu imiphumela yokuzala.
• Izinkinga zokuvuthwa kwamaqanda: Izimo ezifana nesifo se-polycystic ovarian syndrome (PCOS) zingavela noma zibe zimbi ngokuhamba kwesikhathi. Ukungavuthwa kahle kwamaqanda kusho amathuba ambalwa okukhulelwa emjikelezweni ngamunye.
• Ukwakhiwa okungajwayelekile kwesibeletho: Ama-fibroid, ama-polyp, noma izicubu zamangwebu (isifo sika-Asherman) — ikakhulukazi ngemva kokuhlinzwa kokubeletha ngohlelo (caesarean section) noma ukuhlinzwa esibelethweni — kungaphazamisa ukunamathela kombungu noma kubangele ukulahleka kokukhulelwa okuqhubekayo.
• I-Endometriosis: Lesi sifo esiqhubekayo singavela noma sibe sibi kakhulu ngemva kokukhulelwa kokuqala, sidale ukunamathela kwezicubu okuthinta amashubhu e-Fallopian, ama-ovari noma udonga lwesibeletho.
• Ukuvinjelwa kwamashubhu e-Fallopian: Izifo ezifana nesifo sokuvuvukala kwezitho zangasese zabesifazane (pelvic inflammatory disease, PID), ezingalandela ukubeletha kwangaphambilini noma ukulahleka kokukhulelwa, zingadala amanxeba avale amashubhu.
• Izinguquko esisindweni somzimba: Ukushintsha kakhulu kwesisindo kusukela ekhulelweni kwangaphambilini — kungaba ukuzuza noma ukwehla — kungaphazamisa ibhalansi yamahomoni nokuvuthwa kwamaqanda.

Izimbangela Zobulili Besilisa

• Ukwehla kwezinkomba zembewu yesilisa: Inani lembewu, ukunyakaza kwayo, nokwakheka kwayo kungashintsha kakhulu ngokuhamba kwesikhathi. Amadoda akhe abantwana eminyakeni yawo yama-20 angabona ukwehla okulingekayo kusukela maphakathi nawo-30 kuya kuma-40.
• I-Varicocele: Imithambo yegazi ekhulisiwe esikhwameni samasende ingavela noma ibe mandla kakhulu, ikhuphule izinga lokushisa kwamasende futhi iphaze ukukhiqizwa kwembewu yesilisa.
• Izinto zendlela yokuphila: Ukukhula kwengcindezi, ukwanda kwesisindo, ukuphuza utshwala, noma ukubhema kusukela ekukhulelweni kwangaphambilini kungalimaza ikhwalithi yesidoda.
• Izifo zezokwelapha: Izifo ezisanda kutholakala ezifana nesifo sikashukela, izifo zendlala yegilo, noma izifo zokuzivikela komzimba (autoimmune) zingathinta ukuzala kokubili kwabesilisa nabesifazane.

Izimbangela Ezihlangene Noma Ezingachazwanga

Cishe ku-10–20% wamacala okungabi nenzalo kwesibili, akukho sizathu esicacile esitholakalayo — ukuxilongwa okubizwa ngokuthi "ukunganaki ukuthi kungani kungabi nenzalo (unexplained infertility)." Lokhu kungakhathaza kakhulu, kodwa akusho ukuthi akukho zindlela zokwelashwa. Imibhangqwana eminingi enalesi simo esingachazwanga iphendula kahle ezinguqukweni zendlela yokuphila, ukwesekwa ngokudla, kanye nobuchwepheshe bokuzala obusizwa (assisted reproductive techniques).

Isisindo Sezemizwa Sokungabi Nenzalo Kwesibili

Ukungabi nenzalo kwesibili kuphethe umthwalo oyingqayizivele wezemizwa ovame ukuncishiswa umthwalo wawo yimindeni nabangani abahlosile kahle. Amazwana afana nokuthi "okungenani unomunye" noma "phumula nje kuzokwenzeka" angazwakala engamukeleki futhi elahla imizwa, noma etshiwo ngenhloso enhle. Usizi oluhambisana nokungabi nenzalo kwesibili luyiqiniso futhi lufanele ukuqashelwa.

Ucwaningo olushicilelwe ku-Social Science & Medicine lwathola ukuthi abesifazane abahlangabezana nokungabi nenzalo kwesibili babika izinga elifanayo lokucindezeleka kwengqondo nalabo abanezinkinga zokuqala zokungabi nenzalo — okuhlanganisa ukukhathazeka, ukucindezeleka, nokwehla kokuzithemba. Nokho kwakuncane kakhulu ukuthi bafune usizo lochwepheshe bezengqondo, ngokuvamile ngoba bezizwa ubuhlungu babo bungabalulekile njengalabo abangakaze bakhulelwe neze.

Kulabo abasebenomntwana, ulwazi lokungabi nenzalo kwesibili luyinkimbinkimbi kakhulu ngenxa yesifiso sokumnika umfowabo noma udadewabo, imizwa yephutha ngokufuna omunye umntwana, kanye nobunzima bokugcina umoya omuhle ekhaya kumntwana okhona ngenkathi nisebenza usizi enhliziyweni. Lezi zendlaleko zobunzima zenza ukwesekwa kwengqondo kube yingxenye ebalulekile — futhi evame ukubukelwa phansi — yokunakekelwa.

Kukhona amaqembu okusekela akhethekile ekungabi nenzalo kwesibili kokukhulelwa, kokubili ku-inthanethi nangokomzimba. Izinhlangano ezifana ne-RESOLVE: The National Infertility Association zinikeza izinsiza ezenzelwe le nkinga, ukwesekwa ontanga, kanye nesiqondiso sokuhamba nezinselele ezihlukile zokungabi nenzalo kwesibili.

Ukuthola Ukuxilongwa: Okufanele Ukukulindele

Uma usuzame ukukhulelwa izinyanga eziyi-12 (noma izinyanga eziyisi-6 uma uneminyaka engaphezu kuka-35) ngaphandle kwempumelelo, sekuyisikhathi sokufuna ukuhlolwa kokungabi nenzalo. Lokhu kuvame ukuqala kudokotela wakho ojwayelekile noma kudokotela we-OB-GYN ngaphambi kokudluliselwa kudokotela okhethekile ngezingxaki zama-hormone nokuzala (reproductive endocrinologist, REI) uma kudingeka.

Ukuhlolwa Kokuqala Kwabesifazane

• Izivivinyo zegazi zama-hormone: I-FSH, LH, estradiol, AMH (i-anti-Müllerian hormone), kanye nokusebenza kwendlala yegilo kuvame ukuhlolwa ukuze kuhlolwe isabelo samaqanda asesele (ovarian reserve) nokulinganiselwa kwama-hormone.
• I-ultrasound ye-pelvic: Ukubalwa kwama-antral follicle (AFC) kunganikeza ukuqonda ngesitokwe samaqanda esebenzayo, kuyilapho igumbi lesibeletho nama-ovary kuhlolwa ukuze kutholakale noma yiziphi izinkinga zesakhiwo.
• I-Hysterosalpingography (HSG): Inqubo ye-X-ray ehlola ukuthi amashubhu e-fallopian avulekile yini kanye nokuma kwegumbi lesibeletho.
• Izithombe ezengeziwe: Uma kukholakala ukuthi kukhona ama-fibroids, ama-polyps, noma i-endometriosis, i-hysteroscopy noma i-laparoscopy inganconywa.

Ukuhlaziywa Kwesidoda Kwabesilisa

Ukuhlaziywa kwesidoda kuhlola inani lesidoda, indlela esihamba ngayo (motility), ukwakheka kwaso (morphology), nenani laso (volume). Lokhu kungenye yamathesti okukwazi ukuzala anolwazi oluningi futhi angabizi kakhulu, futhi kufanele kwenziwe ekuqaleni kunoma yikuphi ukuhlolwa kokungazali — kungakhathaliseki ukuthi indoda isike yaba uyise ngaphambilini yini. Ukungazali okuvela ohlangothini lwesilisa kunikela cishe ku-40–50% wazo zonke izimo zokungazali, futhi lesi sibalo siyafana nasekungazaleni kwesibili.

Izinketho Zokwelashwa Kokungazali Kwesibili

Ukwelashwa kuncike ngokuphelele embangeleni oyinhloko otholakele ngesikhathi sokuhlolwa. Ezinye izibini zithola ukuthi ukungenelela okulula kuphela kubuyisela ukukwazi ukuzala, kanti ezinye zingase zidinge usizo oluthuthukile kakhulu.

Ukwenza Kube Ngcono Indlela Yokuphila Nokudla

Ngaphambi kokusebenzisa ukwelashwa kwezokwelapha, izinguquko eziyisisekelo zempilo zingaletha ukuthuthuka okubalulekile ekuzaleni. Kwabesifazane, ukulungisa isisindo somzimba, ukunciphisa ukuphuza utshwala, ukuphatha ingcindezi, nokuqinisekisa ukuthi kudliwa kahle amavithamini nezakhamzimba ezibalulekile — ikakhulukazi i-folate, i-vitamin D, i-CoQ10, nama-omega-3 fatty acids — kusekela ikhwalithi yamaqanda nempilo yamahomoni. Kwabesilisa, izinguquko ezifanayo zihambisana nokwanele kwe-zinc, i-selenium, nama-antioxidant zingathuthukisa kakhulu izimfanelo zesidoda.

Ukukhuthaza Ukuchamuka Kweqanda (Ovulation Induction)

Kwabesifazane abanezinkinga zokuvuthwa kweqanda, imithi efana ne-clomiphene citrate (Clomid) noma i-letrozole ingabhalwa ukuze ivuse ukuchamuka kweqanda okuvamile. Le mithi ivame ukusetshenziswa ndawonye nokuhlela isikhathi socansi noma ukufakelwa isidoda esibelethweni (IUI).

Ukufakelwa Isidoda Esibelethweni (Intrauterine Insemination, IUI)

I-IUI ihilela ukufakwa kwesidoda esihlanziwe, esiqinisiwe ngokuqondile esibelethweni ngesikhathi esisondelene nenkathi yokuvuthwa kweqanda. Iyahlasela kancane kune-IVF futhi ingase isebenze kahle kakhulu kwezinye izimbangela zokungazali kwesibili, kuhlanganise nokungasebenzi kahle okuncane kwamasidoda (mild male factor infertility) noma izinkinga zesibeletho (cervical factors).

Ukuchanyuselwa Kwezibungu Ngaphandle Komzimba (In Vitro Fertilisation, IVF)

I-IVF iyindlela ephumelela kakhulu yokwelashwa kokungazali ngenxa yezimbangela eziningi zokungazali kwesibili, ikakhulukazi ukuncipha kwesitokwe samaqanda esebenzayo (diminished ovarian reserve), ukuvinjelwa kwamashubhu e-fallopian, noma ukungazali okungachazwanga. Ngesikhathi se-IVF, amaqanda akhishwa bese achanyuselwa esibhedlela ngaphambi kokuba ama-embryo akhiqizwayo adluliselwe esizalweni. Izinga lempumelelo liyahluka kakhulu ngokuya ngeminyaka nobungozi obutholakele.

Ukungenelela Ngokuhlinzwa

Ezimweni lapho ama-fibroid, ama-polyps, noma ama-adhesions enza kube nzima ukukhulelwa, ukuwahlinza uwasuswe kungabuyisela amandla okuzala ngaphandle kwesidingo sokuzaliswa okusizwa. Ngokufanayo, ukulungisa i-varicocele emadodeni kungathuthukisa izinkomba zesidoda futhi kwandise ithuba lokukhulelwa ngokwemvelo.

Ukusekelwa Kokudla Ekungazaleni Kwesibili

Ukunakekelwa kokudla kudlala indima eyisisekelo empilweni yokuzala, futhi izithasiselo eziqondiswe kahle zingasekele ukungazali kwamaqembu womabili. Ubufakazi bocwaningo lwezokwelapha bugqamisa izakhamzimba ezibalulekile eziningana:

• I-folate (noma i-methylfolate): Ibalulekile ekwahlukaneni kwamaseli nasekwakhiweni kwe-DNA, i-folate isekela ikhwalithi yamaqanda futhi yehlisa ingozi yokukhubazeka komgogodla wengane (neural tube defects). Abesifazane abanezinguquko zofuzo ze-MTHFR kufanele bakhethe i-methylfolate kunokusebenzisa i-folic acid.
• CoQ10 (Coenzyme Q10): I-antioxidant enamandla esekela ukusebenza kwama-mitochondria kumaqanda nasemazinyweni esidoda. Ucwaningo luphakamisa ukuthi ukuthatha i-CoQ10 kungathuthukisa ikhwalithi yamaqanda kwabesifazane abanokwehla kwesitoko samaqanda (diminished ovarian reserve).
• Uvithamini D: Ukuntuleka kovithamini D kuhlotshaniswa nokwehla kokuzala kokubili emadodeni nasebesifazane. Amazinga afanele asiza ekulinganiseni amahomoni, ukunamathiselwa kombungu (implantation), nasekukhulelweni kokuqala.
• Amafutha e-omega-3: I-DHA ne-EPA zisekela izindlela zokulwa nokuvuvukala, ubuqotho besikhumba sesidoda, kanye nentuthuko yokuqala yobuchopho bengane esesiswini.
• I-zinc ne-selenium: Zibucayi ekukhiqizeni isidoda nasekuvikeleni i-DNA yesidoda ekulimaleni okubangelwa i-oxidative stress.
• Insimbi: Izinga elanele lensimbi emzimbeni libalulekile ekwakhekeni kweqanda (ovulation) nasekunciphiseni ingozi yokungazali okubangelwa ukungavuthwa kwamaqanda.

Nini Okufanele Ucabange Ngokufuna Omunye Udokotela Noma Ukudluliselwa Kuchwepheshe

Uma udokotela wakho ojwayelekile noma udokotela wezifo zabesifazane (OB-GYN) engakatholi imbangela ecacile ngemuva kokuhlolwa kokuqala, noma uma uke wazama ukukhulelwa isikhathi esingaphezu konyaka (noma izinyanga eziyisi-6 uma ungenza iminyaka engaphezu kwengu-35), kudingeka ukudluliselwa kuchwepheshe we-reproductive endocrinology. Osolwazi be-REI bakhethekile ekuxilongeni nasekwelapheni izimo zokungazali eziyinkimbinkimbi futhi banokufinyelela kumathuluzi athuthukile okuxilonga nasekwelapheni angatholakali kodokotela abajwayelekile.

Kuyavumeleleka futhi ukufuna olunye uluvo lodokotela uma uzwa sengathi ukukhathazeka kwakho kuyendelelwa phansi, uma ukwelashwa kungakazali imiphumela ngemuva kwemijikelezo eminingana, noma uma ukuxilongwa kwakho kukushiya unemibuzo engaphenduliwe. Umkhakha wezokwelapha ukungazali uyaqhubeka nokuvela, futhi odokotela abahlukene banganikeza imibono ehlukene.

Izikhungo zokuzala ezinamazinga aphezulu empumelelo zishicilela idatha yemiphumela yazo ngokusebenzisa i-Society for Assisted Reproductive Technology (SART), okwenza iziguli ezizayo zikwazi ukuqhathanisa izikhungo ngokuya ngamaqembu eminyaka kanye nezifo — umthombo obalulekile uma ukhetha ukuthi uyofuna kuphi ukwelashwa.

Ukuya Phambili: Ukwakha Uhlelo

Ukungabi nabantwana kwesibili kungazwakala kukhungathekisa, kodwa ukuya phambili kuba lula uma unenhlelo ecacile. Nansi indlela ehleliwe ongayilandela:

1. Funa ukuhlolwa masinyane: Ungalindi wethembe inhlanhla. Uma uhlangabezana nezindinganiso zokuhlolwa, hlela isikhathi kudokotela.
2. Hlola bobabili nibambisene kusenesikhathi: Cishe ingxenye yezimo zokungabi nabantwana ihilela uhlangothi lomlingani wesilisa. Ukuhlola bobabili kusukela ekuqaleni kusindisa isikhathi.
3. Thuthukisa impilo yakho eyisisekelo: Ukudla, isisindo, ukuphatha ingcindezi, nekhwalithi yokulala konke kuthinta imiphumela yokuzala.
4. Yakha inethiwekhi yokusekelwa: Kungaba ngokusebenzisa usomtholampilo wezengqondo, iqembu lokusekelwa, noma abangani abethembekile, ungazami ukubhekana nalokhu wedwa.
5. Zibekele okulindelekile okungokoqobo: Qonda amazinga empumelelo yezindlela zokwelashwa ezahlukene esimeni sakho naso ebudeni beminyaka yakho.
6. Gcina uxhumano nomlingani wakho: Ukungabi nabantwana kwesibili kungafaka ubudlelwane ngaphansi kwengcindezi. Nikanani isikhathi sokuxhumana, nenze izinqumo ndawonye, futhi nigcine ubusondelene obungagxilile kuphela ekukhulelweni.

Imibuzo Evame Ukubuzwa Ngokungabi Nabantwana Kwesibili

1. Ingabe ukungabi nabantwana kwesibili kungaphela ngokwako?

Kwezinye izimo — ikakhulukazi lapho kungatholakali sizathu esiyisisekelo — imibhangqwana iyakwazi ukukhulelwa ngokwemvelo ngokuhamba kwesikhathi. Nokho, akufanele nilinde kuze kube phakade, ikakhulukazi kwabesifazane abaneminyaka engaphezu kuka-35 lapho ukwehla kwamandla okuzala okuhlobene neminyaka kushesha khona. Uma usuzamile ukukhulelwa izinyanga eziyi-12 (noma izinyanga ezi-6 uma uneminyaka engaphezu kuka-35), funa ukuhlolwa kungakhathaliseki ukuthi wake wakhulelwa kalula ngaphambilini.

2. Ingabe ukube uke wahlinzwa ngesinqunyi (caesarean section) kudala ukungabi nabantwana kwesibili?

Ukuhlinzwa ngesinqunyi kungesinye isikhathi kungaba negalelo ekungabini nabantwana kwesibili. Ukulimala kwesibeletho noma ukunamathela ngaphakathi (i-Asherman's syndrome) kungavela ngemva kwenqubo, okuholele ekutheni umbungu ungakwazi ukunamathela kahle. Ukube uke wahlinzwa ngesinqunyi ngaphambilini kungahambisana ne-placenta praevia ekukhulelweni okuzayo. I-HSG noma i-hysteroscopy ingasiza ukuhlola umgodi wesibeletho uma lokhu kukukhathaza.

3. Ingabe ukuncelisa kungathinta ukungabi nabantwana kwesibili?

Yebo. I-prolactin, ihomoni ekhuthaza ukukhiqizwa kobisi lwebele, ivimba ukukhishwa kweqanda. Ukuncelisa isikhathi eside kungabambezela ukubuyela kwemijikelezo yokuya esikhathini evamile nokukhishwa kweqanda. Lapho ukuncelisa sekuphelile, imandla okukhulelwa ngokuvamile abuyela ezingeni lawo elijwayelekile, yize lokhu kungathatha izinyanga ezimbalwa.

4. Ingabe ukungabi nabantwana kwesibili kuvamile ngemuva kokulahlekelwa yisisu?

Ukulahlekelwa yisisu ngokuvamile akubangeli ukungabi nabantwana kwesibili. Iningi labesifazane abake balahlekelwa yisisu liyakwazi ukukhulelwa ngempumelelo emva kwalokho. Nokho, ukulahlekelwa yisisu okuqhubekayo (ukulahlekelwa okuthathu noma ngaphezulu) kudinga ukuba kuphenywe izimbangela eziyisisekelo ezifana nokungajwayelekile kwamakhromosomu, izinkinga zokubopha kwegazi, noma ukungajwayelekile kwesibeletho.

5. Iminyaka ithinta kanjani ukungabi nabantwana kwesibili?

Iminyaka ingesinye sezinto ezibaluleke kakhulu ekungabi nabantwana kwesibili. Isibalo samaqanda esisele (ovarian reserve) siyehla ngokuhamba kweminyaka, futhi ikhwalithi yamaqanda yehla ngokushesha ngemva kweminyaka engu-35. Owesifazane oke wakhulelwa kalula eneminyaka engu-28 angase abhekane nesimo sokuzala esihlukile kakhulu eneminyaka engu-36 noma engu-38. Izinguquko ezihlobene neminyaka kwekhwalithi yesidoda nazo zingandisa isikhathi esithathayo ngaphambi kokukhulelwa kowesilisa.

6. Ingabe ukucindezeleka kungadala ukungabi nabantwana kwesibili?

Naphezu kokuthi ukucindezeleka kungenzeka kungabi yisizathu esisodwa kuphela sokungabi nabantwana kwesibili, ukucindezeleka okuqhubekayo kuphazamisa ibhalansi yamahomoni ngokwenyusa i-cortisol, okungaphazamisa ukuvuthwa kwamaqanda kanye nokukhiqizwa kwesidoda. Ukulawula ukucindezeleka ngokuzindla, ukuzivocavoca, ukwelashwa, noma ezinye izindlela kusekela impilo yokuzala iyonke.

7. Ngabe bobabili ozakwethu kufanele bahlolwe ukungabi nabantwana kwesibili?

Impela. Izici eziphathelene nokungabi nabantwana kowesilisa zifaka isandla cishe ku-40–50% wabo bonke ubunzima bokukhulelwa, futhi lokhu kusebenza ngokufanayo nasekungabi nabantwana kwesibili. Ngisho noma indoda ike yaba nezingane ngaphambilini, izimfanelo zesidoda sayo zingashintsha ngokuhamba kwesikhathi. Ukuhlaziywa kwesidoda kuyisinyathelo sokuqala esingahlaseli umzimba, esibiza kancane, nesibalulekile.

8. Mangaki amathuba empumelelo e-IVF ngokungabi nabantwana kwesibili?

Amazinga empumelelo ye-IVF ngokungabi nabantwana kwesibili ayahlukahluka ngokuya ngeminyaka nangokuxilongwa. Kwabesifazane abangaphansi kweminyaka engu-35, amazinga okubeletha izingane eziphilayo ngomjikelezo ngamunye we-IVF ngokuvamile asukela ku-40–50%. Kwabesifazane abaneminyaka engu-35–37, la mazinga ehla aye cishe ku-30–35%, kanti kwabahamba ngeminyaka engaphezu kwengu-40, ngokuvamile aba ngu-10–20%. Lezi zibalo zibonisa umthelela omkhulu weminyaka futhi ziveza ukubaluleka kokuhlolwa ngesikhathi.

9. Ngabe ukungabi nabantwana kwesibili okungachazwanga kungelashwa?

Yebo. Noma kungabi khona ukuxilongwa okusobala, zikhona izindlela eziningi zokwelapha. Izindaba eziningi zabashadile abanezingane ezingazange zichazwe kahle zokungabi nabantwana kwesibili ziphendula ekukhuthazweni kokuvuthwa kwamaqanda okuhambisana nocansi oluhlelwe ngesikhathi, i-IUI, noma i-IVF. Ukulungisa indlela yokuphila nokwesekwa kokudla nakho kungathuthukisa imiphumela futhi kuhlale kunconywa njengehlelo elihambisana nokwelashwa kwezokwelapha.

10. Ngingakuthola kuphi ukwesekwa ngokungabi nabantwana kwesibili?

I-RESOLVE: The National Infertility Association (resolve.org) inikeza amaqembu okugqugquzelana, izinsiza zemfundo, nomugqa wosizo okhethekile wokungabi nabantwana kwesibili. Imiphakathi eku-inthanethi efana naleyo ekwi-Reddit (r/secondaryinfertility) inikeza ukwesekana nozakwenu. Ochwepheshe bengqondo abenza ngokukhethekile kwezempilo yokuzala nabo bangahlinzeka ngesiqondiso esibalulekile ekubhekaneni nezinselelo zemizwa zokungabi nabantwana kwesibili.