Izibalo zokungazali 2021: Bangaki imibhangqwana ethintekayo ngokungazali?

Izindaba

Kuyini ukungazali? | Ukusabalala kokuzala | Izibalo zomhlaba zokuzala | Izibalo ze-U.S. Zokuzala | Izibalo zokungazali ngocansi | Izibalo zokungazali ngobudala | Izibalo zokungazali ngenxa yohlanga nobuzwe | Izinkinga ezivamile | Izibalo ze-IVF | Izindleko | Izimbangela | Ukwelashwa | I-Epidemiology | Imibuzo evame ukubuzwa | Ucwaningo

Ukungabi nenzalo, noma ukungakwazi ukukhulelwa ngemuva kokuzama unyaka owodwa, kungaba nzima kubantu nabashadikazi ukuthi badlule kukho. Ukungatholi inzalo kuvamile, futhi kungasho nokukhulelwa kepha kube nokuzala ingane ishonile noma ukuphuphunyelwa yizisu. Ake sibheke ezinye izibalo zokuzala ukuze sikuqonde kangcono ukuthi kuyini nokuthi kubathinta kanjani abantu.

Kuyini ukungazali?

Ukungabi nenzalo ukwehluleka ukukhulelwa noma ngabe usuya ocansini kaningi futhi olungaphephile unyaka owodwa. Ukungabi nenzalo kungathinta abesilisa nabesifazane futhi imvamisa kuyazihlola ngokuhluleka ukukhulelwa. Abanye besifazane nabo bangaba nomjikelezo wokuya esikhathini omude kakhulu noma omfushane kakhulu, futhi ukuba nezinkinga ezithile zempilo ezifana nesifo sokuvuvukala okhalweni noma i-uterine fibroids kungahle kudalele umuntu ekutheni angabi nenzalo.

Odokotela bangenza izinhlobo eziningi zokuhlolwa ukusiza ukuthola ukuthi yini engadala izinkinga zokuzala kumuntu noma kubashadikazi. I-Transvaginal ultrasounds ingasiza ekutholeni ukungahleleki okungaba khona kwesibeletho, ukuhlolwa kwegazi kungabheka amazinga angajwayelekile we-hormone, futhi ukuhlaziywa kwesidoda kungathola ukungajwayelekile kwesidoda emadodeni okungenzeka kudlala indima ekungazali. Ukwelashwa kokungazali kuyathuthuka njalo, futhi abantu abaningi ekugcineni bayakwazi ukukhulelwa ngempumelelo.

Kuvame kangakanani ukungazali?

• Kulinganiselwa ukuthi u-15% wemibhangqwana uzoba nenkinga yokukhulelwa. (UCLA Health, 2020)
• Emhlabeni jikelele, izithandani eziyizigidi ezingama-48.5 zithola inzalo. ( I-Endocrinology Yezinto Zokuzala Ezizalisayo , 2015)
• Cishe i-9% yamadoda kanye ne-10% yabesifazane abaneminyaka eyi-15 kuya kwengama-44 babike izinkinga zokungazali e-United States. (CDC, 2013 kanye neHhovisi Lezempilo Labesifazane, 2019)

Izibalo zokuzala emhlabeni wonke

• Amazwe ayi-9 kwangu-10 anesilinganiso sokuzala okuphelele ese-Afrika alandelwa yi-Afghanistan. (ICentral Intelligence Agency, 2017)
• I-Yurophu eseNingizimu, iMpumalanga Yurophu, neMpumalanga ye-Asia zinamanani aphansi okuzala emhlabeni anezingane ezibalelwa ku-1.5 ngokwesifazane ngamunye. (UNFPA, 2018)
• ISweden inezinga eliphakeme kakhulu lokuzala eYurophu (cishe izingane eziyi-1.9 ngowesifazane ngamunye). (UNFPA, 2018)
• Umbhangqwana owodwa kwaba-4 emazweni asathuthuka uthinteka ngokungatholi abantwana. (WHO, 2004)

Izibalo zokungazali e-United States

• I-U.S. Inesilinganiso sezingane eziyi-1.87 ezizalwa ngowesifazane ngamunye. (ICentral Intelligence Agency, 2017)
• Cishe ama-85% emibhangqwana izokwazi ukukhulelwa onyakeni wokuqala wokuzama. (UCLA Health, 2020)
• Ngokwengeziwe, imibhangqwana engu-7% izokwazi ukukhulelwa onyakeni wayo wesibili wokuzama. (UCLA Health, 2020)
• Ukungatholi inzalo kuthinta abesifazane abangu-10% abaneminyaka ephakathi kwengu-15 nengama-44 e-U.S. (CDC, 2019)
• Isigamu (48%) semibhangqwana enenkinga yokukhulelwa asibheki isimo sayo njengokuzala. (I-SingleCare, 2020)

Izibalo zokungazali ngocansi

• Njengoba kubikwe ngabesilisa abayi-9% abaneminyaka eyi-15 kuya kwengama-44 kanye no-10% wabesifazane abalinganayo, ukungabi nenzalo kucishe kuvame kwabesilisa njengoba kwenzeka kwabesifazane base-U.S. (CDC, 2013 kanye neHhovisi Lezempilo Labesifazane, 2019)
• Ama-30% wamacala okuzala angabhekiswa kwabesifazane kuphela, ama-30% angabhekiswa kowesilisa kuphela, ama-30% angabangelwa inhlanganisela yabo bobabili abalingani, kanti amacala ayi-10% anesizathu esingaziwa. (Izimpendulo Zenzalo, 2020)

Izibalo zokungazali ngobudala

Imvamisa, iziguli zami zokuzala zingabancane njengama-20s abo futhi zindala ezineminyaka ephakathi kwengu-40, uSara Mucowski, MD, uchwepheshe wezokuzala I-Dallas IVF .

• Owesifazane oyedwa kwabane ophilile oneminyaka engama-20 nengama-30 ubudala uzokhulelwa kunoma yimuphi umjikelezo wokuya esikhathini. (I-American College of Obstetrics and Gynecologists, 2018)
• Owesifazane oyedwa kwabayishumi ophilile oneminyaka engama-40 ubudala uzokhulelwa kunoma yimuphi umjikelezo wokuya esikhathini. (I-American College of Obstetrics and Gynecologists, 2018)
• Ngokuvamile, ukuzala kuqala ukwehla kwabesifazane abaningi abaneminyaka engama-20 nengama-30 bese kwehla ngokushesha ngemuva kweminyaka engama-35. (I-American Society for Reproductive Medicine, 2012)
• Imibhangqwana lapho umlingani wesilisa eneminyaka engama-40 noma ngaphezulu kungenzeka abe nobunzima bokukhulelwa. (CDC, 2019)
• Ikhwalithi yesidoda ngokuvamile ayibi yinkinga kubantu besilisa kuze kube ngemuva kweminyaka engama-60. (I-American Society for Reproductive Medicine, 2012)

Izibalo zokungazali ngenxa yohlanga nobuzwe

• Abesifazane baseHawaii nabasePacific Island Island babenezinga eliphakeme kakhulu lokuzala e-U.S ngo-2018 kwalandelwa abaseMelika baseSpain nabaseMelika baseMelika.
• Abamhlophe baseMelika nabase-Asia babenamanani aphansi okuzala ngo-2018.

(Isitatimende, 2019)

Izinkinga ezivamile zokuzala

Izinkinga zokungabi nenzalo nokungazali, njengokukhulelwa yizisu, zingathinta kabi impilo yomuntu jikelele kanye nekhwalithi yempilo. Imibhangqwana eminingi efuna ukuqala umndeni futhi engakwazi ukukhulelwa izobhekana nosizi ngokwengqondo nangaphakathi kwabantu olungaba nomthelela omubi ezingeni lempilo yabo.

• Ukungabi nenzalo kungesinye sezizathu eziyinhloko zesehlukaniso phakathi kwezithandani. ( Ijenali Yomhlaba Wonke Ye-Biomedicine Yokuzala , 2020)
• Kuze kube ngama-60% wabantu abangenanzalo ababike izimpawu zengqondo ezinamazinga aphezulu kakhulu okukhathazeka nokudangala kunabantu abavundile. ( Ukwelashwa Kwemitholampilo, 2014)
• Cishe abesifazane abangama-41% abangenanzalo banengcindezi. ( I-BMC Women's Health , 2004)
• Cishe ama-87% abesifazane abangenanzalo banexhala. ( I-BMC Women's Health , 2004)
• Abesifazane abakhulelwa nge-IVF banethuba eliphakeme lokubeletha ngaphambi kwesikhathi. (I-Ultrasound ku-Obstetrics & Gynecology, 2017)

Izibalo ze-IVF

• E-U.S., I-12% yabesifazane abaneminyaka yobudala bokubeletha basebenzise insizakalo yokungazali (CDC, 2017).
• Cishe u-2% wokuzalwa bukhoma e-U.S. Kungumphumela wobuchwepheshe bokusiza bokuzala (i-ART). (CDC, 2017)
• Abesifazane abaneminyaka engama-30 kuya kwengama-33 banethuba elihle lokuphumelela (58%) phakathi nomjikelezo wabo wokuqala we-IVF uma kuqhathaniswa nabesifazane beminye iminyaka yobudala. (Izixazululo Zokuzala)
• Kokunye ukuhlola kwabesifazane abafuna ukwelashwa kokuzala, ama-4% abesifazane asebenzise imishanguzo kuphela, ama-21% asebenzise i-IUI, ama-53% asebenzise i-IVF, kwathi ama-22% awazange alandele ukwelashwa okususelwa kumjikelezo. ( Ukuzala Nokuzala , 2011)

Izindleko zokwelashwa kokuzala

• Zonke izindleko zokwelashwa zokuzala zingaba kusuka ku- $ 5,000 kuya ku- $ 73,000 ( Ukuzala Nokuzala , 2011)
• Isiguli esimaphakathi sihamba ngemijikelezo emibili ye-IVF, silethe izindleko eziphelele ze-IVF (kufaka phakathi izinqubo nemithi) phakathi kuka- $ 40,000 no- $ 60,000. (I-SingleCare, 2020)
• Izindleko ezilinganisiwe ezingama-85% ze-IVF zivame ukukhokhwa ephaketheni. ( Ukuzala Nokuzala , 2011)
• Izingane ze-IVF zivunywa kakhulu ezibhedlela kunezingane ezingezona eze-IVF. Izindleko zokunakekelwa esibhedlela ngemuva kokubeletha kwezingane ze-singleton IVF zazicishe ziphindwe kabili kunalezo ze-singleton ezingezona i-IVF. ( Ukukhiqizwa Komuntu, 2007)

Izimbangela zokuzala

Ngokwenhlolovo yokungabi nenzalo yakwaSingleCare, ama-25% wabashadikazi abayazi imbangela yezinkinga zabo zokuzala.

Ukungabi nenzalo kwabesifazane imvamisa kungenxa yezinkinga nge-ovulation ezingadalwa yizinkinga ze-ovulation njenge-polycystic ovary syndrome ( I-PCOS ), Ukwehluleka okuyisisekelo kwe-ovarian (POI), nomai-hyperprolactinemia. Ukungabi nenzalo kwabesifazane nakho kungadalwa ukungajwayeleki kwesibeletho noma komlomo wesibeletho, ukulimala kwamashubhu e-fallopian, i-uterine fibroids, i-endometriosis, ukuya esikhathini kokuqala, izicubu zesibeletho, kanye nokwelashwa komdlavuza noma ukucindezeleka okukhulu kwengqondo.

Ukungasebenzi kahle kwe-Ovulatory kuvamile impela, ikakhulukazi ngobunzima esibhekana nabo njengomphakathi onesisindo esikhulayo; ukuthwala isisindo esiningi kuvame ukuthinta ukusebenza kwe-ovulating, kusho uJessica Scotchie, MD, ongumsunguli we Imithi Yokuzala YaseTennessee ngubani oqinisekiswe ngamabhodi kabili ku-endocrinology yokuzala nokungazali (i-REI).Abesifazane baqala imindeni yabo ngeminyaka emidala ngokwesilinganiso (abaningi balinde kuze kube yiminyaka engama-30, kanti izizukulwane zangaphambilini zivame ukuqala imindeni ephakathi kweminyaka engama-20-25). Ukuqala umndeni usemdala kungadala ukuthi izinga lamaqanda nezici zokungasebenzi kahle kwe-ovari kudlale indima enkulu ekungazali. Izinkinga ze-anatomical ezifana ne-endometriosis kanye namashubhu we-fallopian avinjiwe zivame kakhulu futhi, kubonakala okungenani ezigulini eziyi-15 kuye kwezingu-20%.

Ukungabi nenzalo kwabesilisa kuvame ukubangelwa amasende angasebenzi kahle. I-Varicocele yisimo lapho imithambo emasendeni yendoda inkulu kakhulu, ebangela ukuthi ishise, okuthinta ukubala kwesidoda nesimo. Ikhwalithi yesidoda nayo ingathinteka yizimo zezempilo ezinjengesifo sikashukela, ukukhubazeka kofuzo, namasende angafunwanga. Uma isidoda singalethwanga kahle ngenxa ye-ejaculation ngaphambi kwesikhathi noma izinkinga zesakhiwo, lokhu kungathinta nokuzala. Ngisho nokuchayeka kwemvelo kumakhemikhali anobuthi noma izibulala-zinambuzane kungathinta impilo yokuzala kanye nekhwalithi yesidoda.

Ukwelapha ukungazali

Izindaba ezimnandi ukuthi, kuphela i-10% yamacala okuphela kokuzala angenakulapheka; lezo yizinkinga eziwela ngaphansi kwesambulela esingu-10% samacala okuzala ngenxa yokungaziwa, kusho uJolene Caufield, umeluleki omkhulu ku UHoward onempilo , inhlangano engenzi nzuzo yokuphila okunempilo, ukuqeqeshwa ngempilo, nokunakekelwa kwezempilo, kufaka phakathi impilo yezocansi. Ama-90% asele angalashwa futhi aphathwe ngenxa yentuthuko yezokwelapha kule minyaka engama-30 edlule. Faka, ukukhulelwa kwe-in vitro (noma i-IVF). Le nqubo iyindlela yokwelashwa enconywe kakhulu yokungabi nenzalo kuzo zombili izinhlangothi.

Kuhlolo lwe-SingleCare lwango-2020 lokungazali, ama-60% wabaphenduli babike ukuthi bathola uhlobo oluthile lokwelashwa kokuzala. I-IVF, imishanguzo yokuzala, kanye nokwenziwa kwe-ovulation kwakuyizindlela ezintathu zokwelashwa ezivame kakhulu kulabo abathatha inhlolovo. Ababili kwabathathu abaphendulile baphinde bazama amakhambi emvelo noma eminye imithi yokubasiza ukuba bakhulelwe.

In vitro fertilization (IVF), intrauterine insemination (IUI), insemination yokufakelwa (AI), kanyei-intracytoplasmic sperm injection (ICSI) yizo zonke izindlela zokwelashwa eziphumelele kakhulu ekusizeni abantu ukuthi bakhulelwe. Kube nokuthuthuka okusha ku-IVF ukusiza ukuyenza iphumelele, njenge ukuhlolwa kokufakelwa kwezakhi zofuzo ngaphambi kokufakwa , futhi abacwaningi baqhubeka ngokufuna izindlela ezintsha zokwenza ukwelashwa kokuzala kube ngcono.

Ngaphezu kwe-ART nezinqubo zokuhlinza, ukwelashwa kokuzala kubandakanya inhlanganisela yemithi. Nayi eminye yemithi ejwayelekile esetshenziselwa ukwelapha ukungabi nenzalo:

• ICrinone (iprogesterone gel)
• ICetrotide (cetrorelix)
• I-Clomid (i-clomiphene citrate))
• I-Metformin ye-PCOS

I-Epidemiology yokungazali

Ukungatholi inzalo kuya ngokuya kwanda, ikakhulukazi ngoba imibhangqwana eminingi ilinde ukuba nezingane kamuva empilweni. Umbhangqwana owodwa kwezingu-4 emazweni asathuthuka uthinteka ngokungazali, futhi cishe Imibhangqwana eyizigidi ezingama-48.5 uhlangabezana nenzalo emhlabeni wonke. Abanye odokotela nabacwaningi bangathi ukungabi nenzalo sekuba ubhadane, kanti izindlela zokwelashwa kokungazali ziyathandwa kakhulu njengoba imibhangqwana ifuna izindlela zokuqala umndeni.

Imibuzo nezimpendulo zokungazali

Ngabe amanani okuzala angakhula?

Ukungabi nenzalo kuyanda. Ukusetshenziswa kobuchwepheshe bokusiza bokuzala (i-ART) ngemibhangqwana engenanzalo kuyanda ngo 5% kuya ku-10% ngonyaka. Ngo-1950, kwakukhona isilinganiso sezingane ezinhlanu ngowesifazane oyedwa emhlabeni wonke, ngokusho kuka izizwe Ezihlangene . Kukhona isilinganiso sezingane ezimbili ngowesifazane ngamunye emhlabeni wonke ngo-2020.

E-US, kube nokwehla kwesikhathi eside kwamazinga okuzalwa nokuzala okuye kwabangelwa yizici eziningi ezibandakanya imfundo esezingeni eliphakeme namathuba emisebenzi yabesifazane, umshado wakamuva, ukufinyelela okuthuthukisiwe kokuvimbela inzalo, ukubambezeleka kokuthola izingane, nokwehla kosayizi womndeni, UDkt Mucowski uthi.

Bangaki abashadikazi abangazali?

Mayelana 12% kuye ku-15% imibhangqwana ayikwazi ukukhulelwa ngemuva kokuzama ukukhulelwa unyaka owodwa.

Ngabe ukungabatholi abantwana kuyalinyusa inani lezehlukaniso?

Kwezinye izifundo, ukungabi nenzalo kuhambisana nezinga lenyuke lesehlukaniso phakathi kwemibhangqwana engazali.

Yini engadala ukungabi nenzalo kowesifazane?

Ukungabi nenzalo kowesifazane kuvame ukubangelwa i- ukwehluleka ukuphuma kwamaqanda , kodwa futhi kungaba izifo, i-endometriosis, ukungajwayelekile kohlelo lokuzala, noma ezinye izinkinga ngomjikelezo wokuya esikhathini.

Ingabe likhona ikhambi lokuzala?

Ukwelashwa kokungazali, kufaka phakathi imishanguzo nezinqubo ezifana ne-IVF, kungasiza imibhangqwana ukunqoba ukungabi nenzalo futhi izuze ukukhulelwa. Ukuthi umuntu uzokwazi yini ukunqoba ukungazali kwabo noma nini kuzoya ngezimo zabo ezihlukile, ubudala, nomlando wezokwelapha.

Ucwaningo

• Ucwaningo lwango-2020 lokuzala: Izimbangela, ukwelashwa, amazinga empumelelo, i-SingleCare
• Izimpawu, ukwelashwa, ukuxilongwa , UCLA
• Imibuzo evame ukubuzwa , I-CDC
• Ukungabi nenzalo , IHhovisi Lezempilo Labesifazane
• Ukungabi nenzalo nokungasebenzi kahle e-United States, 1982-2010 , I-CDC
• Incwadi yamaqiniso emhlabeni , I-Central Intelligence Agency
• Umbono oyingqayizivele ngokungazali kwabesilisa emhlabeni wonke , I-Endocrinology Yezinto Zokuzala Ezizalisayo
• Izinselelo ezibangelwa ukuzala okuphansi eLatin America naseCaribbean , UNFPA
• Ukusabalala komhlaba wonke kokungazali, ukungabi bikho kwemali, nokungabi nezingane , I-WHO
• Izibalo eziyi-13 zokuzala ungazazi , Izimpendulo Zenzalo
• Ubudala nokuzala , I-American Society Yezokwelapha Ngokuzala
• Ukuba nengane ngemuva kweminyaka yobudala engama-35 , I-American College of Obstetrics kanye neGynecologists
• Inani lokuzala lonke e-United States ngo-2018 ngohlanga lukamama , Isitatimende
• Indima yokuqeqeshwa kokuqina ekuyekethiseni abafakizicelo bezithandani ezingenanzalo ngesahlukaniso , Ijenali Yomhlaba Wonke Ye-Biomedicine Yokuzala
• Ucwaningo lobudlelwano phakathi kokukhathazeka, ukudangala nesikhathi sokuzala , I-BMC Women's Health
• I-Psychopathology, izici ezingokomzwelo nokwelulekwa ngokwengqondo ekungazali , Ukwelashwa Kwemitholampilo
• Ubungozi bokuzalwa ngaphambi kwesikhathi ngaphambi kokukhulelwa kwe-singleton okukhulelwe ngemuva kokwelashwa kwe-IVF / ICSI , I-Ultrasound ku-Obstetrics & Gynecology
• Ubuchwepheshe obusizwayo bokuzala — umbiko wamazinga empumelelo yomtholampilo wenzalo , I-CDC
• Amazinga empumelelo e-ART , I-CDC
• Izinga lokuphumelela lomjikelezo wokuqala we-IVF , Izixazululo Zokuzala
• Ibiza malini i-IVF? , Ukunakekelwa
• Izindleko zokwelashwa kokuzala: Imiphumela evela ocwaningweni lweqembu elizothatha izinyanga eziyi-18 , Ukuzala Nokuzala
• Ukulaliswa ngemuva kokubeletha kanye nezindleko zokunakekelwa kwezempilo phakathi kwezingane ze-IVF , Ukukhiqizwa Komuntu