ICSI - insemination. ICSI - rau txoj kev. Yuav ua li cas yog txawv los ntawm IVF IVF + ICSI?

Ib tug loj tus naj npawb ntawm infertile khub niam txiv yuav ua niam ua txiv ntev-awaited tus me nyuam ua tsaug rau cov kev taw qhia ntawm pab kev ua me nyuam technologies. Dag nyob rau hauv vitro fertilization (IVF) - lub feem ntau hnyav txoj kev. Lub indications rau nws siv ntau hom ntxiv lawm tshob nyob rau hauv ob qho tib si poj niam thiab txiv neej. Nyob rau hauv lub pathology cov txheej txheem efficiency yuav ncav cuag 50% thiab saum toj no. ICSI-fertilized - ib tug high-kev ua tau zoo variant ntawm IVF.

Ib me ntsis keeb kwm

Rau cov thawj lub sij hawm nyob rau hauv vitro fertilization txoj kev siv nyob rau hauv ces nyob rau hauv 1976. Tab sis, hmoov tsis, qhov no cev xeeb tub yog ectopic (khi). Tab sis twb nyob rau hauv 1978 nyob rau hauv tib lub tsev kho mob tau yug los Bourn Hall - thawj tus me nyuam "xeem raj". Nws niam - Luizy Braun - raug tshem tawm txoj hlab qe menyuam. Thiab nyob rau hauv 1993, thawj ib tug twb nqa tawm nyob rau hauv Belgium ICSI-fertilization. Xyuas ntawm lub txheej txheem, rau feem ntau feem, lub high efficiency ntawm no txoj kev. Tab sis ib lub rooj yog tshwj xeeb, thiab cov ntseeg khov kho nyob rau hauv ob qho tib si qhov zoo thiab tsis zoo tshwm sim, ntawm chav kawm, muaj peev xwm tsis tau.

Yuav ua li cas nqa tawm nyob rau hauv vitro fertilization txoj kev?

Ua ntej ntawm tag nrho cov, koj yuav tsum yauv mus ua ib txhij txhua kev xeem. Txij li thaum cov txheej txheem yog nqa tawm "nyob rau hauv vitro", lub cev ntawm ib tug poj niam thiab ib tug txiv neej yog muab tau tus kab hlwb. Ua li no, siv cov tshuaj nyob rau hauv lub neej yav tom ntej leej niam tsim kho lub maturing ntawm qe thiab npaj lub endometrium rau cev xeeb tub. Tom qab ncav qhov yuav tsum tau kawm, los ntawm tej ntawm zes qe menyuam oocyte retrieved. Yuav kom tshwm sim fertilization, lawv muab tso rau hauv ib txoj kev kuaj raj nrog cov phev, qhov twg tej yam kev mob zoo xws li tej yam ntuj tso. Tom qab peb mus rau tsib hnub, lub zaum embryos yog thauj mus rau hauv lub uterine kab noj hniav. Feem ntau nqa peb los yog plaub embryos, raws li tej zaum ib txhia yuav tsis lees txais los ntawm tus poj niam lub cev thiab yuav tsim tsuas yog ib qho ntawm lawv. Tab sis raws li ib tug tshwm sim ntawm IVF yuav tuaj thiab ntau yam uas cev xeeb tub.

Yuav ua li cas yog txawv los ntawm IVF IVF + ICSI?

Nyob rau hauv tsoos IVF qe nrog phev muab tso rau hauv ib tug tshwj xeeb qhov chaw uas ntxiv fertilization yog ib tug ntuj txoj kev (muaj yog ib tug nyias muaj nyias ib cov kev taw qhia ntawm cov phev mus rau hauv lub cytoplasm ntawm lub qe). ICSI-txoj kev Nws yuav hno cov phev rau hauv ib qho qe los ntawm cov microneedle kev txhaj tshuaj. Ntawm cov phev zoo thiab cev xeeb tub pes tsawg zaus ntawm nws tshwm sim, raws li ib tug txoj cai, tsis yog nyob ntawm seb. Rau cov txheej txheem, koj yuav tsum muaj tsawg kawg yog ib tug zoo tshaj ntawm cov phev.

Yuav ua li cas yog cov txheej txheem ntawm ICSI?

Tom qab ua kom tiav tag nrho cov kev npaj theem (raws li nyob rau hauv cov pa IVF): ntawm zes qe menyuam stimulation, tej kev kho mob phev sau thiab pib npaj mus rau fertilize lub qe. Yuav kom qhov no kawg, lub embryologist siv ib tug tshwj xeeb reagent tuskheej nws tiv thaiv khaubncaws sab nraud povtseg. Nyob rau hauv lub tshuab kuaj kab, coj cov tshaj cum kab. Ob leeg hlwb yog muab tso rau hauv ib tug tshwj xeeb muaj menyuam tsis taus tej tus yuav tsum tau kub. Tom qab ntawd, ib tug micropipette tshwj xeeb taag ovum los ntawm cov phev tus Tsov tus tw twb sib cais thiab muab tso rau hauv ib tug microneedle. Embryologist siv manipulators nrog huab ceev faj, menyuam cov scene los ntawm lub tshuab kuaj kab thiab tswj lawv txhua txhua zog qhia phev rau hauv lub qe. ICSI-txoj kev yog tam sim no ua kom tiav. Tam sim no koj yuav tsum tos kom txog thaum tom qab fertilization thiab cov thawj cell division. Yuav ua li cas yog txawv los ntawm IVF IVF + ICSI nyob rau hauv tas li ntawd mus rau lub txheej txheem ntawm conception? Nruj me ntsis hais lus, qhov no txim hluav taws xob thiab qhov xaus. Tom qab ib tug muaj kev vam meej fertilization, tus poj niam yuav tsum nyob rau hauv lub qhov kev saib xyuas ntawm cov kws kho mob raws li tau zoo raws li tom qab IVF.

Yuav ua li cas lub sijhawm piv txwv ntawm txoj kev ICSI?

Fertilization los ntawm ICSI nqa tawm nyob rau hauv lub loj tshaj plaws ntaub ntawv ntawm cov txiv neej ntxiv lawm tshob, untreatable. Piv txwv li:

• Azoospermia - ib tug ua tiav tsis tuaj kawm ntawv ntawm cov phev nyob rau hauv lub ejaculate.

• Teratozoospermia - xub ntiag ntawm spermatozoa muaj tej configuration, nyob rau hauv ib tug npaum li tsawg tshaj li 14%.

• Oligozoospermia - tsis txaus tus naj npawb ntawm cov phev.

• Congenital tsis tuaj kawm ntawv ntawm lub vas deferens.

• Mob tom qab vasectomy.

Nyob rau hauv tas li ntawd, cov ICSI txoj kev siv rau cov neeg pluag kev kawm ntawm cov zoo thiab ntau pes tsawg leeg ntawm cov phev, tsis tshua muaj zoo "unfrozen" phev ntawm yav tas los hai tau npaj siab ntawm IVF, ntxiv lawm tshob undetermined keeb kwm.

Yuav ua li cas los npaj rau lub txheej txheem?

Ua ntej cov txheej txheem, ICSI poj niam thiab ib tug txiv neej yuav tsum xeem dhau ib tug series ntawm kev ntsuam xyuas:

• ntshav hom, v zoo tshaj;

• syphilis;

• AIDS;

• tus kab mob siab C thiab B.

Tau ntawm analyses yog siv tau rau cov tom ntej no peb lub hlis.

Ib tug poj niam yuav tsum nqa tawm xws li kev tshawb fawb raws li:

• ntshav tsom xam rau cov tshuaj hormones (FSH, LH, prolactin, estradiol, testosterone, progesterone, TTG, DHA-S);

• kua ntswg los ntawm qhov chaw mos huam rau thaum kab mob thiab kev sib deev kis cov kab mob;

• ntshav tsom xam thiab kev soj ntsuam biochemistry;

• urinalysis general;

• Smear rau tus muaj;

• coagulation tsom xam.

Raws li kev npaj rau ICSI yuav tsum tau sib tham nrog ib tug gynecologist rau tau contraindications.

Rau cov txiv neej, cov tseem ceeb tshaj plaws kev tshawb fawb nyob rau hauv kev npaj rau fertilization txoj kev yog phev. Nws yog los ntawm no tsom xam yog txiav txim los ntawm lub peev xwm ntawm tus txiv neej yuav xeeb tub. Phev tsom xam qhia cov ntau thiab zoo cov yam ntxwv ntawm cov phev, raws li zoo raws li ib tug tswv cuab ntawm lub nram qab no kev tshawb fawb:

• spermotest - tsom xam ntawm cov phev muaj peev xwm kom muaj muaj nyob rau hauv ib txoj kev kuaj raj;

• txiav txim tus xov tooj ntawm leucocytes nyob rau hauv cov phev ;

• qhia kom paub txog kab mob;

• Mart-xeem;

• tsuas smear tsom xam.

Nyob rau hnub ntawm oocyte tej poj niam yog txwv tsis pub rau noj, haus dej haus tsuas yog tom qab tus kws kho mob tso cai. Ib tug txiv neej peb los yog plaub hnub ua ntej qhov kev yog tsis txhob com rau ob peb hnub tsis tau haus dej haus cawv.

cov hauj lwm zoo ntawm cov txheej txheem

ICSI-fertilization ua rau conception nyob rau hauv 30-60% ntawm cov neeg. Nws nyob rau lub xeev ntawm kev ua me nyuam hlwb, ob qho tib si cov poj niam thiab cov txiv neej (tej zaum ib tug ntawm lawv yog ib tug kev tshuaj ntsuam genetic anomaly), raws li zoo raws li lub peev xwm embryologist uas tau ua qhov txheej txheem (thaum lub sij hawm ntawm txoj kev ntawm lub qe yuav puas). Yog hais tias fertilization tau tshwm sim, yuav tshwm sim hais tias ntawm lub tshiab tsim hlwb yuav tsim ib tug noj qab nyob zoo embryo yog 90-95%. Nws yuav tsum tau muab sau tseg tias zoo tau nyob rau hauv ntau yam me nyuam tsawg dua cov pa. Yog hais tias lub txiaj ntsim ntawm tus txheej txheem ob peb embryos tau tej zaum yuav nqa tawm lawv kev txuag siv kua nitrogen. Tej embryos yuav tsis poob nws cov khoom txawm tias tom qab ob peb xyoos.

Uas yuav cuam tshuam rau cov kev tshwm sim ntawm txoj kev sai?

muaj kev vam meej ICSI-fertilization Nws yog nyob ntawm ntau yam:

• Partner muaj hnub nyoog;

• ua ntxiv lawm tshob;

• tsev kho mob;

• tus kws kho mob kev coj;

• qe xeev.

Rau ib tug zoo tshwm sim txoj kev yuav tsum tau active spermatozoa los ntawm kua phev txiv neej txiv neej thiab poj niam high-zoo oocytes. Yog hais tias ib tug txiv neej muaj tsis muaj active phev, qhov yuav tshwm ntawm conception tsawg.

Qhov kev xaiv ntawm physiologically mature phev

Txiv neej zoo tshaj muaj ib tug loj feem nyob rau hauv txoj kev loj hlob ntawm lub embryo. Feem ntau qhov ua rau ntawm cov txiv neej ntxiv lawm tshob ua hauj lwm pab ib tug loj tus naj npawb ntawm tsis paub qab hau phev nyob rau hauv lub ejaculate. Cov paub tab phev rau khi rau hyaluronic acid. Nws yog raws li nyob rau hauv no txoj kev thiab xaiv cov kev kawm hlwb. Tus kws kho mob embriologist xaiv biochemically competent phev txuam nrog gialorunanom. Nws yog ib cov physiologically mature hlwb yuav tsum tau siv rau ICSI.

ICSI-fertilization: tus nqi ntawm cov txheej txheem

Txhua txhua hnub, dozens ntawm cov poj niam yog xav nyob rau hauv efficiency, nqi ntawm cov txheej txheem, tab tom nrhiav rau qhov zoo tshaj plaws lub tsev kho mob rau cov txheej txheem. Nyob rau hauv Russia, npaj siab rau kwv lam tus nqe ntawm ib-ICSI fertilization yog 150-200 txhiab rubles. Txawv teb chaws, cov nqi ntawm xws li ib tug txheej txheem saum toj no. Nyob rau hauv Ixayees - kwv yees li 2-fold. Nyob rau hauv lub tebchaws United States, Lub teb chaws Yelemees, Switzerland - nyob rau hauv 3-4 lub sij hawm.

tau txaus ntshai

Txawm tias heev heev zoo, ICSI, fertilization Nws muaj ib tug loj drawback - natural xaiv tau tsis ua hauj lwm ntawm no. Qhov no yog tshwj xeeb tshaj yog tseem ceeb rau cov txivneej nrog lub xub ntiag ntawm kev tshuaj ntsuam genetic cov kab mob (e.g., Klinefelter lub syndrome, thiab lwm tus) uas yog tsis tau xeeb tub tsis muaj kev siv ntawm ancillary hom kev kawm. Tej cov kab mob yuav tsum pub thiab tshwm sim los tau ntau xyoo. Caj glitches nyob rau hauv yav tom ntej cov me nyuam tsis tsim vim lub IVF txoj kev nws tus kheej. Txawm li cas los, ntxiv lawm tshob niam txiv muaj peev xwm muaj kev cuam tshuam cov kev kho mob ntawm offspring. Nyob rau hauv thiaj li yuav ntes tau chromosomal thiab kev tshuaj ntsuam genetic txawv txav nyob rau hauv ib tug neeg embryo, nws yog pom zoo kom mus nqa tawm pre-implantation tus mob. Nws yuav ua tau rau cov theem tshaj rau blastomeres.

Yuav ua li cas lwm txoj kev nyob rau hauv vitro fertilization?

KHOOM PLIG - oocytes thiab phev (gametes) yog pauv mus rau txoj hlab qe raj, yog tsawg kawg yog ib tug ntawm lawv hau.

Zefta - fertilized oocytes (zygotes) yog thauj mus rau hauv txoj hlab qe raj.

OD - ECO oocyte pub , ua raws li los ntawm thauj cov embryo mus rau hauv lub tsev me nyuam retsipientki. Qhov no yog siv nyob rau hauv qhov qhaj ntawv los ntawm lub zes qe menyuam nyob rau hauv cov poj niam thiab cov ua txhaum ntawm lawv lub zog, kev tshuaj ntsuam genetic mob nyob rau hauv lub niam, lub ntuj lawm.

Lub "surrogate niam" - embryos genetic cov niam txiv rau tus me nyuam coj tus kheej yog pauv mus rau lub tsev me nyuam ntawm lwm tus poj niam. Yog vim li cas rau qhov no tej zaum yuav tsis tuaj kawm ntawv los yog inadequacy ntawm lub tsev me nyuam ntawm tus neeg mob, tab sis, nrog rau lub preservation ntawm zes qe menyuam muaj nuj nqi.

IVF txoj kev yog, ntawm chav kawm, ib tug kim heev thiab lub sij hawm-siv, cov khoom siv uas tsim nyog mus nqa tawm insemination, muaj tsis nyob rau hauv tag nrho cov tsev kho mob kom nrhiav tau ib tug tsim nyog tus kws kho mob yog tseem nyuaj heev. Txawm li cas los, qhov kev pab cuam pub rau ntau childless khub niam txiv kom paub tias cov kev xyiv fab loj ntawm cov niam thiab cov txiv.