He aha te Whakauru-a-Roto (IUI)? Te Whāinga, te Hātepe & Ngā Hua

Ko te whakauru-a-roto (IUI) he rongoā momonatanga e whakanohohia ai te purapura i tūkinotia ki roto tonu i tō kōpū i te wā e pūāwai ana koe. Whakaarohia me te mea e hoatu ana ki te purapura he timatanga pai i runga i tōna haerenga ki te tūtaki i tō hua manu. Mā tēnei hātepe ngawari e āwhina ngā tokorua ki te wikitoria i ētahi wero momonatanga mā te whakatata i te purapura ki te wāhi e tupu ai te whakawhānau.

Ko te IUI te nuinga o te wā ko tētahi o ngā rongoā momonatanga tuatahi e tūtohu ana ngā tākuta nā te mea he iti ake te pākaha, ā, he iti ake te utu i ētahi atu kōwhiringa. He maha ngā tokorua e kite ana i te whakamarie i te mōhiotanga e mahi ana tēnei hātepe me ngā tukanga tūturu o tō tinana, kaua ki te whakakapi katoa i a rātou.

He aha te whakauru-a-roto (IUI)?

Ko te IUI he hātepe momonatanga e whakanoho ana i te purapura horoia me te whakakaha ki roto tonu i tō kōpū mā tētahi ngongo angiangi, ngawari e kīia ana he katetā. Mā tēnei hātepe e karo te kōpū me te tara, e whakatakoto ana i te purapura ki te taha o ō ngongo fallopian i te wāhi e tupu ai te whakawhānau.

I te wā o tēnei rongoā, ka haere te purapura o tō hoa, o te purapura kaiwhakawhiwhi rānei, mā tētahi hātepe horoi motuhake i te taiwhanga. Mā tēnei hātepe e tango te purapura kāore i te kaha, ā, e whakakaha ana i te purapura hauora, kaha rawa atu mō te hātepe. Ko te katoa o te hātepe e pā ana ki te torutoru meneti noa iho, ā, he rite te āhua ki te whakamātautau pelvic rānei.

Ko te mea e rerekē ai te IUI i te hapūtanga tūturu ko te wā tika me te whakatakoto. Ka āta aroturuki tō tākuta i tō huringa pūāwai, ā, ka mahi i te hātepe i te wā e tukuna ana tō hua manu, e hoatu ana ki te purapura te tūponotanga pai rawa atu ki te tae atu me te whakawhānau i tō hua manu.

He aha te take e mahia ai te whakauru-a-roto (IUI)?

Ka āwhina te IUI i ngā tokorua ki te wikitoria i ngā wero momonatanga motuhake e aukati ana i te purapura mai i te tae atu, i te whakawhānau rānei i tētahi hua manu i te tūturu. Ka tūtohu pea tō tākuta i tēnei rongoā i te wā kāore anō i tupu te hapūtanga tūturu i muri i te whakamātau mō te 6-12 marama, i runga i tō tau me ō āhuatanga.

Ko ngā take tino nui e kīia ana e ngā tākuta mō te IUI ko te kore tamariki o te kōpū, arā, ka aukati te hūpē matotoru o te kōpū i te neke o te pūtau tane. Ko ētahi wāhine ka whakaputa hūpē rawa te waikawa, te matotoru rānei, e kore ai e pai te kauhoe o te pūtau tane. Ka karo katoa te IUI i tēnei arai mā te whakatakoto i te pūtau tane ki roto tonu i te kōpū.

Ko te kore tamariki o te tane tētahi atu take nui mō te IUI. Ki te iti te maha o te pūtau tane o tō hoa, te ngoikore o te neke o te pūtau tane, te āhua rānei o te pūtau tane, ka āwhina te horoi me te whakakaha i te pūtau tane hei kōwhiri i ngā pūtau tane pai mō te whakawhānau. Mā tēnei ka nui ake te tūponotanga ki te hapū i te whakamātau i te taiao.

Ka pā te kore tamariki e kore e whakamāramahia ki te 10-15% o ngā tokorua, ā, he kōwhiringa pai te IUI hei rongoā tuatahi. Ki te hoki mai ngā whakamātautau katoa he pai, engari kāore anō i puta te hapū, ka āwhina te IUI mā te whakapai i te wā me te whakatakoto i te pūtau tane.

Ka whakamahi hoki ngā wāhine takitahi me ngā tokorua wahine-wahine i te IUI me te pūtau tane mai i te kaiwhakarato hei whakatutuki i te hapū. E whai ana tēnei tikanga i tētahi ara tika ki te mātua i te wā kāore he hoa tane i roto i te whārite.

Ko ngā take kāore i te nuinga engari he mea nui ko te endometriosis ngawari, te ngoikore o te whakaputa, te wā rānei e hiahia ana koe ki te whakamahi i te pūtau tane tio i te mea he rongoā mate pukupuku, he tūnga rānei i te hōia. Ka kōrero tō tākuta mō te tika o te IUI mō tō āhuatanga motuhake.

He aha te tikanga mō te IUI?

He tere, he tika hoki te tikanga IUI, ā, e iti iho i te 10 meneti te roa i te tari o tō tākuta. Ka takoto koe ki runga i tētahi tēpu whakamātau pērā i te wā o te whakamātau pelvic, ā, ka whakauru tō tākuta i tētahi speculum hei kite i tō kōpū.

I mua i te tīmatanga o te tikanga, ka hoatu e tō hoa tētahi tauira pūtau tane i te whare haumanu, ka whakawerahia, ka whakaritea rānei te pūtau tane mai i te kaiwhakarato i mua i te tio. Ka horoia, ka whakakaha e ngā tohunga taiwhanga te pūtau tane, ā, e pā ana ki te 1-2 haora te roa. Mā tēnei tikanga ka tango i te pūtau tane kāore i te kaha, ngā huakita, me ētahi atu mea ka pā ai te kōpū.

I te wā o te whakato, ka whakauru tō tākuta i tētahi ngira angiangi, ngawari mā roto i tō pūwaha me roto i tō kōpū. Ka āta werohia te pūtau tane kua rārangihia mā roto i tēnei ngira. Ko te nuinga o ngā wāhine e kī ana he mamae ngawari, pērā i te mamae o te wā, ahakoa karekau ētahi e pōhēhē ana.

I muri i te whakaurunga o te pūtau tane, ka okioki koe i runga i te tēpu mō te 10-15 meneti. Kāore tēnei wā okioki poto e hiahiatia ana mō te angitu, engari he maha ngā wāhine e kite ana he whakatenatena. Ka taea e koe te hoki ki ō mahi noa tonu, tae atu ki te mahi me te whakakori tinana.

E tūtohu ana ētahi tākuta kia whakatakoto i te tukanga me ngā rongoā whakatōpū kia nui ake ai ō tūponotanga ki te tuku i ngā hua maha. Ko ētahi e pai ana ki te mahi me tō huringa tūturu. Ka whakawhirinaki tō huarahi motuhake ki tō aromatawai momoāhua me te mahere maimoatanga.

Me pēhea te whakarite mō tō tukanga IUI?

Ka tīmata te whakarite mō te IUI mā te māramatanga ki tō huringa whakatōpū, ka āta aroturukihia e tō tākuta mā ngā whakamātautau toto me ngā ultrasound. Ka haere koe ki te aroturuki i te rā 10-12 o tō huringa ki te tirotiro i ō taumata homoni me te kite i te ahunga o ō hua.

Ka tohutohu pea tō tākuta i ngā rongoā momoāhua pērā i te Clomid, i te letrozole rānei hei whakahihiko i te whakatōpū me te tuku pea i ngā hua maha. Ka whakanui ēnei rongoā i ō tūponotanga ki te hapū engari me āta aroturuki kia kore ai e nui rawa te whakahihiko. Whaia tō mahere rongoā kia rite ki te tohutohu mō ngā hua pai.

I mua i te tukanga, arotahi ki ngā mahi hauora me te oranga whānui e tautoko ana i te momoāhua. Kei roto i tēnei ko te tango i ngā huaora i mua i te whānautanga me te waikawa folic, te pupuri i te kai hauora, te moe pai, me te whakahaere i te ahotea mā ngā tikanga whakangāwari, i te whakakori tinana ngawari rānei.

I te rā o tō tukanga, mau kākahu hāneanea, me te kai i tētahi kai māmā i mua. Ko ētahi wahine e pā ana ki te mamae ngawari i muri i te IUI, nō reira he āwhina te whai i tētahi tangata hei taraiwa i a koe ki te kāinga, ahakoa kāore i te hiahiatia. Kaua e whakamahi i ngā tampons, te douching, te whai i te moe tahi rānei mō te 24-48 haora i mua i te tukanga.

Mēnā kei te whakarato tō hoa i te tauira parāoa, me ārai ia i te whakangahau mō te 2-5 rā i mua i te tukanga. Mā tēnei wā ārai e āwhina te whakarite i te maha me te kounga o te parāoa. Ko ngā wā poto, roa rānei ka whakaiti i te kounga o te parāoa.

Whakawhitiwhiti kōrero mō ngā rongoā e tango ana koe ki tō tākuta, tae atu ki ngā taapiri i runga i te kaute. Ko ētahi matū ka raru i te whānautanga, i te tukanga rānei. Mā tō rōpū hauora koe e ārahi mō te aha hei haere tonu, hei whakamutu rānei mō tētahi wā.

Me pēhea te pānui i ō hua IUI?

Ka whanganga te angitu o te IUI mā te whakatutuki i te hapūtanga, ā, ka whakamātautau koe mō tēnei i te rua wiki i muri i te tukanga. Ka whakarite tō tākuta i tētahi whakamātautau toto hei tirotiro i ō taumata hCG (gonadotropin chorionic tangata), he tika ake tēnei i ngā whakamātautau hapū i te kāinga i tēnei wā.

Ko te tatari e rua wiki i waenga i te IUI me te whakamātautau ka uaua te āhua o te ngākau mō te maha o ngā tokorua. I tēnei wā, ka kite pea koe i ngā tohu pēnei i te ngawari o te u, te mamae ngawari, te ngenge rānei, engari ka pā ēnei i ngā rongoā whānautanga, kaua i te hapūtanga. Kaua e pānui rawa i ngā tohu tōmua.

He rerekē ngā reiti angitu mō te IUI i runga i tō tau, te take mō te kore whānautanga, me te whakamahi i ngā rongoā whānautanga. I te nuinga, ko ngā wahine i raro i te 35 tau te 10-20% te tūponotanga o te hapūtanga i ia huringa IUI, i te mea ka heke tēnei ki te 5-10% mō ngā wahine i runga i te 40 tau.

Ki te kore e angitu tō huringa IUI tuatahi, kaua e ngaro te tūmanako. He maha ngā tokorua e hiahia ana i ngā nganatanga maha, ā, he rite tonu ngā reiti angitu mō ngā huringa tuatahi e 3-4. Ka arotake tō tākuta i ngā mea i pā, ā, ka whakatika pea i ngā rongoā, i te wā rānei mō ngā huringa ā muri ake nei.

Ko te whakamātautau hapū pai i muri i te IUI te tikanga i mahi te tikanga, engari me haere tonu te aroturuki. Ka tirohia e tō tākuta ngā taumata hCG ia rā, ia rā, kia mōhio ai kei te piki tika ana, ā, ka whakarite i te ultrasound i te 6-7 wiki hei whakaū i te whanaketanga o te hapū.

Me pēhea te whakapai ake i ō reiti angitu IUI?

He maha ngā āhuatanga ka āwhina i te whakanui i ō tūponotanga ki te angitu IUI, ka tīmata mā te wā tika o te tikanga me te ovulation. Ka whakamahi tō tākuta i ngā whakamātautau toto me ngā ultrasound hei tautuhi i te wā pai, engari ka taea hoki e koe te aroturuki i ngā tohu pēnei i ngā huringa hūpē o te kaki kōpū me te mamae paku i te puku.

Ko te pupuri i te oranga hauora ka whai pānga nui ki ngā reiti angitu IUI. Aronga ki te kai i te kai taurite e whai ana i te folate, antioxidants, me ngā ngako hauora i te wā e whakawhāiti ana i ngā kai tukatuka, te nui o te kawhe, me te waipiro. He āwhina te whakakori tinana i te wā katoa, engari karo i ngā mahi whakangungu kaha ka raru pea i te whakato.

He wāhi nui te whakahaere i te ahotea i te angitu o te maimoatanga momona. Whakaarohia te whakauru i ngā tikanga whakangā pēnei i te whakaaroaro, te yoga, te acupuncture rānei ki tō rātou rā. He maha ngā tokorua e kite ana i te āwhina o te tohutohu mō te whakatere i ngā piki me ngā heke o te ngākau o te maimoatanga momona.

Mēnā e kai paipa ana koe, ko te mutu i mua i te IUI ka tino whakapai ake i ō reiti angitu. Ka pā te paipa ki te kounga o te hua manu, ka whakaiti i te rere o te toto ki ngā okana whakatipuranga, ā, ka raru pea i te whakato. Ka taea e tō tākuta te whakarato rauemi hei āwhina i a koe ki te mutu i te haumaru.

He mea nui kia whai tika i te hōtaka rongoā kia angitu ai. Whakaritea ngā whakamaharatanga waea mō ngā rongoā whakatipu uri, ā, haere ki ngā pōhiri aroturuki katoa. Ahakoa ngā hē iti i te wā ka pā ki te hāora, ka whakaiti i ō tūponotanga ki te hapū.

He pai ki ētahi tokorua ngā tāpiringa whakatipu uri pēnei i te CoQ10, te huaora D, te waikawa ngako omega-3 rānei, engari me kōrero tonu ki tō tākuta i te tuatahi. Ko te mea e pai ana mō tētahi tangata, kāore pea e tika mō tētahi atu, ā, ka taea e ētahi tāpiringa te whakararu i ngā rongoā whakatipu uri.

He aha ngā āhuatanga e pā ana ki ngā reiti angitu IUI?

Ko tō tau te āhuatanga nui e pā ana ki ngā reiti angitu IUI, ka heke te whakatipu uri i muri i te 30 tau, ā, ka tere ake i muri i te 35 tau. Ko ngā wāhine kei raro i te 35 tau te nuinga o ngā reiti angitu, ā, ko te hunga kei runga ake i te 40 tau ka whai hua pea mai i ngā maimoatanga kaha ake pēnei i te IVF.

Ko te take i raro iho o te kore whakatipu uri e pā ana ki ngā putanga IUI. Ko ngā tokorua he iti te raru o te tane, he raru rānei o te kaki kōpū, ka kite i ngā hua pai, ā, ko te hunga he nui te endometriosis, he aukati rānei i ngā ngongo fallopian, ka iti pea ngā reiti angitu me te IUI anake.

Ko tō rāhui ovarian, e inea ana mā ngā whakamātautau pēnei i te AMH (hormone anti-Müllerian) me te tatau follicle antral, e pā ana ki te pai o tō urupare ki ngā rongoā whakatipu uri me te kounga o tō hua manu. Ko ngā rāhui ovarian teitei ake te nuinga e hono ana ki ngā reiti angitu IUI pai ake.

He mea nui anō te roa o te kore whakatipu uri, ko ngā tokorua e ngana ana mō ngā wā poto ake te nuinga o ngā putanga pai ake. Ki te mea kua ngana koe ki te hapū mō ētahi tau, tērā pea he raru kei raro iho e kore e taea e te IUI anake te whakatika.

Ko ngā tawhā kounga o te pānga o te pūtau, tae atu ki te tatau, te neke, me te hanganga, e pā tika ana ki te angitu IUI. Ko te nui o te raru o te tane ka hiahia pea ki te IVF me te ICSI (whakauru pūtau pūtau intracytoplasmic) mō ngā hua pai ake i te mea ka taea e te IUI te whakarato.

Ko ētahi atu āhuatanga kāore i te whānui ko ngā hē o te kōpū, ngā āhuatanga ā-tinana, ngā mate pērā i te PCOS, te korenga o te thyroid rānei. Ko te whakatika i ēnei āhuatanga e pūtake ana, he maha ngā wā ka whakanui i ngā reiti angitu o te IUI.

He aha ngā tūponotanga me ngā raruraru o te IUI?

Ko te IUI te tikanga he tino haumaru, he iti noa ngā tūponotanga, engari he mea nui kia mārama ki ngā raruraru ka puta i mua i te haere tonu. Ko te pānga taha tino noa he mamae ngawari i te wā, i muri rānei i te tikanga, ka ngaro i roto i ngā hāora ruarua.

He raruraru onge engari he nui te mate, ka puta i roto i te iti iho i te 1% o ngā tikanga IUI. Ko ngā tohu ko te kirika, te mamae nui o te puku, te rereke rānei o te wai mai i te tara i ngā rā i muri i te rongoā. Whakapā atu ki tō tākuta tonu mēnā ka pā ki a koe ēnei tohu.

He maha ngā hapū (māhanga, toru) ka puta pinepine ki te IUI, ina koa ka whakamahia ngā rongoā whakatipu. Ahakoa he maha ngā hoa tāne me ngā hoa wahine e manaaki ana i ngā māhanga, he nui ake ngā tūponotanga o ngā hapū maha mō te whaea me ngā pēpi, tae atu ki te whānautanga i mua i te wā me ngā raruraru o te hapū.

Ka puta te mate hyperstimulation ovarian (OHSS) mēnā kei te tango koe i ngā rongoā whakatipu me te IUI. Ko te OHSS ngawari ka pā te pupuhi me te kore mārie, engari ko ngā take nui ka mōrearea. Ka āta aroturukihia koe e tō tākuta hei ārai i tēnei raruraru.

He mea nui te ahotea aronganui ki te rongoā IUI. Ko te tūmanako me te pouri ka uaua mō ngā whanaungatanga me te hauora hinengaro. Whakaarohia te tautoko tohutohu i roto i tō haerenga whakatipu.

Ko te hapū ectopic, kei te whakato te pūtau i waho o te kōpū, ka puta i roto i te 1-2% o ngā hapū IUI. He rite tēnei ki ngā reiti whakatipu tūturu, me te hiahia kia aro mai te rongoā tonu mēnā ka tāutuhia.

Āhea au e kite ai i te tākuta mō te IUI?

Whakaarohia te kōrero ki tō tākuta mō te IUI mēnā kua ngana koe ki te hapū mō te 6 marama (mēnā kei runga ake koe i te 35 tau) rānei 12 marama (mēnā kei raro koe i te 35 tau) kāore i angitu. He pai ake te kōrero wawe mēnā he mōrearea tō whānautanga, he wā haukoti rānei.

He mea nui te rongoā tonu mēnā ka pā te mamae nui ki te puku, te nui o te toto, te kirika, ngā tohu rānei o te mate i muri i te IUI. Ahakoa he onge ngā raruraru, he mea nui te rongoā wawe mēnā ka puta.

Whakaritea he whakaritenga whai muri mēnā he pātai āu mō ngā pānga taha o ngā rongoā whānautanga, mēnā rānei kei te uaua koe i te taha aronganui ki te tukanga rongoā. Ka taea e tō tākuta te whakatika i ngā rongoā, te whakarato rānei i ngā rauemi tautoko atu.

I muri i te 3-4 ngā huringa IUI kāore i angitu, kua tae te wā ki te arotake anō i tō mahere rongoā. Ka tūtohu pea tō tākuta kia neke ki te IVF, kia tirotiro rānei i ētahi atu take whānautanga kāore i kitea i te tīmatanga.

Whakapā atu ki tō kaiwhakarato hauora mēnā ka hē te huringa paheketanga i te wā o te rongoā IUI, mēnā rānei ka pā ngā tohu pēnei i te nui o te pūhihi, ngā huringa nui o te ngākau, te mamae pūmau rānei i te wā e tango ana i ngā rongoā whānautanga.

Me kōrero ngā wāhine takitahi, ngā tokorua o te ira tangata kotahi ki ngā tohunga whānautanga i te wā e rite ana ki te tīmata ki te ngana ki te hapū me te pūmua takoha. Ka āwhina te whakamahere wawe ki te whakanui i te wā me ngā huarahi rongoā.

Ngā pātai e pātai pinepine ana mō te IUI

Q.1 He mamae te IUI?

Ko te nuinga o ngā wāhine e whakaahua ana i te IUI he mamae ngawari e rite ana ki te whakamātautau puku, te Pap smear rānei. Ka pōturi pea te mamae i te wā e haere ana te katita i tō kōpū, engari he torutoru noa ngā hēkona te roa. He iti iho i te 10 meneti te roa o te tukanga katoa, ā, ka tere te ngaro o te mamae. Ko te tango i te rongoā mamae i te taha o te kaute i te haora i mua i te tukanga ka āwhina i te whakaiti i te mamae.

Q.2 E hia ngā huringa IUI me whakamātau au i mua i te neke ki te IVF?

E ai ki te nuinga o nga tohunga mo te whanautanga me whakamatau kia 3-4 nga huringa IUI i mua i te whakaaro ki te IVF, me te whakaaro kei te whakamahi koe i nga rongoa whanautanga hei whakanui i ou tupono. He rite tonu nga reeti angitu mo nga huringa tuatahi, engari ka tino heke i muri i te wha o nga whakamatautau. Heoi, kei runga tenei tohutohu i to tau, te tātaritanga whanautanga motuhake, me te pai o to urupare ki nga rongoa. Ko nga wahine neke atu i te 38 tau te pakeke ka tere ake te neke ki te IVF na te mea e aro ana ki te wa.

Q.3 Ka taea e au te korikori tinana i muri i te IUI?

Ka taea e koe te hoki ki nga mahi noa i muri tonu i te IUI, tae atu ki te korikori ngawari ki te ngawari. Heoi, he maha nga taakuta e kii ana kia karohia nga mahi whakangungu kaha, te hiki taumaha, me nga mahi e nui ai te wiri mo nga haora 24-48 tuatahi. He pai nga mahi ngawari penei i te hikoi, te kauhoe, te yoga ranei, a tera pea ka awhina i te whakaiti i te ahotea. Whakarongo ki to tinana me te karo i nga mea e raru ai koe.

Q.4 He aha te rereketanga i waenga i te IUI me te IVF?

Ka whakatakotohia e te IUI te parāoa ki roto i to kōpū i te wa e puta ana te whakawhānau i roto i ou ngongo fallopian. Kei roto i te IVF te tango i nga hua mai i ou ovaries, te whakawhānau i a raatau ki te parāoa i roto i te taiwhanga, me te whakawhiti i nga kukune i puta ki roto i to kōpū. He iti ake te pokanga o te IUI, he iti ake te utu, me te mahi tahi me to huringa taiao, i te wa e tuku ana te IVF i nga reeti angitu teitei ake engari e hiahia ana kia nui ake nga rongoa, nga tikanga, me te aroturuki.

Q.5 E hia te wa ka taea e au te tango i te whakamatautau hapū i muri i te IUI?

Taria kia 14 nga ra i muri i te IUI i mua i te tango i te whakamatautau hapū kia kore ai e puta nga hua rūpahu. Ko te whakamatautau wawe rawa ka puta he kino rūpahu na te mea me whai wa nga taumata hCG ki te hanga kia nui ai te kitea. Mena i whakamahia e koe he pere whakaoho kei roto te hCG hei whakaoho i te ovulation, tatari kia 10-14 nga ra kia whakawātea i tō pūnaha kia kore ai e puta nga pai rūpahu. He tairongo ake te whakamatautau toto i te tari o to taakuta, he tika ake hoki i nga whakamatautau hapū i te kainga i tenei waataata.