Created at:1/13/2025
Question on this topic? Get an instant answer from August.
I-Intrauterine insemination (IUI) ukwelashwa kokuzala lapho isidoda esilungiswe ngokukhethekile sifakwa ngqo esibelethweni sakho ngesikhathi ovula ngaso. Cabanga ngakho njengokunikeza isidoda isiqalo ohambweni lwabo lokuhlangana neqanda lakho. Le nqubo emnene isiza imibhangqwana ukunqoba izinselelo ezithile zokuzala ngokuletha isidoda eduze nalapho umquba wenzeka ngokwemvelo.
I-IUI ivame ukuba ngelinye lamacala okuqala okwelashwa kokuzala odokotela abancoma ngoba ayihlaseli kangako futhi ishibhile kunezinye izinketho. Imibhangqwana eminingi ithola induduzo ngokwazi ukuthi le nqubo isebenza nezinqubo zomzimba wakho zemvelo kunokuzishintsha ngokuphelele.
I-IUI iyinqubo yokuzala efaka isidoda esihlanzekile nesigxilisiwe ngqo esibelethweni sakho ngeshubhu elincane, eliguquguqukayo elibizwa nge-catheter. Le nqubo idlula emgodini wesitho sangasese sowesifazane kanye nesitho sangasese, ibeka isidoda eduze kwamashubhu akho e-fallopian lapho umquba wenzeka khona.
Ngesikhathi sokwelashwa, isidoda somlingani wakho noma isidoda somnikeli sidlula enqubweni ekhethekile yokuhlanza elebhu. Le nqubo isusa isidoda esingasebenzi futhi igxilise isidoda esinempilo kunazo zonke, esihambayo kakhulu ngenqubo. Yonke inqubo ngokuvamile ithatha imizuzu embalwa nje futhi izizwa ifana nokuhlolwa okuvamile kwe-pelvic.
Okwehlukanisa i-IUI nokukhulelwa kwemvelo yisikhathi esifanele nendawo. Udokotela wakho uqapha ngokucophelela umjikelezo wakho wokuqeda ukuvuthwa kweqanda futhi wenza inqubo ngesikhathi lapho iqanda lakho likhishwa, enikeza isidoda ithuba elingcono kakhulu lokufinyelela nokuvundisa iqanda lakho.
I-IUI isiza imibhangqwana ukunqoba izinselelo ezithile zokuzala ezivimbela isidoda ukuthi singafinyeleli noma singavundisi iqanda ngokwemvelo. Udokotela wakho angase ancome lokhu kwelashwa lapho ukukhulelwa kwemvelo kungenzekanga ngemva kokuzama izinyanga eziyi-6-12, kuye ngeminyaka yakho kanye nezimo.
Izizathu ezivame kakhulu odokotela abatusa ngazo i-IUI zihlanganisa ukungazali ngenxa yesici somlomo wesibeletho, lapho amafinyila aqinile omlomo wesibeletho evimba ukunyakaza kwesidoda. Abanye besifazane bakhiqiza amafinyila anesithako esiningi noma aqinile kakhulu ukuthi isidoda singabhukuda ngaso ngempumelelo. I-IUI idlula lesi sithiyo ngokuphelele ngokubeka isidoda ngqo esibelethweni.
Ukungazali ngenxa yesici sendoda kungenye yezizathu ezivame kakhulu ze-IUI. Uma umlingani wakho enesibalo esiphansi sesidoda, ukunyakaza okungalungile kwesidoda, noma ukuma okungajwayelekile kwesidoda, inqubo yokugeza nokugxilisa ingasiza ekukhetheni isidoda esingcono kakhulu sokukhulelwa. Lokhu kukunika ithuba elingcono lokukhulelwa kunokuzama ngokwemvelo.
Ukungazali okungachazeki kuthinta cishe u-10-15% wemibhangqwana, futhi i-IUI ingaba inketho yokuqala yokwelashwa enhle kakhulu. Uma zonke izivivinyo zibuyela kokujwayelekile kodwa ukukhulelwa kungenzekanga, i-IUI isiza ngokuthuthukisa isikhathi nokubekwa kwesidoda.
Abesifazane abangashadile kanye nemibhangqwana yabesifazane bobulili obufanayo nabo basebenzisa i-IUI ngesidoda somnikeli ukuze bathole ukukhulelwa. Le nqubo inikeza indlela eqondile yokuba ngumzali lapho umlingani wesilisa engeyona ingxenye yomjikelezo.
Izizathu ezingavamile kodwa ezibalulekile zihlanganisa i-endometriosis encane, ukungasebenzi kahle kokukhipha isidoda, noma uma udinga ukusebenzisa isidoda esiqandisiwe ngenxa yokwelashwa komdlavuza noma ukuthunyelwa kwamasosha. Udokotela wakho uzoxoxa ukuthi ngabe i-IUI ilungile yini ngesimo sakho esithile.
Inqubo ye-IUI ngokwayo iyashesha futhi iqondile, ngokuvamile ithatha ngaphansi kwemizuzu eyi-10 ehhovisi likadokotela wakho. Uzoqamba amanga etafuleni lokuhlolwa njengoba kwenzeka ngesikhathi sokuhlolwa okuvamile kwe-pelvic, futhi udokotela wakho uzofaka i-speculum ukuze abone umlomo wakho wesibeletho.
Ngaphambi kokuthi inqubo iqale, umlingani wakho unikeza isampula lesidoda emtholampilo, noma isidoda somnikeli esiqandisiwe ngaphambilini sincibilikiswa futhi silungiswe. Ochwepheshe belabhu bageza futhi bagxilise isidoda, okuthatha cishe amahora angu-1-2. Le nqubo isusa isidoda esingasebenzi, amagciwane, nezinye izinto ezingabangela ukuqaqamba.
Ngesikhathi sokufakelwa ngempela, udokotela wakho ufaka ikhathetha elincanyana, eliguquguqukayo ngomlomo wakho wesibeletho nangaphakathi esibelethweni sakho. Isidoda esilungisiwe bese sinjengwa kancane ngale khathetha. Abesifazane abaningi bachaza ukuzwa njengokugabha okuncane, okufana nokugabha kokuya esikhathini, nakuba abanye bengazizwa lutho nhlobo.
Ngemuva kokuthi isidoda sifakwe, uzophumula etafuleni imizuzu engaba ngu-10-15. Lesi sikhathi sokuphumula esifushane asidingeki ngokwelashwa ukuze kuphumelele, kodwa abesifazane abaningi bakuthola kuqinisekisa. Ungabe usaqhubeka nemisebenzi yakho ejwayelekile ngokushesha, okuhlanganisa umsebenzi nokuzivocavoca.
Abanye odokotela batusa ukuhlela inqubo ngemithi yokukhishwa kwamaqanda ukuze kwandiswe amathuba akho okukhipha amaqanda amaningi. Abanye bakhetha ukusebenza ngomjikelezo wakho wemvelo. Indlela yakho ethile izoncika ekuhlolweni kwakho komuntu siqu kokuzala kanye nohlelo lokwelashwa.
Ukulungiselela i-IUI kuqala ngokuqonda umjikelezo wakho wokukhishwa kwamaqanda, okuzoqashwa udokotela wakho ngokucophelela ngezivivinyo zegazi kanye ne-ultrasounds. Ngokuvamile uzoza ukuze uqashwe cishe ngosuku lwama-10-12 lomjikelezo wakho ukuze uhlole amazinga akho e-hormone futhi ubone ukuthi amaqanda akho athuthuka kanjani.
Udokotela wakho angase akwelule imithi yokuzala efana ne-Clomid noma i-letrozole ukuze kuvuselelwe ukukhishwa kwamaqanda futhi kungenzeka ukuthi kukhishwe amaqanda amaningi. Le mithi yandisa amathuba akho okukhulelwa kodwa idinga ukuqashwa ngokucophelela ukuvimbela ukukhuthazwa ngokweqile. Landela isimiso sakho semithi ngqo njengoba kunqunywe imiphumela engcono kakhulu.
Ngaphambi kwenqubo, gxila empilweni ejwayelekile kanye nemikhuba yempilo ezosekela ukuzala. Lokhu kuhlanganisa ukuthatha amavithamini angaphambi kokubeletha ane-folic acid, ukugcina ukudla okunempilo, ukuthola ukulala okwanele, nokuphatha ukucindezeleka ngezindlela zokuphumula noma ukuzivocavoca okumnene.
Ngosuku lwenqubo yakho, gqoka izingubo ezikhululekile futhi udle ukudla okulula ngaphambi kwalokho. Abanye besifazane bahlangabezana nokuhlunguha okuncane ngemuva kwe-IUI, ngakho-ke ukuba nomuntu ozokuqhuba ekhaya kungaba usizo, yize kungadingeki. Gwema ukusebenzisa ama-tampon, i-douching, noma ukuba nobuhlobo bobulili amahora angu-24-48 ngaphambi kwenqubo.
Uma umlingani wakho enikeza isampula lesidoda, kufanele agweme ukuphuma kwesidoda izinsuku ezingu-2-5 ngaphambi kwenqubo. Lesi sikhathi sokuyeka sisiza ukuqinisekisa ukubalwa kwesidoda okungcono kakhulu kanye nekhwalithi. Izikhathi ezimfushane noma ezinde zinganciphisa ikhwalithi yesidoda.
Xoxa ngemithi oyithathayo nodokotela wakho, okuhlanganisa nezithasiselo ezingaphezu kwe-counter. Ezinye izinto zingaphazamisa inzalo noma inqubo uqobo. Ithimba lakho lezokwelapha lizokuqondisa ukuthi yini okufanele uqhubeke nayo noma uyeke okwesikhashana.
Impumelelo ye-IUI ilinganiswa ngokuthi uyakhulelwa yini, okuyilokho ozovame ukukuhlola cishe emasontweni amabili ngemuva kwenqubo. Udokotela wakho cishe uzohlela ukuhlolwa kwegazi ukuze ahlolisise amazinga akho e-hCG (i-human chorionic gonadotropin), okuyiqiniso kakhulu kunezivivinyo zokukhulelwa zasekhaya kulesi sigaba sokuqala.
Ukulinda amasonto amabili phakathi kwe-IUI nokuhlolwa kungazizwa kuyinselele ngokomzwelo emibhangqwaneni eminingi. Ngesikhathi esinjalo, ungase uqaphele izimpawu ezinjengobumnene besifuba, ukuhlunguha okuncane, noma ukukhathala, kodwa lokhu kungadalwa imithi yokuzala kunokukhulelwa. Zama ukungafundi okuningi ezimpawini zakuqala.
Amanani empumelelo e-IUI ahlukahluka kakhulu ngokuya ngeminyaka yakho, isizathu sokungazali, nokuthi ngabe imithi yokuzala yayisetshenzisiwe yini. Ngokuvamile, abesifazane abangaphansi kweminyaka engu-35 banamathuba angaba ngu-10-20% okukhulelwa ngomjikelezo ngamunye we-IUI, kuyilapho lokhu kwehla ku-5-10% kwabesifazane abaneminyaka engaphezu kwengu-40.
Uma umjikelezo wakho wokuqala we-IUI ungaphumeleli, ungalahli ithemba. Imibhangqwana eminingi idinga imizamo eminingi, futhi amazinga empumelelo ahlala evumelana ngemijikelezo yokuqala engu-3-4. Udokotela wakho uzobuyekeza okwenzekile futhi angashintsha imithi noma isikhathi semijikelezo ezayo.
Ukuvama kokuhlolwa kokukhulelwa ngemva kwe-IUI kusho ukuthi inqubo isebenze, kodwa uzodinga ukuqhubeka nokuqapha. Udokotela wakho uzohlola amazinga e-hCG njalo ezinsukwini ezimbalwa ukuze aqinisekise ukuthi ayenyuka ngendlela efanele futhi ahlele i-ultrasound cishe ngamasonto angu-6-7 ukuze aqinisekise ukuthi ukukhulelwa kuqhubeka ngendlela ejwayelekile.
Izinto eziningana zingasiza ukuthuthukisa amathuba akho empumelelo ye-IUI, kusukela ngesikhathi esifanele senqubo ngokuphelele nge-ovulation. Udokotela wakho usebenzisa ukuhlolwa kwegazi kanye ne-ultrasounds ukuze aqonde kahle umzuzu ongcono kakhulu, kodwa ungaqapha nezimpawu ezinjengokushintsha kwe-mucus yesitho sangasese sowesifazane nobuhlungu obuncane besinqulu.
Ukugcina indlela yokuphila enempilo kunomthelela omkhulu emazingeni empumelelo ye-IUI. Gxila ekudleni ukudla okulinganiselayo okucebile nge-folate, ama-antioxidants, namafutha anempilo ngenkathi ukhawulela ukudla okucutshungulwe, i-caffeine eningi, notshwala. Ukuzivocavoca okuvamile okulinganiselwe kuyasiza, kodwa gwema ukuzivocavoca okukhulu okungase kuphazamise ukufakwa.
Ukuphatha ukucindezeleka kudlala indima ebalulekile empumelelweni yokwelashwa kokuzala. Cabangela ukufaka amasu okuphumula njengokuzindla, i-yoga, noma i-acupuncture emsebenzini wakho. Imibhangqwana eminingi ithola ukwelulekwa kusiza ekuhambeni ngokuphakama nokuphansi okungokomzwelo kokwelashwa kokuzala.
Uma ubhema, ukuyeka ngaphambi kwe-IUI kungathuthukisa kakhulu amazinga akho empumelelo. Ukubhema kuthinta ikhwalithi yeqanda, kunciphisa ukugeleza kwegazi ezingxenyeni zokuzala, futhi kungaphazamisa ukufakwa. Udokotela wakho angakunikeza izinsiza zokukusiza ukuthi uyeke ngokuphepha.
Ukulandela isimiso sakho semithi ngokuqondile kubalulekile ukuze uphumelele. Setha izikhumbuzi zocingo zemithi yokuzala futhi uye kuwo wonke ama-aphoyintimenti okuqapha. Ngisho nokuhlukahluka okuncane ngesikhathi kungathinta ukuvuthwa kwamaqanda futhi kunciphise amathuba akho okukhulelwa.
Abanye abantu abashadile bayazuza ezinzuzweni zokuzala ezinjenge-CoQ10, uvithamini D, noma ama-omega-3 fatty acids, kodwa njalo xoxa ngalokhu nodokotela wakho kuqala. Okusebenzela umuntu oyedwa kungase kungafaneleki komunye, futhi ezinye izithasiselo zingaphazamisa imithi yokuzala.
Iminyaka yakho iyona nto ebaluleke kakhulu ethinta amazinga okuphumelela e-IUI, lapho ukuzala kwehla kancane ngemva kweminyaka engama-30 futhi ngokushesha ngemva kwama-35. Abesifazane abangaphansi kweminyaka engama-35 ngokuvamile banamazinga okuphumelela aphezulu kakhulu, kuyilapho labo abangaphezu kwama-40 bangazuza ekwelashweni okunamandla okufana ne-IVF.
Imbangela eyisisekelo yokungazali ithinta kakhulu imiphumela ye-IUI. Abantu abashadile abanokungazali okuncane kwabesilisa noma izinkinga zomlomo wesibeletho bavame ukubona imiphumela emihle kakhulu, kuyilapho labo abane-endometriosis enzima noma amashubhu e-fallopian avalekile bangase babe namazinga okuphumelela aphansi nge-IUI yodwa.
Isizinda sakho sama-ovari, esilinganiswa ngezivivinyo ezinjenge-AMH (i-anti-Müllerian hormone) kanye nokubalwa kwe-antral follicle, kuthinta ukuthi usabela kanjani kahle emithini yokuzala kanye nekhwalithi yakho yeqanda iyonke. Izizinda eziphezulu zama-ovari ngokuvamile zihambisana namazinga okuphumelela e-IUI angcono.
Ubude bokungazali nabo buyabaluleka, ngabantu abashadile abaye bazama izikhathi ezimfushane ngokuvamile benemiphumela engcono. Uma ubezama ukukhulelwa iminyaka eminingana, kungase kube nezinkinga eziyisisekelo ukuthi i-IUI yodwa ayikwazi ukuzixazulula.
Izilinganiso zekhwalithi yesidoda ezihlanganisa ukubala, ukunyakaza, kanye nokwakheka kuqondile kuthinta impumelelo ye-IUI. Ukungazali okukhulu kwabesilisa kungase kudingeke i-IVF ene-ICSI (i-intracytoplasmic sperm injection) ukuze uthole imiphumela engcono kunalokho i-IUI engakunikeza.
I-IUI ngokuvamile iyinqubo ephephile kakhulu enezingozi ezincane, kodwa kubalulekile ukuqonda izinkinga ezingaba khona ngaphambi kokuqhubeka. Umphumela ovamile ukuba khona kwemiqondo emincane ngesikhathi noma ngemva kwenqubo, evame ukuxazululwa emahoreni ambalwa.
Ukunyuka kwamagciwane kuyinkinga engavamile kodwa ebucayi, eyenzeka ngaphansi kuka-1% wezinqubo ze-IUI. Izimpawu zihlanganisa umkhuhlane, ubuhlungu obukhulu be-pelvic, noma ukukhishwa kwesitho sangasese esingajwayelekile ezinsukwini ezilandelayo ukwelashwa. Xhumana nodokotela wakho ngokushesha uma uhlangabezana nalezi zimpawu.
Ukukhulelwa okuningi (amawele, amathathu) kwenzeka kaningi nge-IUI, ikakhulukazi uma imithi yokuzala isetshenziswa. Ngenkathi imibhangqwana eminingi yamukela amawele, ukukhulelwa okuningi kuthwala izingozi eziphakeme kokubili kumama nakubantwana, okuhlanganisa ukuzalwa ngaphambi kwesikhathi kanye nezinkinga zokukhulelwa.
I-ovarian hyperstimulation syndrome (OHSS) ingenzeka uma uthatha imithi yokuzala nge-IUI. I-OHSS emnene ibangela ukuqunjelwa nokungakhululeki, ngenkathi amacala abucayi angaba yingozi. Udokotela wakho ukuqapha ngokucophelela ukuvimbela le nkinga.
Ukucindezeleka ngokomzwelo kuyinto yangempela okufanele icatshangelwe ngelashwa le-IUI. Ithemba nokudumala kungaba yinselele ebudlelwaneni nasempilweni yengqondo. Cabangela ukusekelwa kokwelulekwa kuyo yonke indlela yakho yokuzala.
Ukukhulelwa kwe-ectopic, lapho i-embryo ifakwa ngaphandle kwesibeletho, kwenzeka cishe ku-1-2% yokukhulelwa kwe-IUI. Lokhu kufana namazinga okukhulelwa kwemvelo futhi kudinga ukunakekelwa kwezokwelapha ngokushesha uma kutholakele.
Cabanga ngokuxoxa nge-IUI nodokotela wakho uma uzama ukukhulelwa izinyanga eziyi-6 (uma ungaphezu kweminyaka engama-35) noma izinyanga eziyi-12 (uma ngaphansi kweminyaka engama-35) ngaphandle kwempumelelo. Ukubonisana ngaphambi kwesikhathi kufanelekile uma wazi izici eziyingozi zokuzala noma izikhathi ezingajwayelekile.
Ukunakekelwa kwezempilo ngokushesha kuyadingeka uma uhlangabezana nobuhlungu obukhulu besinqe, ukuphuma kwegazi okuningi, umkhuhlane, noma izimpawu zokutheleleka ngemva kwe-IUI. Nakuba izinkinga zingavamile, ukwelashwa ngokushesha kubalulekile uma zenzeka.
Hlela i-aphoyintimenti yokulandela uma unokukhathazeka mayelana nemiphumela emibi yemithi yokuzala noma uma ukhathazeka ngokomzwelo ngenqubo yokwelashwa. Udokotela wakho angashintsha imithi noma anikeze izinsiza zokusekela ezengeziwe.
Ngemva kwemijikelezo ye-IUI engaphumelelanga engu-3-4, sekuyisikhathi sokuhlola kabusha uhlelo lwakho lokwelashwa. Udokotela wakho angase ancome ukushintshela ku-IVF noma ukuhlola ezinye izinkinga ezingaba khona zokuzala ezingabonakalanga ekuqaleni.
Xhumana nomhlinzeki wakho wezempilo uma umjikelezo wakho wokuya esikhathini ungajwayelekile ngesikhathi sokwelashwa kwe-IUI noma uma uhlangabezana nezimpawu ezinjengokuzuza isisindo esiningi, izinguquko ezinzima zemizwa, noma ikhanda eliqhubekayo ngenkathi uthatha imithi yokuzala.
Abesifazane abangashadile noma imibhangqwana yobulili obufanayo kufanele ixoxe nochwepheshe bezokuzala uma sekulungele ukuqala ukuzama ukukhulelwa ngesidoda somnikeli. Ukuhlela kusenesikhathi kusiza ukuthuthukisa isikhathi kanye nezindlela zokwelapha.
Abesifazane abaningi bachaza i-IUI njengembangela yokungakhululeki okuncane okufana nokuhlolwa okuvamile kwesinqe noma i-Pap smear. Ungase uzwe ukuqaqamba okuncane lapho i-catheter idlula emqaleni wakho wesibeletho, kodwa lokhu kuvame ukuthatha imizuzwana embalwa kuphela. Inqubo yonke ithatha ngaphansi kwemizuzu eyi-10, futhi noma yikuphi ukungakhululeki kuvame ukuxazululwa ngokushesha. Ukuthatha umbulali wezinhlungu ongaphezu kwe-counter cishe ihora ngaphambi kwenqubo kungasiza ukunciphisa noma yikuphi ukuqaqamba.
Ochwepheshe abaningi bezempilo yokuzala batusa ukuzama imijikelezo engu-3-4 ye-IUI ngaphambi kokucabangela i-IVF, uma ucabanga ukuthi usebenzisa imithi yokuzala ukuze uthuthukise amathuba akho. Amazinga empumelelo ahlala njalo emijikelezweni yokuqala embalwa, kodwa ancipha kakhulu ngemuva komzamo wesine. Kodwa-ke, lokhu kutuswa kuncike eminyakeni yakho, ukuxilongwa okuthile kokuzala, nokuthi usabela kanjani emithini. Abesifazane abangaphezu kweminyaka engama-38 bangase baphuthume e-IVF ngokushesha ngenxa yokuzwela kwesikhathi.
Ungaqala kabusha imisebenzi ejwayelekile ngemuva nje kwe-IUI, okuhlanganisa ukuzivocavoca okulula kuya kokulingene. Kodwa-ke, odokotela abaningi batusa ukugwema ukuzivocavoca okunamandla amakhulu, ukuphakamisa izinto ezinzima, noma imisebenzi ebangela ukushaqeka okukhulu emahoreni okuqala angu-24-48. Imisebenzi emnene efana nokuhamba, ukubhukuda, noma i-yoga ilungile ngokuphelele futhi ingase isize nokunciphisa ukucindezeleka. Lalela umzimba wakho futhi ugweme noma yini ebangela ukungakhululeki.
I-IUI ibeka isidoda ngqo esibelethweni sakho ngenkathi umquba wenzeka ngokwemvelo emashubeni akho e-fallopian. I-IVF ihlanganisa ukuthatha amaqanda kuma-ovari akho, iwaqhumisa ngesidoda elabhorethri, bese idlulisela ama-embryo avelayo emuva esibelethweni sakho. I-IUI ayihlaseli kangako, ayibizi kakhulu, futhi isebenza nomjikelezo wakho wemvelo, ngenkathi i-IVF inikeza amazinga empumelelo aphezulu kodwa idinga imithi eminingi, izinqubo, nokuqapha.
Linda okungenani izinsuku eziyi-14 ngemuva kwe-IUI ngaphambi kokuthatha ukuhlolwa kokukhulelwa ukuze ugweme imiphumela engamanga. Ukuhlola ngokushesha kungase kunikeze okungalungile ngoba amazinga e-hCG adinga isikhathi sokwakha ngokwanele ukuze atholwe. Uma usebenzise isibhamu esiqukethe i-hCG ukuze ubangele i-ovulation, linda okungenani izinsuku eziyi-10-14 ukuze isuse uhlelo lwakho ukuze ugweme okuhle kwamanga. Ukuhlolwa kwegazi ehhovisi likadokotela wakho kuzwela futhi kunembe kakhulu kunezivivinyo zokukhulelwa zasekhaya kulesi sigaba sokuqala.