Izilwane zomyeni wami zakhulelwa
Ngingathanda ukwabelana ngolwazi lwami oluyimpumelelo ekukhulelweni, okwakuwuhambo olugcwele izinselele nethemba ngesikhathi esifanayo, ikakhulukazi njengoba umyeni wami ehlushwa ukuntula isidoda, okwaziwa ngokwezokwelapha ngokuthi “i-azoospermia.” Isikhathi esifunda ngaso lokhu kwakunzima kakhulu futhi kusikhungathekisa, kodwa sanquma ukungadikibali futhi sibheke zonke izindlela ezingaba khona zokufeza iphupho lethu lokuba nengane.
Saqala uhambo lwethu ngokuya kodokotela abangochwepheshe bezokuzala, lapho sahlola khona izivivinyo eziningi ukuze sithole imbangela eqondile ye-azoospermia futhi sihlole izinketho ezitholakalayo kithi. Kwakubaluleke kakhulu ngathi ukuba sizihlanganise nethimba lezokwelapha elinolwazi neliqondayo, elasinikeza ukusekelwa kwengqondo nokuziphatha kanye nesiqondiso sezokwelapha.
Phakathi kwezinketho ezihlongozwayo, i-ICSI yayiyithemba lethu elikhulu. Le ndlela idinga ukukhipha isidoda ngqo esendeni uma sitholakala ngamanani amancane kakhulu, noma sisebenzise isidoda somnikeli uma singekho ngokuphelele. Isinqumo sasinzima, kodwa sanquma ukuqhubekela phambili ngesibindi nethemba.
Washukunyiswa isibeletho ukuze andise amathuba akhe okukhulelwa, futhi ngemva kwamasonto ambalwa, kwenziwa i-IVF. Izinsuku ezilandela ukuhlinzwa zazigcwele ukukhathazeka nokulangazelela, kodwa salondoloza ukholo nethemba. Ekugcineni, imiphumela yaba mihle, futhi injabulo yethu yayingachazeki ngokuthi sasiyoba abazali.
Phakathi nalolu hambo, safunda ukubekezela nokuphikelela, futhi sabona ukubaluleka kokusekelwa komndeni nokwengqondo ekunqobeni izinselele. Siphinde sazisa kakhulu isayensi nobuchwepheshe bezokwelapha obunikeza ithemba kubabhangqwana abaningi ababhekene nobunzima bokukhulelwa.
Ingabe ukukhulelwa kwenzeka ngokuntuleka kwesidoda?
Uma owesilisa engakwazi ukukhulelwa, yena nomkakhe baya kudokotela ukuze bahlole izimbangela zale nkinga, futhi kungase kutholakale ukuthi isizathu ukuntuleka kwesidoda. Khona-ke kuphakama umbuzo: Kungenzeka yini ukuthi ukukhulelwa kwenzeke singekho isidoda?
Ukuvundisa kudinga ukuhlangana kwesidoda neqanda. Ezimweni ezingavamile, ukuvundiswa kungase kwenzeke nakuba enye yazo inokukhubazeka okuncane. Kodwa-ke, uma isidoda singekho nhlobo, akunakwenzeka ukuthi ukukhulelwa kwenzeke ngokwemvelo. Ngakho-ke, impendulo yombuzo wokukhulelwa esimweni sokuntuleka kwesidoda ukuthi ukukhulelwa akukwazi ukwenzeka ngokwemvelo kulokhu.
Kusho ukuthini ukuntula isidoda?
I-Azospermia ibhekisela ekungabibikho kwesidoda esidodeni sowesilisa, okuvimbela ukuvundiswa nokuholela ekungazali.
Lesi simo esibonakala ku-1% kuphela wabesilisa, siyimbangela yazo zonke izinkinga zokungazali kwabesilisa ezingaba ngu-15%. Ukuqaphela lesi simo kudinga ubuchwepheshe bezokwelapha obuhlukile, njengoba ngezinye izikhathi kuba nzima ukusixilonga ngenxa yobuqili bezimpawu ezihambisana naso.
Izinhlobo ze-azoospermia
Inkinga yokungabikho kwesidoda ihlukaniswa ngezinhlobo ezimbili eziyinhloko Uhlobo lokuqala luyisithiyo, okwenzeka ngenxa yokuvinjelwa okuvimbela ukufika kwesidoda ezinkingeni zomsebenzi wamasende.
1- I-Hormonal azoospermia
Igama elithi pretesticular azoospermia yisimo sezokwelapha esibonakala ngokungabi bikho kwesidoda ngenxa yezinkinga ku-pituitary gland noma i-hypothalamus ebuchosheni, njengoba lesi sici sithinta ukukhiqizwa kwamahomoni adingekayo ukuze kumiswe isidoda. Okubaluleke kakhulu kulawa mahomoni i-follicular hormone (FSH) ne-luteinizing hormone (LH), edingekayo ekusebenzeni kahle kwamasende.
2- Ukushoda kwesidoda ngenxa yesende
Ukungabikho kwesidoda ku-testicle kubonisa ukukhubazeka ohlelweni lokwakheka kwalawa maseli ngaphakathi kwamasende, okuholela ekungabini ngokuphelele kwesidoda kuwo.
3- I-obstructive azoospermia
Lesi simo sibizwa ngokuthi i-obstructive infertility noma i-post-castration, lapho inqubo ye-biological yokukhiqiza isidoda emasendeni yenzeka ngendlela efanele, kodwa kunesithiyo esivimbela lesi sidoda ukuba sihambe ngokuphumelelayo ku-urethra ngesikhathi sokuphuma.
Izimpawu ze-azoospermia
Ikakhulukazi, azikho izimpawu ezihlukene ezibonisa ngokucacile amacala e-azoospermia ngokwawo, kodwa kunezimpawu ezithile udokotela onguchwepheshe angase aziqaphe futhi aphethe ngokuthi lesi simo sikhona, ikakhulukazi esimweni sokuhlupheka ngenxa yobunzima bokukhulelwa. Izimpawu ezingase zitholakale kubantu abane-azoospermia zihlanganisa:
- Ukuncipha kobukhulu bamasende uma kuqhathaniswa nosayizi ojwayelekile.
- Ukuncipha kwenani lesidoda esiqhanyelwe.
- Ukubhekana nobunzima ekutholeni i-erection.
- Ukubonakala kwemithambo ye-varicose ku-testicle.
- Ukuzwa ubuhlungu lapho uchama.
- Izinselelo ezihlobene nokuqhanyelwa.
- Ukubambezeleka kokuthomba noma izimpawu zakhona akuzona kuphela lesi sibonakaliso futhi zingase zihlotshaniswe nezinye izifo, ngakho-ke kunconywa ukuba ufune iseluleko sezokwelapha ukuze unqume imbangela futhi ulaphe.
Izindlela zokwelapha i-azoospermia
Ukwelapha izinkinga zokungazali ezihlanganisa i-azoospermia, kusetshenziswa inqubo ebizwa ngokuthi i-ICSI.
Ngale ndlela, amaqanda akhishwa kowesifazane bese kuthathwa isampula yezicubu zamasende endodeni ukuze kukhishwe isidoda ngendlela yaselabhorethri. Elabhorethri, la masampula alungiswa ngokucophelela bese kukhethwa isidoda esifanele ukuze kuqhutshekwe nenqubo yokumila.
Khona-ke isidoda sihlanganiswa namaqanda endaweni efanelekile elingisa izimo zemvelo ngaphakathi kwesibeletho, lapho inqubo yenzeka ngaphansi kokuqondisa okuseduze kwethimba lezokwelapha. Ngemva kokuba ukumila sekuphelile futhi ukuvundiswa sekufinyelelwe, imibungu idluliselwa esibelethweni sowesifazane ukuze iqhubeke nokukhula.
Le ndlela isetshenziselwa ukusiza imibhangqwana ukuba inqobe izinselele ezihlukahlukene zokungabi nabantwana futhi ibenze bakwazi ukufeza iphupho lokuba umzali, okwandisa ithemba labaningi lokuqala umndeni.
Ingabe ukukhulelwa kwenzeka ngesidoda esincane?
Izinto eziningi zempilo nezemvelo zithinta isibalo esiphansi sesidoda, futhi lezi zici zihlanganisa okulandelayo:
- Ukuchayeka emithini yokwelapha noma ngemisebe esetshenziswa ukulwa nomdlavuza kunganciphisa ukukhiqizwa kwesidoda.
- I-Varicocele, lapho imithambo ikhula khona, ithinta kabi ama-testicles.
- Izifo ezingamahlalakhona ezifana nesifo sikashukela nazo zingadala ukuncipha kwesidoda.
- Ukuhlinzwa kwangaphambilini okubandakanya isende noma esinyeni kungaba nomthelela.
- Ukusebenzelana nezinhlanganisela zamakhemikhali ezithile noma ukuchayeka kuma-X-ray kuphazamisa ukukhiqizwa kwesidoda.
- Ukusetshenziswa kwezidakamizwa kanye nokukhuluphala kunganciphisa ukusebenza kahle kokuzala.
Naphezu kwalezi zinselele, ukukhulelwa kungenzeka ngisho nesidoda esincane uma kulandelwa izinyathelo ezithile, njenge:
- Gwema ukubhema.
- Ukwehlisa isisindo ngokuzivocavoca njalo nokudla okunomsoco.
- Gwema ukugqoka izingubo ezimpintshayo ezingase zinyuse izinga lokushisa lamasende futhi ziphazamise ukukhiqizwa kwesidoda.
- Gwema ukusebenzisa izidakamizwa ezikhuthaza ukusebenza kwezemidlalo.
- Uma usenobunzima bokukhulelwa ngokwemvelo ngemva konyaka, udokotela wakho angase atuse izindlela ezifana nokuzalanisa okwenziwa noma i-ICSI.
Ingabe ikhona imithi yokwelapha inzalo yabesilisa?
Inhlanganisela yezinto zemvelo ingasetshenziswa ukuthuthukisa inzalo emadodeni kanye nokwelapha izinkinga zokungazali. Le ngxube iqukethe izithako zemvelo ezihlolwe ngempumelelo.
Phakathi kwalezi zithako sithola uju, okuwumthombo ocebile wezinzuzo zezempilo, kanye ne-watercress, eyaziwa ngezindawo zayo ezizuzisayo zempilo yezocansi, ngaphezu kwe-royal jelly, esetshenziswa njengesikhuthazo samandla nobungqabavu.
Iqembu lamafutha emvelo liphinde lengezwe kule ngxube, kuhlanganise namafutha e-ginger, aziwa ngezici zawo ezivuselelayo, namafutha embewu emnyama, enomlando omude wokusetshenziswa kweminye imithi.
Ngaphezu kwamafutha e-basil, amafutha e-radish, amafutha ka-anyanisi, namafutha e-ulethisi, ngayinye yazo inikeza izinzuzo ezihlukahlukene zezempilo. Imbewu yeSesame ne-cardamom iqeda le ngxube ngezithako zayo ezinomsoco nezishukumisayo.
Ngokuhlangene, lezi zingxenye zakha ukwelashwa kwemvelo okunomthelela ekwenzeni ngcono inzalo emadodeni, futhi ihlolwe ngempumelelo ukuze kuzuzwe imiphumela emihle.
Ukuxilongwa kwe-azoospermia
Ukuba khona kwe-azoospermia kutholwa ngokuhlolwa kwesidoda, okuyingxenye yokuhlolwa kwezokwelapha okujwayelekile kwabesilisa ngaphambi komshado.
Lokhu kuhlola kukala ukuba khona noma ukungabi khona kwesidoda. Uma lesi simo sitholakala, udokotela uqala ukuhlola okuphelele ukuze athole izizathu eziholele kulesi simo, okumenza aphakamise izindlela ezingcono kakhulu zokwelapha.
Ukuhlolwa kweHormonal
Ukuhlolwa kwaselabhorethri okuhlobene nezinkinga zokuzala kuhlanganisa ukuhlaziya amazinga amahomoni amaningana, okuhlanganisa amahomoni avuselela i-follicle kanye ne-luteinizing (i-FSH ne-LH), ngaphezu kokulinganisa amazinga e-testosterone, i-prolactin, i-estradiol, ne-thyroxine.
Lokhu kuhlola kwenza udokotela akwazi ukuqonda futhi ahlole izici ezithinta izimo zokuntuleka kwesidoda, futhi anqume ukuthi imbangela ingenxa yokuvimbeka noma enye imbangela engavimbeli. Ukuze athole ngokunembile imbangela, udokotela angase asebenzise isampula elisendeni ukuze alihlole ngokunembe kakhudlwana elabhorethri.
Ukuhlolwa kwezithombe
Udokotela angase atuse ukuhlolwa kwe-ultrasound kwamasende ukuze athole ulwazi olunembile olunomthelela ekuxilongweni. Lokhu kuhlola kunquma ubukhulu bama-testicles, kuthola ukuba khona kwanoma yimaphi ama-cysts noma i-varicose veins kuwo, futhi kuvumela ukubonwa kwezinkinga zokuzalwa okungenzeka.
Ezimweni zokuxilonga i-azoospermia ngenxa yokuvimbela, ukuhlolwa kwe-imaging kuyadingeka ukuze kutholakale indawo yokuvimbela okuthinta ukugeleza kwesidoda.
Isampula yamasende
Ukuze kuqondwe izizathu ezibangela ukungabikho kwesidoda, kukhishwa izicubu zesende ukuze kuhlolwe ngokucophelela elabhorethri. Lokhu kuhlola kwembula ukuthi azikho yini izinkinga ngokwakheka kwezicubu, njengokukhubazeka kokuzalwa noma ukuwohloka kwamangqamuzana akhiqiza isidoda.
Uma lezi zicubu ziphilile futhi ibhalansi ye-hormonal izinzile, kungenzeka ukuthi imbangela iwukuvinjelwa okuvimbela ukudlula kwesidoda. Ngakho-ke, kunconywa ukuqhuba ukuhlolwa okwengeziwe ukuze kutholakale indawo kanye nembangela yokuvimbela ngokusekelwe ekuhloleni kukadokotela.
Ukuhlolwa kofuzo
Lapho bexilonga i-azoospermia, odokotela ngezinye izikhathi babona izimpawu ezingase zibonise izinkinga zofuzo. Kulezi zimo, udokotela utusa ukuhlolwa kofuzo ukuze kutholwe izimbangela eziwumsuka.
Phakathi kwalokhu kuhlola kubalwa i-karyotyping, esiza ekuboneni iziyaluyalu ezifana ne-Klinefelter syndrome kanye nesifo sokubuyela emuva kwabesilisa.
Futhi, ukuhlaziya i-chromosome ye-Y kuyadingeka kulo mkhakha, njengoba ukuba khona kwezinguquko ezithile kule chromosome, njengokususwa, ngokwesibonelo, kwakha cishe u-6% wezimo ze-azoospermia.
Ukukhetha izivivinyo ezifanele kuncike ekuhloleni kukadokotela isimo kwezinye izimo, kungase kwanele ukwenza izivivinyo zehomoni ukuze kutholakale imbangela, kuyilapho ezinye izimo zingadinga uphenyo olunembe kakhudlwana nolubanzi.
Ukuvimbela isidoda zero
Kunezizathu eziningana zokungatholi abantwana kwabesilisa ngenxa yokuntuleka kwesidoda, futhi lezi zizathu ziyahlukahluka phakathi kwalokho okufuzwayo nokungenakuvinjelwa, nalokho okutholwayo futhi okungagwenywa ngokuthatha izinyathelo ezithile zokuvimbela. Ngakho-ke, ungathatha izinyathelo ezilandelayo ukunciphisa izimbangela ezitholiwe:
- Kungcono ukugwema imidlalo eshubile futhi enodlame ukuze kuvikelwe amasende kunoma yikuphi ukulimala.
- Kubalulekile ukuqapha noma yiziphi izinguquko ezingase zenzeke emasendeni futhi uxhumane nodokotela ngokushesha ukuze ahlole isimo futhi anqume izinyathelo ezingcono kakhulu zokwelashwa.
- Kumelwe uzibophezele ekuhloleni ngezikhathi ezithile ukuba khona kwe-varicocele futhi ulandele udokotela onguchwepheshe ukuze uthole ukwelashwa kusenesikhathi ngaphambi kokuba isimo sibe sibi kakhulu.
- Kunconywa ukunciphisa ukuchayeka kumakhemikhali anobuthi nemisebe ngangokunokwenzeka ukuze kugwenywe umthelela wawo omubi ekuvundeni.
- Kuyadingeka ukugwema ukusetshenziswa kwemithi engekho emthethweni futhi evinjelwe emhlabeni wonke ngoba inemiphumela emibi ekukhiqizeni isidoda.