Ibiza malini i-IVF?
Imfundo YezempiloYini i-IVF? | Izindleko ze-IVF | Ukutholakala komshuwalense | Ezezimali | Gcina imali kuzidakamizwa zokuzala
Uma unenkinga yokukhulelwa, awuwedwa. Amaphesenti ayishumi nantathu yemibhangqwana e-United States inezinkinga zokungazali. Ukungabi nenzalo kuvamile futhi kungadalwa yizinto ezahlukahlukene ezinjengobudala, isikhathi esingajwayelekile, ukukhiqizwa kwesidoda okungavamile, noma isimo sezokwelapha esivele sikhona sokuzala.
Ngenhlanhla, kunezinhlobonhlobo zokwelashwa kokuzala kodwa i okuvame kakhulu i-intrauterine insemination (IUI) kanye ne-in vitro fertilization (IVF). Eqinisweni, cishe amaphesenti amabili ukuzalwa bukhoma kwase-U.S. ngonyaka kungumphumela wobuchwepheshe bokusiza bokuzala — indlela eyinhloko i-IVF. Kunezingane ezingama-81,478 ezizalwe ngo-2018 ngenxa yalezi zindlela.
Yini i-IVF?
I-IVF inqubo elandelwayo elabhoratri esiza ekukhulelweni ngempumelelo kweqanda elingaphandle komzimba, elingisa ukukhulelwa kwemvelo nokukhuthaza ukukhulelwa okujwayelekile nokubeletha ukuthi kwenzeke.
Isazi sokuzala singancoma i-IVF ukuze ikhulelwe ngenxa yezizathu eziningana, kufaka phakathi umlando wokwelashwa okwehlulekile kokuzala, ukungazali okungaqondakali, noma ingozi yesifo sofuzo.
Kwesinye isikhathi [umbhangqwana] kungenzeka wehluleke ngezinye izindlela zokwelapha, njengokukhulelisa okwenziwa, kusho ULynn Westphal , MD, isikhulu sezokwelapha semitholampilo yokuzala yakwa Kind Kind. Owesifazane ubengavimba amashubhu e-Fallopian noma indoda ibe nesibalo esincane sesidoda.Eminye imibhangqwana ingahle ithwale isifo sofuzo (njenge-cystic fibrosis) futhi ifune ukuhlola imibungu ukuze ingabi nengane ethintekile. Uma owesifazane engakwazi ukuthwala ukukhulelwa, kuzodingeka enze i-IVF ukufaka imibungu kwisivumelwano.
Isebenza kanjani
- Isinyathelo sokuqala se-IVF imvamisa sibandakanya ukuthatha imishanguzo evusa amaqanda futhi esiza amaqanda ukwakheka kwenqubo.
- Lapho amaqanda esekhulile, udokotela uzowakhipha kuma-ovari esebenzisa inaliti. Amaqanda afakwa esitsheni futhi afukanyelwe.
- Enqubeni ebizwa ngokuthi ukuvundisa, isidoda — kungaba isidoda esinikelayo noma esivela kumlingani wakho — sizofakwa emaqandeni bese siqashwa ukuqinisekisa ukuthi ukukhulelwa kuphumelele futhi umbungu usuthuthukile.
- Lapho umbungu uthathwa njengolungele ukudluliselwa, udokotela uzofaka umbungu esibelethweni. Ukusuka lapho, umbungu kufanele utshale ulwelwesi lwesibeletho.
Izinga lokuphumelela le-IVF
Izinga lempumelelo lokukhulelwa ngemuva komjikelezo owodwa we-IVF kuyehluka futhi kuncike kakhulu eminyakeni yowesifazane. Imvamisa, kudingeka imijikelezo engaphezu kweyodwa ukuze uphumelele. Umtholampilo owodwa wenzalo unikeza izilinganiso ezilandelayo ngomjikelezo wokuqala, ngokususelwa eminyakeni yobudala:
- Abesifazane abangaphansi kweminyaka engama-30 banamathuba okuphumelela angama-46%.
- Abesifazane abaneminyaka engama-30 kuya kwengama-33 banamathuba angama-58 okuphumelela.
- Abesifazane abaneminyaka engama-34 kuya kwengama-40 banamathuba angama-38 okuphumelela.
- Abesifazane abaneminyaka engama-40 kuya kwengama-43 banamathuba angaphansi kuka-12% okuphumelela.
Ngaphezu kwalokho, amaqanda abanikeli nawo angasetshenziswa futhi akhiqize izinga eliphakeme lokuphumelela ( 55% ) wokukhulelwa okuholela ekuzalweni okuphilayo ngokuqhathaniswa nemibhangqwana eminingi ephendukela ku-IVF futhi engasebenzisi i-egg donor. Lokhu kungenzeka okungenani ngokwengxenye ngenxa yeminyaka emaphakathi yobudala yabanikeli bamaqanda: iminyaka engama-26 ubudala. Lokhu kumane kuqinisa ukuthi iminyaka yeqanda lowesifazane elisetshenziswe kule nqubo ihumusha emathubeni okuphumelela kwenqubo. Abesilisa abavame ukuthintwa yizinkinga zokuzala kuze kube yilapho beneminyaka okungenani engama-50 ubudala.
Izindleko ze-IVF
Izindleko ezijwayelekile zomjikelezo owodwa we-IVF ngungaphezu kwe- $ 20,000, ngokusho kwe- Inzalo IQ . Lesi sibalo senza iinqubo kanye nezindleko zemithi. Kodwa-ke, isiguli esimaphakathi se-IVF sihamba ngemijikelezo emibili, okusho ukuthi inani eliphelele le-IVF livame ukuba phakathi kuka- $ 40,000 no- $ 60,000.
Nakhu ukuwohloka kwe-Izindleko ze-IVF:
- Ukuhlolwa kwangaphambi kwe-IVF kokuzala noma ukubonisana:
- $ 200- $ 400 ngokuvakasha okusha kusazi sokugcina semvelo sokuzala
- $ 150- $ 500 nge-ultrasound ye-pelvic ukuhlola isibeletho nama-ovari
- $ 200- $ 400 yokuhlolwa kwegazi okuhlobene nokuzala
- $ 50- $ 300 ukuhlaziywa kwesidoda
- $ 800- $ 3,000 ye-hysterosalpingogram (HSG), okuwuvivinyo olusebenzisa udayi ukuhlola amashubhu wesibeletho kanye nawomqansa
- $ 3,000- $ 5,000 ngemithi yokuzala
- $ 1,500 yokuqapha i-ultrasound nomsebenzi wegazi
- $ 3,250 ukuthola amaqanda
- $ 3,250 yezinqubo zelabhoratri ezingafaka okunye noma konke okulandelayo:
- Ukucutshungulwa kwe-Andrology kwesampula yesidoda
- Isiko le-Oocyte nokukhulelwa
- Umjovo wesidoda se-Intracytoplasmic (ICSI)
- Ukuchamisela okusizwayo
- Isiko leBlastocyst
- Ukukhishwa kombungu
- Ukuhlolwa kofuzo:
- $ 1,750 we-biopsy yombungu
- $ 3,000 yokuhlaziywa kofuzo
- $ 3,000 ukudluliswa kombungu:
- Ukulungiswa kwelebhu kombungu
- Inqubo yokudlulisa, njengoba kudingeka ukufeza ukukhulelwa okuyimpumelelo, kuze kudluliswe kudluliswe kathathu
Imininingwane yezindleko ezivela ku- Ukunakekelwa Kwezempilo e-University of Mississippi futhi Isikhungo Sokuzala Okuthuthukile saseChicago . Qaphela: Uhlelo lwakho lokwelashwa lwe-IVF kungenzeka lungafaki konke lokhu okungenhla.
Ngabe umshuwalense uyayivala i-IVF?
Ukutholakala kwe-IVF nezindleko ezihambisana nayo kuyahlukahluka phakathi kwezinhlelo ezahlukahlukene zomshuwalense, izinkampani nezifundazwe. Isibonelo, ezinye izinkampani zomshuwalense ukumboza ukuhlolwa kokuxilongwa kepha hhayi ukwelashwa. Abanye abahlinzeki bahlanganisa imizamo elinganiselwe ye-IVF, kanti abanye abayimbozi neze i-IVF.
Iningi labantu likhokhela i-IVF ephaketheni, kusho uLev Barinskiy, oyi-CEO ye Umshuwalense Wezezimali . Izinhlelo zendabuko zokuzala zivame ukumboza ukuhlolwa kokuxilongwa kanye nomjikelezo owodwa we-IVF noma i-IUI, kuya ngomshwalense.
Kubalulekile ukwenza ucwaningo lwakho futhi ukhulume nomtholampilo wakho ophethe umshuwalense kanye nokuzala mayelana nezindleko zenqubo yakho ngomshwalense nangaphandle kwawo.
Njengamanje, I-18 ithi sebedlulise imithetho egunyaza amabhizinisi ukuthi anikeze izinzuzo zokuzala ngamazinga ahlukahlukene okuhlanganisa abasebenzi babo, kuchaza uBarinskiy. Abanye ohulumeni basekhaya badinga izinqubomgomo zomshuwalense wezempilo ukukhokhela ukuhlolwa nokwelashwa kokungazali. Ukuhlanganiswa kwehlukile ezifundazweni, ngakho-ke kuzodingeka ufunde igunya lombuso lapho umqashi wakho azinze khona.
I-International Foundation of Employee Benefit Plans ikhishwe imiphumela kusuka ocwaningweni lwango-2018 oluthola abaqashi abangama-31% nabasebenzi abangama-500 noma ngaphezulu banikela ngohlobo oluthile lwezinzuzo zokuzala. Ngocwaningo bathole nokuthi:
- Ama-23% amboza ukwelashwa kwe-vitro fertilization (IVF)
- Ama-7% amboza izinsizakalo zokuvuna amaqanda / amaqanda
- I-18% imboza imithi yokuzala
- U-15% umboza ukuhlolwa kofuzo ukuthola izingqinamba zokungazali
- I-13% imboza izindlela zokwelashwa ezingezona eze-IVF
- U-9% uvakashela abeluleki
Njengoba ukungazali kubandakanya bobabili abalingani, kubalulekile ukuthi owesilisa nowesifazane bacwaninge ukuthi uhlelo lwabo luhlanganisani kubandakanya ukuhlaziywa kwesidoda nokunakekelwa kokuzala kwabesilisa.
Izinsizakusebenza zomshuwalense wokuzala owengeziwe:
Nawa amanye amakhasi ezinsiza ezivela ezinkampanini eziphezulu zomshuwalense wezempilo maqondana nezinsizakalo zokuzala kanye nokutholakala kwe-IVF:
Kungcono ukubiza futhi ukhulume nomphathi wakho womshuwalense ngqo ukuze uthole umbono ocacile wokuthi yini futhi engamboziwe. Eminye imibuzo ongafuna ukuyibuza ifaka phakathi:
- Ngabe inqubomgomo yami ihlanganisa ukuxilongwa ukuthola isizathu sokuzala?
- Ngabe ngidinga ukuthunyelwa ukubona isazi sokuzala?
- Ingabe inqubomgomo yami ikhava ukusakazwa kwe-intrauterine (IUI)?
- Ngabe inqubomgomo yami ihlanganisa in vitro fertilization (IVF)? Uma kunjalo, ingabe ihlanganisa izinqubo ezingeziwe ezifana ne-intracytoplasmic sperm injection (ICSI), cryopreservation (embryo freezing), imali yokugcina imibungu efriziwe, ukudluliswa kwemibungu efriziwe?
- Ingabe ukugunyazwa kwangaphambili kuyadingeka kunoma yiziphi izinqubo ezihlanganisiwe?
- Ingabe kunenani eliphezulu lomhlomulo wokuzala?
- Ingabe inqubomgomo yami ihlanganisa imishanguzo ejojowe? Uma kunjalo, ingabe zidinga ukugunyazwa noma ukusetshenziswa kwekhemisi ekhethekile?
- Ngingayithola yini incazelo ebhaliwe yezinzuzo zami?
Ngezansi kukhona amakhodi wokukhokha (Amakhodi we-CPT) ongabhekisa kuwo lapho ukhuluma nomphathi wakho womshuwalense:
| Amakhodi wokukhokha we-IVF womshuwalense | |
|---|---|
| Ukufakwa ngaphakathi kwe-intrauterine (IUI) |
|
| IVF in vitro fertilization (IVF) |
|
| Ukudluliswa kombungu okubandayo (FET) |
|
| Imithi |
|
Izinketho zezimali ze-IVF
Ngenkathi i-IVF isabiza ngisho nangomshuwalense, kunezinye izindlela zokwehlisa izindleko. Isibonelo, iReproductive Medical Associates (RMA), enezindawo eziyi-19 e-U.S., Inohlelo olubanzi lwe-IVF futhi izinsizakalo zezimali zokuzala exhumanisa imibhangqwana nezinhlelo ezahlukahlukene zokuboleka nokukhokha. Izinhlelo ezitholakala nge-RMA zifaka:
- Ukubolekisa Izixazululo Zeziguli
- Ukuzala kwe-ARC
- Izimali Zokuzala New Life
- Uhlelo lwe-WINFertility
- Ukubolekwa Kwezokunakekelwa Kwezempilo
- Umndeni Wesikhathi Esizayo
- Isikweletu Esibumbene Sezokwelapha
INational Infertility Association nayo ine- uhlu wezinhlelo zokuxhasa inzalo.
Kunezinhlangano eziningi ezingenzi nzuzo ezihlinzeka ngosizo lwezezimali kulabo abanenkinga yokungatholi inzalo ngezibonelelo.
Iningi (elingenzi nzuzo) linikela ngoxhaso ngenani elithile maqondana nokwelashwa (okungukuthi $ 5,000), kepha izibonelelo zeParental Hope zikhokha izindleko ezigcwele ze-IVF, uthi UDavid bross , umqambi nomongameli weParental Hope. Okungenzi nzuzo okukhulu okusekela umphakathi wokuzala Ithemba Lomzali , BabyQuest , ICade Foundation , futhi Izinqwaba zezibusiso.
I-Parental Hope inikeza usizo lwezezimali kumibhangqwana engazaliyo ngohlelo lwabo lweParental Hope Family Grant, olufaka isibonelelo se-IVF. Kwi-IVF ne-FET (izibonelelo), sihlanganyele ne-Institute for Reproductive Health futhi zombili izibonelelo zikhokhela izindleko ezigcwele zalezo zinqubo zokwelashwa, kuchaza uBross.
Kunezingenzi-nzuzo eziningi zasekhaya nezikazwelonke ezinikezela ngezibonelelo. Yize ukuthola isibonelelo kungaqinisekisiwe njengoba kunenqubo yokufaka isicelo, akukubi ukufaka isicelo. Qiniseka ukuthi ufunda izidingo zokufaneleka ngaphambi kokufaka isicelo soxhaso ngoba ezinye izinhlelo zinezimali.
Ungayonga kanjani imali kumuthi wokuzala
Imithi ifaka ingxenye ebalulekile kuzindleko eziphelele ze-IVF.Abesifazane badinga imishanguzo eminingi ngesikhathi senqubo ye-IVF, kusho uDkt Westphal. Abesifazane abaningi bafakwa amaphilisi okuvimbela inzalo kuqala ukusiza ngesikhathi sokwelashwa kwabo. Ukuvuselela ama-ovari, abesifazane bayajovwa nge-hormone evuselela i-follicle (isb. I-Follistim, i-Gonal-F) cishe izinsuku eziyisishiyagalolunye kuya kweziyi-12. Njengoba ama-follicles ('ama-egg sacs') ekhula, imishanguzo iyangezwa ukuvimbela ukukhiqizwa kweqanda kusenesikhathi, imvamisa i-gonadotropin-ikhipha i-hormone antagonist (isb.Ganirelix, Cetrotide).
Uyachaza ukuthi enqubweni yokubuyisa nokudlulisa amaqanda, owesifazane uthola umjovo we-chorionic gonadotropin (HCG), ama-antibiotic, ne-progesterone.
Ukonga imali ngezidakamizwa zokuzala, qala ushayele inkampani yakho yomshuwalense noma ubheke kwifomula yezidakamizwa yohlelo lwakho. Noma izinqubo ze-IVF zingahlanganiswa ngumshuwalense, eminye imithi ingaba njalo.
Uma i-copay yakho yemithi yokuzala isephezulu kakhulu noma uma ungenawo umshwalense, usenezinketho eziningi zokonga imali. Ungaxhumana nabenzi bezidakamizwa futhi ubuze ngamakhuphoni womkhiqizi noma izinhlelo zosizo lweziguli. Isibonelo, i Uhlelo Lokunakekelwa Kobubele ngu-EMD Serono angonga iziguli ezifanelekile kuze kufike ku-75% isephulelo se-Gonal-F.
I-SingleCare yehlisa intengo yemithi eminingi esetshenziswe ngesikhathi senqubo ye-IVF. Sebenzisa ithebula elingezansi ukuthola amakhuphoni amahhala, lawo wonke amakhasimende ekhemisi lase-U.S. Angalisebenzisa noma ngabe anomshuwalense noma cha.
| Izindleko zezidakamizwa zokuzala kanye namakhuphoni | |||||
|---|---|---|---|---|---|
| Igama lomuthi | Isebenza kanjani | Umthamo ojwayelekile | Intengo emaphakathi | Intengo ye-SingleCare ephansi kakhulu | |
| I-Lupron (leuprolide acetate) | Kuvimbela ukukhiqizwa kweqanda ngaphambi kwesikhathi | Umjovo ongaphansi kuka-0.25-1 mg nsuku zonke izinsuku ezingama ~ 14 | $ 880.98 ngekithi yezinsuku eziyi-14 | $ 364.90 ngekithi yezinsuku eziyi-14 | Thola isigqebhezana |
| I-Follistim AQ cartridge (follitropin beta) | Kushukumisa ukukhula nokuthuthuka kwamaqanda, kukhuthaza ukukhiqizwa kwesidoda emadodeni | 200 umjovo ongama ongena ngaphansi nsuku zonke izinsuku ezingama ~ 7. Umthamo ungakhuphuka ube ngamayunithi angama-500 nsuku zonke ngokususelwa ekuphenduleni kwe-ovari. | $ 2,855.19 nge-900-unit cartridge ngayinye | $ 2,187.06 nge-cartridge engu-900-unit | Thola ikhadi le-Rx |
| I-Ovidrel (choriogonadotropin alfa) | Kubangela ukukhishwa kwamaqanda kuma-ovari | 250 mcg / 0.5 mL umjovo ongena ngaphansi kanye | $ 267.99 ngomjovo ngamunye | $ 178.75 ngomjovo ngamunye | Thola isigqebhezana |
| Ganirelix | Kuvimbela ukukhiqizwa kweqanda ngaphambi kwesikhathi | 250 mcg / 0.5 mL umjovo ongena ngaphansi nsuku zonke (kuze kuqondiswe ukuphatha i-hCG) | $ 512.99 | $ 447.03 ngomjovo ongu-250 mcg | Thola isigqebhezana |
| ICetrotide (cetrorelix) | Kuvimbela ukukhiqizwa kweqanda ngaphambi kwesikhathi | Umjovo ongaphansi kuka-0.25 mg kanye ngosuku (kuze kuqondiswe ukuphatha i-hCG) | $ 318.99 ngekithi engu-0.25 mg | $ 241.08 ngekithi engu-0.25 mg | Thola isigqebhezana |
| I-Doxycycline | Yehlisa ubungozi bokutheleleka ngesikhathi somjikelezo we-IVF | I-100 mg capsule kabili ngosuku izinsuku ezingama-4, kuqala usuku lokubuyisa amaqanda | $ 43.76 ngama-20, amaphilisi ayi-100 mg | $ 14.31 ngama-20, amaphilisi ayi-100 mg | Thola isigqebhezana |
| I-Endometrin (progesterone) | Iqina futhi ilungise ulwelwesi lwesibeletho ukugcina ukufakwa kweqanda elikhulelwe | Amaphilisi ayi-100 mg ngaphakathi izikhathi ezingama-2-3 nsuku zonke amasonto ayi-10-12 ngudokotela | $ 373.99 ibhokisi ngalinye | $ 265.32 ibhokisi ngalinye | Thola isigqebhezana |
| I-Estrace (estradiol) | Inikeza i-estrogen emzimbeni, esiza ku-IVF ngezizathu ezahlukahlukene | Ithebhulethi engu-1-2 mg ngomlomo kabili ngosuku izinsuku eziyi-14 | $ 17.69 per 30, 1 mg amaphilisi | $ 6.24 per 30, 1 mg amaphilisi | Thola isigqebhezana |
Ngezansi: Thatha isikhathi sakho ngohambo lwakho lwe-IVF
Njengoba iziguli eziningi zidlula ezinkambisweni eziningi ze-IVF ngaphambi kokukhulelwa ngempumelelo, kubaluleke kakhulu ukukala izindleko nekhwalithi yomtholampilo ukuze ukwazi ukukhokhela imijikelezo eminingi uma kudingeka. Nalu uhlu lokuhlola lwemibuzo nokucatshangelwa lapho ukhetha umtholampilo wenzalo:
- Ingabe umtholampilo wakho unikela ngohlelo lwembuyiselo lwe-IVF?
- Yimuphi umshuwalense owamukelwa izindleko ze-IVF?
- Yiziphi izinsizakalo ze-IVF ezinikezwa emtholampilo?
- Yini ukwehla kwezindleko zezinsizakalo?
- Ngabe uncoma noma yiziphi izinsizakalo zokuxhasa ngemali wenzalo?
- Ingabe indawo yomtholampilo ilungele mina nomlingani wami?
- Ngabe umtholampilo nabasebenzi bawo babuyekezwa kakhulu phakathi kwezinye iziguli nochwepheshe?
- Lithini izinga labo lokuphumelela? I- Isitholi somtholampilo we-SART wenzalo ikuvumela ukuthi ubuke izibalo zokuzala zomtholampilo ngokuthayipha ikhodi ye-zip.
Kubalulekile futhi ukubheka isidingo sokuthatha ikhefu phakathi kwemijikelezo ye-IVF. Isikhathi esijwayelekile phakathi kwemijikelezo ye-IVF umjikelezo owodwa ogcwele wokuya esikhathini, ngokusho kwe- Isikhungo Sokuzala SikaCarolinas . Lokhu kuvame ukuhumushelwa emasontweni amane kuye kwayisithupha ngemuva kokudluliswa kombungu nokuhlolwa kokukhulelwa okungalungile ukuqala omunye umjikelezo we-IVF.
Ngokuvamile, isiguli kufanele silinde phakathi kwezinqubo ze-IVF kuze kube yilapho umzimba waso ubuyele esimeni sangaphambi kwe-IVF, kusho uPeter Nieves, isikhulu sezentengiso WINUkuzala . Okusho ukuthi uqala umjikelezo omusha wokuya esikhathini futhi ama-hormone akhe ayisisekelo nosayizi we-ovary abuyele esimeni sakhe sokuphumula esijwayelekile.
Izizathu zokuthatha amakhefu phakathi kwemijikelezo ye-IVF zingafaka izidingo zomzimba, ezezimali nezomzwelo. Eminye imithi ingadala ukuvuvukala, odokotela abaningi abakholelwa ukuthi kufanele kwehle ngaphambi kokuqala umjikelezo omusha. Izindleko zezezimali nezingokomzwelo ze-IVF nazo zingathinta impilo yakho nobudlelwano nomlingani wakho, ngakho-ke ukuthatha isikhathi ukulungiselela omunye umjikelezo kubalulekile.
