He aha te Whakawhānau-a-Roto (IVF)? Te Whāinga, te Hātepe me ngā Hua

Ko te whakawhānau-a-roto (IVF) he rongoā momoā e whakakotahi ana i te hua manu me te pūtau pūngāwerewere i waho o te tinana i roto i te rihi taiwhanga. Mā tēnei hātepe e hanga ngā pūtau whānau ka taea te whakawhiti ki tō kōpū hei āwhina i a koe kia hapū.

Kua āwhina te IVF i miriona ngā whānau puta noa i te ao ki te whakatutuki i tā rātou moemoeā kia whai tamariki. Ahakoa te ahua uaua i te tuatahi, mā te māramatanga ki te hātepe ka āwhina i a koe kia māia ake, kia rite hoki mēnā kei te whakaaro koe ki tēnei ara ki te whānautanga.

He aha te Whakawhānau-a-Roto (IVF)?

Ko te IVF tētahi momo hangarau whakatipuranga āwhina e karo ana i ētahi wero momoā mā te whakakotahi i ngā hua manu me ngā pūtau pūngāwerewere i roto i te taiao taiwhanga i raro i te mana. Ko te kupu "in-vitro" te tikanga "i roto i te karaihe," e pā ana ki ngā rihi taiwhanga e tū ai te whakawhānau.

I te wā o te IVF, ka whakahihiko ō ovaries ki te whakaputa i ngā hua manu maha, ka tangohia, ka whakawhānautia ki te pūtau pūngāwerewere i roto i te taiwhanga. Ka whakatipuhia ngā pūtau whānau i puta mai mō ētahi rā i mua i te whakawhitihia o tētahi, neke atu rānei i ngā pūtau whānau hauora ki tō kōpū.

E whai wāhi ana tēnei hātepe ki ngā tokorua me ngā tāngata takitahi ki ngā ara rerekē ki te hapūtanga i te wā e uaua ana te whakatipuranga māori. Kua pai ake te angitu o te IVF i ngā tau tekau kua pahure, me ngā tikanga pai ake me te māramatanga ki te whanaketanga o te pūtau whānau.

He aha te take e mahia ai te IVF?

Ka tūtohutia te IVF i te wā kāore anō ētahi atu rongoā momoā i whai hua, i te wā rānei e uaua ana te whakatipuranga māori i ētahi āhuatanga rongoā motuhake. Ka tūtohu pea tō tākuta i te IVF hei rongoā tuatahi i ētahi āhuatanga, i muri rānei i te whakamātau i ētahi atu huarahi.

Ko ngā take tino noa mō te IVF ko ngā ngongo fallopian kua aukatia, kua pakaru rānei, e ārai ana i ngā hua manu kia tae māori ki te kōpū. Ko te kore momoā o te tāne, pēnei i te iti o te pūtau pūngāwerewere, i te kounga kino rānei o te pūtau pūngāwerewere, tētahi atu tohu auau mō te rongoā IVF.

Koinei nga āhuatanga matua ka arahi ki te rongoā IVF:

• Ngā ngongo fallopian kua aukatia, kua pakaru, kua ngaro rānei
• Te kore tamariki nui i te tane
• Te kore tamariki kāore i whakamāramahia i muri i ētahi atu rongoā
• Endometriosis e pā ana ki te whānautanga
• Ngā raruraru ovulation
• Te kore o te ovarian premature
• Ngā mate ira e hiahia ana ki te whakamātautau embryo
• Ngā rongoā mate pukupuku e pā ana ki te whānautanga
• Ngā tokorua o te ira tangata kotahi e whakamahi ana i te pūtau taihoa
• Ngā wāhine takitahi e whakamahi ana i te pūtau taihoa

Ka arotakehia e tō tohunga whānautanga tō āhuatanga me tō hītori rongoā kia whakatau mēnā ko te IVF te whiringa tika māu. I ētahi wā ka noho te IVF hei kōwhiringa e taunakitia ana i muri i ētahi atu rongoā pēnei i ngā rongoā whānautanga, i te whakawhānau i roto i te kōpū kāore i angitu.

He aha te tikanga mō te IVF?

Ko te tukanga IVF te tikanga e 4-6 wiki mai i te tīmatanga ki te otinga, ā, e whai ana i ētahi mahi i whakaritea. Ko ia mahi i hangaia hei whakanui i ō tūponotanga ki te whakawhānau me te hapū.

Ka tīmata tō haerenga ki te whakaohooho ovarian, ka tango koe i ngā rongoā whānautanga hei akiaki i ō ovaries ki te whakaputa i ngā hua maha hei utu mō te hua kotahi e tipu ana i ia marama. Ka nui ake ō tūponotanga ki te whakawhānau angitu.

Koinei te mea ka tupu i ia wāhanga o te IVF:

1. Te Whakaohooho i te Ōhanga (8-14 rā): Ka werohia koe i ngā werohanga homoni ia rā hei whakatairanga i te hanga hua maha. Ka aroturukihia tō ahunga whakamua e tō tākuta mā ngā whakamātautau toto me ngā ultrasound i ia rā torutoru.
2. Te Tango Hua (1 rā): Ka pūngāwari ana ō hua, ka whiwhi koe i tētahi werohanga whakaoho, ka whai i tētahi tikanga pokanga iti hei kohikohi i ngā hua mai i ō ōhanga mā te whakamahi i te ārahitanga ultrasound.
3. Te Whakawairanga (1 rā): Ka whakakotahitia ō hua ki te parāoa i roto i te taiwhanga. Ka taea tēnei mā te IVF tikanga, te werohanga parāoa intracytoplasmic (ICSI) rānei mēnā e hiahiatia ana.
4. Te Ahurea Embryo (3-6 rā): Ka aroturukihia ngā embryos kua whakawairangatia i a rātou e whakawhanake ana i roto i te taiwhanga. Ka arotakehia e tō embryologist tō rātou kounga me te tipu.
5. Te Whakawhiti Embryo (1 rā): Kotahi, neke atu rānei ngā embryos hauora ka whakawhitia ki tō kōpū mā te whakamahi i tētahi catheter angiangi, ngawari. Ko te tikanga kāore tēnei e mamae, ā, kāore e hiahiatia he rongoā whakamoe.
6. Te Whakamātautau Hapū (10-14 rā i muri mai): Ka tatari koe mō te rua wiki i mua i te tango i tētahi whakamātautau toto hei whakatau mēnā i angitu te maimoatanga.

I roto i tēnei tukanga, ka whakarato tō rōpū hauora i ngā tohutohu taipitopito me te tautoko. He maha ngā whare haumanu e tuku ana i ngā ratonga tohutohu hei āwhina i a koe ki te whakatere i ngā āhuatanga kare-ā-roto o te maimoatanga.

Me pēhea te whakarite mō tō maimoatanga IVF?

Ko te whakarite mō te IVF e hāngai ana ki te whakarite tinana me te kare-ā-roto kia whai wāhi pai koe ki te angitu. Ka tīmata tō whakarite i ngā wiki i mua i te tīmatanga o tō huringa maimoatanga.

Ka tūtohu pea tō tākuta i ētahi huringa oranga me ngā whakamātautau tātari hei whakapai ake i tō hauora i mua i te tīmatanga o te IVF. Ka āwhina ēnei whakaritenga ki te waihanga i te taiao pai rawa atu mō te maimoatanga angitu.

Ko ēnei ngā mahi whakarite matua ka tūtohu pea tō rōpū hauora:

• Te whakamātautau whānui mō te momo tamariki mō ngā hoa tokorua
• Tangohia ngā huaora i mua i te whānautanga, ina koa te waikawa folic
• Kia mau ki te kai hauora me te mahi whakakori tinana i ngā wā katoa
• Kia eke ki te taumaha hauora me te pupuri tonu
• Kati te kai paipa me te whakaiti i te inu waipiro
• Whakaitihia te kai kawhe
• Whakahaerehia te ahotea mā ngā tikanga whakangāwari
• Kia nui te moe (7-9 haora i ia pō)
• Arotakehia ngā rongoā katoa ki tō tākuta
• Whakaarohia te tohutohu, ngā rōpū tautoko rānei

Ka hoatu e tō whare haumanu ngā tohutohu motuhake mō ngā rongoā hei karo me ngā rāhui kai. Ka whakaako hoki rātou ki a koe me pēhea te werohia i a koe anō, ā, ka hoatu ki a koe tētahi maramataka maimoatanga taipitopito.

Me pēhea te pānui i ō hua IVF?

Ko te māramatanga ki ō hua IVF e hāngai ana ki te titiro ki ētahi inenga me ngā putanga matua puta noa i tō huringa maimoatanga. Ka whakamāramahia e tō rōpū hauora ia hua me te aha te tikanga mō tō mahere maimoatanga.

Ko ngā tau tuatahi nui ka kite koe e pā ana ki tō urupare ki te whakaihiihi ovarian. Ka aroturukihia e tō tākuta ō taumata homoni me te maha me te rahi o ngā follicles e whakawhanake ana mā ngā whakamātautau toto me ngā ultrasound.

Koinei ngā hua matua ka tutaki koe i te wā o IVF:

• Ngā taumata Estradiol: E tohu ana ēnei taumata homoni i te pai o te urupare a ō ovaries ki ngā rongoā whakaihiihi
• Te tatau me te rahi o te follicle: E whakaatu ana e hia ngā hua e whakawhanake ana me te wā ka rite ai rātou mō te tango
• Te maha o ngā hua i tangohia: Te tapeke o ngā hua kua pakeke i kohia i te wā o tō tikanga
• Te reiti whakawairakau: Te ōrau o ngā hua i whakawairakau angitu ki te pānga o te pūtau
• Ngā tohu kounga o te embryo: Te aromatawai i te hauora me te whaihua o ō embryos
• Ngā taumata Beta hCG: Te taumata homoni hapū i inehia i roto i tō whakamātautau toto

Ka whakamāramahia e tō tākuta whai mana ki te whakatipu uri ēnei hua i roto i te horopaki o tō āhuatanga takitahi. Ka rerekē ngā reiti angitu i runga i ngā āhuatanga pēnei i te pakeke, te tātaritanga, me ngā tikanga o te hōhipera, nō reira ka āwhina tō tākuta i a koe ki te mārama ki te tikanga o ō hua motuhake.

Me pēhea te whakapai ake i ō reiti angitu IVF?

Ahakoa e kore e taea e koe te whakahaere i ngā āhuatanga katoa e pā ana ki te angitu o te IVF, he maha ngā mahi e tika ana kia mahia e koe hei whakanui i ō tūponotanga. Ka taea e ngā huringa iti o te oranga te whai wāhi nui ki ngā hua o tō maimoatanga.

He wāhi nui tō hauora me tō oranga i roto i te angitu o te IVF. Arā, me arotahi ki te waihanga i te taiao hauora rawa atu mō te hapūtanga me te whanaketanga o te hapū wawe.

Anei ngā huarahi kua whakamatauria hei tautoko i tō maimoatanga IVF:

• Kia mau ki te kai taurite, te kai whai kiko
• Tangohia ngā tāpiringa kua tohua pēnei i te waikawa folic me te huaora D
• Kia kaha te tinana mā te whakakori tinana
• Whakahaerehia te ahotea mā te whakaaroaro, te yoga, te tohutohu rānei
• Kia pai te moe i runga i te wā tika
• Kaua e paowa me te inu waipiro nui
• Whakawhāitihia te kawhe ki te iti iho i te 200mg ia rā
• Whaia ngā tohutohu rongoā katoa
• Haere ki ngā whakaritenga katoa
• Whakaarohia te acupuncture mēnā ka tūtohu tō hōhipera

Ko tō pakeke te āhuatanga nui rawa atu e pā ana ki ngā reiti angitu IVF, me te kite i ngā reiti angitu ake i roto i ngā wāhine taitamariki. Heoi, he maha ngā āhuatanga e whai wāhi ana ki te angitu, ā, ka mahi tō rōpū hauora ki a koe ki te whakanui i tō mahere maimoatanga takitahi.

He aha ngā āhuatanga mōrearea mō te rahunga IVF?

He maha ngā āhuatanga ka pā ki ngā reiti angitu IVF, ā, mā te mārama ki ēnei ka āwhina i a koe kia whai tūmanako tūturu mō tō maimoatanga. Ahakoa e kore e taea te huri i ētahi āhuatanga mōrearea, ka taea te whakatika i ētahi atu mā te whakarerekē i te oranga, i ngā wawaotanga rongoā rānei.

Ko te pakeke te mea nui e pā ana ki ngā hua o te IVF, me te heke o ngā reiti angitu i te nuinga o te wā i te wā e pakeke haere ana ngā wahine. Ka pēnei tēnei nā te mea ka heke te kounga me te nui o ngā hua manu i te wā e pakeke haere ana, e pā ana ki te whakawhānau me te whanaketanga o te pūtau.

Koinei ngā mea nui e pā ana ki te angitu o te IVF:

• Te pakeke o te whaea: Ka heke nui ngā reiti angitu i muri i te 35 tau, ā, ka nui ake te heke i muri i te 40 tau
• Te kounga hua manu kino: Ka puta mai i te pakeke, te ira, te mate rānei
• Te kore tamariki a te tāne: He iti rawa te tatau o te pūtau, he kino rānei te kounga o te pūtau
• Ngā hē o te kōpū: Ngā raruraru hanganga e pā ana ki te whakato o te pūtau
• Ngā take endometrial: Ngā raruraru ki te rārangi o te kōpū
• Ngā rahunga IVF o mua: He maha ngā huringa kāore i angitu ka tohu pea i ngā take kei raro
• Te kai paipa: Ka tino whakaiti i ngā reiti angitu i ngā hoa e rua
• Te momomo: Ka pā ki ngā taumata homoni me te urupare ki te rongoā
• Ētahi mate: Pērā i te PCOS, te endometriosis, te mate autoimmune rānei

Ka arotakehia e tō tākuta ngā take tūpono nei, ā, ka tūtohu pea i ētahi atu whakamātautau, rongoā rānei hei whakatika i ngā mea ka taea te whakarereke. Kia mahara ahakoa te noho mai o ngā take tūpono, he maha tonu ngā tāngata ka whakatutuki i ngā hapū angitu mā te IVF.

He aha ngā raruraru ka puta mai i te IVF?

Ahakoa te haumaru o te IVF, pērā i ētahi atu tikanga rongoā, he tūpono me ngā raruraru ka puta. Ko te nuinga o ngā tāngata ka pāhi i te IVF kāore he raruraru nui, engari he mea nui kia mōhio ki ngā mea hei mātakitaki.

Ko ngā pānga taha tino noa e pā ana ki ngā rongoā whakatipu uri, kei roto ko te mamae ngawari, te pupuhi, me ngā huringa o te ngākau. Ka ngaro ēnei i te nuinga o te wā i te otinga o te rongoā.

Koinei ngā raruraru ka puta hei mōhio:

• Te mate o te pūkahukahu (OHSS): He mate onge engari he kino, ka pupuhi, ka mamae ngā ovaries
• Te hapū maha: He nui ake te tūponotanga o ngā māhanga, toru rānei, he nui ake ngā tūponotanga hauora
• Te hapū ectopic: He paku te piki ake o te tūponotanga o te hapū i waho o te kōpū
• Te toto, te mate rānei: He iti ngā tūponotanga e pā ana ki te tikanga tango hua manu
• Te pēhanga aronganui: Ka raru pea te tikanga maimoatanga i te aronganui
• Ngā hē whānau: He paku te piki ake o te tūponotanga, engari ko te nuinga o ngā pēpi IVF he hauora
• Te whānautanga kōmua: He paku te nui ake o te tūponotanga, ina koa ki ngā hapū maha

Ka āta titiro tō rōpū hauora ki a koe puta noa i te maimoatanga hei whakaiti i ēnei tūponotanga. Ka hoatu e rātou ngā tohutohu taipitopito mō ngā tohu whakatūpato hei mātakitaki me te wā hei whakapā atu ki a rātou tonu.

Āhea au e kite ai i te tākuta mō te kōrero IVF?

Me whakaaro koe ki te kōrero ki tētahi tohunga momo uri mēnā kua kotahi tau koe e ngana ana ki te hapū kāore i angitu, e ono marama rānei mēnā kei runga ake koe i te 35 tau. Heoi anō, ko ētahi āhuatanga hauora ka tika kia kōrero wawe.

Kaua e tatari mēnā he raruraru momo uri tō mohio, he āhuatanga hauora rānei ka pā ki tō kaha ki te hapū. Ka āwhina te kōrero wawe ki te tautuhi i ngā raruraru me te hanga mahere maimoatanga e tika ana mō tō āhuatanga.

Anei ngā āhuatanga me rapu kōrero momo uri wawe tonu:

• Kei runga ake koe i te 35 tau, ā, e ono marama ana koe e ngana ana
• He rerekē, he kore rānei ō wā hēki
• He maha ngā whāki kore i a koe
• He hītori tō koe mō te mate mumura o te pūkahukahu
• Kua tātaihia koe ki te endometriosis
• He raruraru momo uri tō tō hoa
• He hītori whānau tō koe mō te pāhau wawe
• Kua whai maimoatanga mate pukupuku koe ka pā ki te momo uri
• He tokorua koe o te ira kotahi, he tangata takitahi rānei e hiahia ana ki te hapū

Kia mahara, kāore te whai wāhi ki te momo uri e kī ana me whai IVF koe. Ka arotake tō tākuta i tō āhuatanga, ā, ka tūtohu pea i ētahi atu maimoatanga i te tuatahi, pērā i ngā rongoā momo uri, i te whakawhānau i roto i te kōpū.

Ngā pātai e pātai pinepine ana mō te IVF

Q.1 He pai te maimoatanga IVF mō te kore momo uri kāore i whakamāramahia?

Āe, he maimoatanga whai hua te IVF mō te kore momo uri kāore i whakamāramahia, ina koa kāore anō ētahi atu maimoatanga i whai hua. Ko te kore momo uri kāore i whakamāramahia e pā ana ki te 10-15% o ngā take kore momo uri katoa, i te wā kāore te whakamātau paerewa e whakaatu i tētahi take mārama.

Ka āwhina te IVF ki te hinga i ngā raruraru momo uri e kore pea e kitea mā te whakamātau i te wā katoa. Ka taea e te tukanga te tākuta ki te mātakitaki i te kounga o te hēki, ngā reiti whakawhānau, me te whanaketanga o te pūtau, ka taea te whakarato i ngā māramatanga whai hua ki ngā raruraru momo uri pea.

Q.2 Ka pā te tau ki ngā reiti angitu IVF?

He nui te pānga o te tau ki ngā reiti angitu IVF, me te pānga tino nui ki te momo uri o ngā wāhine. Ko ngā reiti angitu teitei rawa atu mō ngā wāhine kei raro i te 35 tau, ā, ka heke haere i te tau, ina koa i muri i te 40 tau.

Ka puta tēnei hekenga nā te mea ka heke te kounga me te nui o te hēki i te tau, e pā ana ki ngā reiti whakawhānau me te whanaketanga o te pūtau. Heoi, he maha ngā wāhine kei runga ake i te 35 tau e whakatutuki tonu ana i ngā hapū angitu mā te IVF, ā, he nui ake te hiranga o ō āhuatanga hauora takitahi i te tau anake.

Q.3 E hia ngā huringa IVF me whakamātau au?

E ai ki te nuinga o nga tohunga mo te whanautanga, me whakamatau kia 2-3 nga huringa IVF i mua i te whakaaro ki etahi atu whiringa, na te mea ka pai ake nga reeti angitu i nga nganatanga i muri mai. Heoi, ko te maha o nga huringa e tika ana mo koe ka whakawhirinaki ki to ahuatanga takitahi, to tau, me te urupare ki te maimoatanga.

Ka arotakehia e to taakuta nga mea penei i te kounga o o hua manu, te whanaketanga o te kukune, me nga take whanautanga e pa ana ki te awhina i te whakatau i te huarahi pai. Ka tutuki te angitu ki etahi tangata i to raatau huringa tuatahi, engari ko etahi atu ka hiahia etahi atu nganatanga, i nga rautaki maimoatanga rereke ranei.

Q.4 Ka taea e nga huringa oranga te whakapai ake i te angitu o te IVF?

Ae, ka taea e etahi huringa oranga te whai paanga pai ki nga reeti angitu o te IVF. Ko te pupuri i te taumaha hauora, te kai i te kai taurite, te korikori tinana i nga wa katoa, me te whakahaere i te ahotea ka taea te tautoko i to maimoatanga whanautanga.

Ko nga huringa tino nui ko te whakamutu i te kai paipa, te whakaiti i te inu waipiro, te tango i nga huaora i mua i te whanautanga, me te moe pai. Ka awhina enei whakarereketanga ki te hanga i te taiao pai rawa atu mo te haputanga angitu me te whanaketanga wawe o te haputanga.

Q.5 Ka hipokina te IVF e te inihua?

He rereke te kapinga inihua IVF i runga i to waahi, mahere inihua, me nga painga o te kaituku mahi. Ko etahi o nga kawanatanga e hiahia ana kia hipokina e nga kamupene inihua nga maimoatanga whanautanga, engari ko etahi atu kaore e whakahau i tetahi kapinga.

Whakapa atu ki to kaiwhakarato inihua kia mohio ki o painga motuhake me nga whakaritenga mo te kapinga, penei i te whakamanatanga o mua, te whakatutuki ranei i etahi paearu. He maha nga whare haumanu whanautanga e tuku ana i nga whiringa putea, i nga mahere utu ranei hei awhina i te maimoatanga kia ngawari ake.