Elena Kalinina, obstetrician-gynecologist , MD, aureate weRF Government Prize yebasa "IVF chirongwa mukurapa imba isina kuberekwa" Pakutanga, nzira ye in vitro fertilization (IVF), iyo inosanganisira kubatana kwezai rakakura ne spermatozoon kunze kwemuviri wemukadzi uye inotevera embryo embryo mu chiberekero, chaifungidzirwa kuti chinogadzirisa dambudziko rimwe chete. Yakanga iri pamusoro pemamiriro ezvinhu apo, nokuda kwechimwe chikonzero, amai vaizouya vakanga vasina mama ma tubhu: kusvikirwa kwavo kunoita kuti mimba isakwanisika, nokuti ndiyo iyo inosangana nei sperm, iyo iyo inotungirwa mazai inoenda ipapo kumubereki kunamatira kumadziro ayo uye kutanga kukura. Kuedza kuvhara dambudziko iri nerubatsiro rweVIV kwakaitwa nevatsvakurudzi vanobva kunyika dzakasiyana, uye munaNovember 1977 kushandiswa kwechirungu embryologist vanachiremba vakava pachena kuti ECO yaizobatsira kukunda marudzi akasiyana ekushaya simba, uye gynecologist kubva kuchipatara Born Born akazobudirira. Chipiri chinotevera, 601-t kuendesa muchibereko chemucheche wakakura kunze kwemuviri wemukadzi akatungamirirwa pakuberekwa kwaLouise-"mwana" wekutanga "kubva pamuviri we test".
MuRussia, kusimbiswa kwemutambo uyu kwakatanga makore matanhatu gare gare: kuedza kwaVladimir Ivanovich Kulakov, mutungamiri weAll-Union Research Center yekudzivirira Amai nevana Child Health (ikozvino SC yeObstetrics, Gynecology nePerinatology), naBris Vasilievich Leonov, avo vakatungamira boka revanyanzvi, vachishandisa kliniki kwaiva neongororo yekuongorora. Pano, mukati, Lenochka akazviratidza-pasinei nekushayikwa kwemai amai vake kubva kumamai uye wechipiri kuedza kweVFF. Kutevera Muscovite Lenochka munaDecember 1986 muLeningrad, mu Research Research of Obstetrics uye Gynecology D. Otto, wekutanga munhau yekodzero yeVF boy yakaberekwa. Nyanzvi dzeCent for Infertility Treatment pa 1st Grad Hospital, inotungamirirwa naProfesa VM Zdanovsky, yakaitawo zviitiko zvinoshamisa. Saka, kuburikidza nekuedza kwemapoka akasiyana-siyana evatsvakurudzi, nzira yeECO yakagamuchira kodzero yehupenyu munyika yedu, uye kubva panguva iyo kukura kwayo kwakatanga zvishoma nezvishoma kuwedzera.
Vabereki vanofara
Nokufamba kwenguva, takaona kuti IVF inogona kubatsira kukunda marudzi akasiyana-siyana ekushaya vana, zvose zvevakadzi nevakadzi. Iri rondedzero zvino rinoratidza zvinetso zvaimbofungidzirwa kuti hazvigoni kuitika: kuvhiringidzika kwe fallopian tubes, isingagoni kudzorerwa nekuvhiyiwa; serious hormonal disorders; kusabereka kunokonzerwa nezvikonzero zvisingazivikanwi. Mukuwedzera, iyo nzira yakatipa mukana wokukudziridza hurongwa hwevanopa, kuburikidza nevarwere avo pane chimwe chikonzero vasina mazai avo, vanozvigamuchira kubva kune vamwe vakadzi. Iyo inozivikanwa iye zvino uye mukana wekushandura kumabasa eamai vanozvipira vanotsungirira uye vanoberekera mwana pamuviri nekubatsirwa kweii uye chirume che "vatengi".
Nzira yeVF yakave yechokwadi kuburikidza nekurapa kwekusagadzikana kwevarume . Kana nhamba yepermatozoa mune ramangwana papa idiki kana kuti isingakwanisi kushambadzira, hatigoni kungotarisa "akakodzera" anokwanisa, asi tinoiisawo pachena muzai remukadzi, tichienzanisa zvipingamupinyi zvepanyama uye nekuchengetedza kuchengetedzwa kwezvinhu zvayo zvose. Iyi nzira, inonzi ICSI, yakagadzirwa munguva ichangopfuura: mwana wokutanga, akaberekwa nemubatsiro, akaberekwa muna 1993.
Maererano nekucherechedza kwandakaita, nzira yeVF yava kunyanya kuzivikanwa: chikamu pamusana pekuwedzera kwezvakanaka zvayo, chikamu nokuti zvikonzero zvekushaya vana zviri kuwedzera. Mumwe wavo: vakadzi vanofunga nezvekuzvarwa kwemwana panguva iyoyo, apo matambudziko ehutano akawedzerwa.
Valentin Lukin, Ph.D. , aine mubayiro weRF Government Prize nokuda kwebasa rake "IVF chirongwa mukurapa imba isina kuberekwa" ECO inzira yakagadziriswa pakuvandudza kwekuberekwa kwevanhu. Mune ramangwana, hazvizobvumi kuratidzira kusununguka kwevakadzi nevarume, sezvazviri nhasi, zvichatipa mikana mitsva yekudzivirira nekurapa zvirwere zvakakomba zvingagarwa. Pashure pezvose, IVF inobvumira nyanzvi kushanda nemasero anomutsa munhu, uye, zvichida, tichava nemukana wekutungamirira masero aya. Nhasi zvakaoma kwatiri kufungidzira-pfungwa yekuponesa hupenyu hwevanhu nerubatsiro rwekuwedzerwa kweropa yakaita seyakashamisa pakutanga kwezana remakore rechi20 - asi nguva, sezvinozivikanwa, shanduko.
Chimwe chezvinyorwa zvokutanga zvakazvipira kune nzira itsva, iyo yakapa upenyu kuLenochka. Nyaya Yehutano, March 1986 Nemwana achangoberekwa, Elena Kalinina (uyo ari jaya rinotsvakurudza ruzivo muAll-Union Research Center yeAmai nevana Health Health) naValentin Lukin (iye zvino aimbova mukuru muCentral), February 1986 .
Asi isu tichadzoka nhasi. Nekuuya kweAVF, kusununguka kwakava nyore: pasinei nedzimwe ruzivo rwekutanga, mukadzi uyo akatendeukira kwatiri kuti atibatsire ane mukana we30% wekutora pamuviri mukutanga. Uye zvino varwere havasisinazve kupedza makore, vachishandisa zvose zvingaita nzira yekugadzirisa matambudziko avo, nokuti vanogona kudarika.
Pane humwe hutsika uye hutsinye here? Takatotaurira nezvezvinobatsira zvemuitiro. Uye zvakadaro handifaniri kuzvikurudzira kune vose vakaroorana vane matambudziko. Zvakakosha kushandura rubatsiro rwake apo dzimwe mikana yekugadzirisa dambudziko, somuenzaniso, kuporesa, kusashanda. Chimwe muenzaniso: vabereki vemazuva ano vakawana nzira yekutsvakurudza, uye chikonzero chekushaya simba chakanga chisina kuwanikwa, uyezve, makore avo akapfuura kupfuura makore makumi mana-mumamiriro ezvinhu aya, kudzorera kushanya kune dhipatimendi reECO hakubatsiri. Kana zviri izvo zvisingabatsiri zvemuitiro, unofanirwa kuyeuka izvi: zvinosanganisira kukanganisa kwakakomba pamusana pemadzimai emukadzi, izvo zvinogona kukonzera matambudziko asina kunaka. Mukuwedzera, kusabatwa nekushaya rubatsiro ne IVF kunofadza.
Sei mushure mekufamba kweVIVF mapatya uye katatu zvinowanzoonekwa kakawanda?
Sezvatotaurwa, zvinoitika kuti kwete imwe chete asi maviri kana matatu mazai anotora midzi mumubereki. Zvisinei, munhu wose anoziva kuti zvakaoma kutsungirira "kambani" yakadaro kupfuura mwana mumwe chete (kunyanya kana amai vanguva yemberi vari pasi pemakumi mana). Ndicho chikonzero nyanzvi dzeVIV pasi rose dzinotungamirirwa ne "kusikwa" kwekudzivirira kusakwana - mune zvinodiwa zvemukadzi nemwana. Ndicho chikonzero kana vakaroorana vanoda mwana mumwe chete, munharaunda yeVIV vachasangana naye uye vanotakura kamwana kamwechete, kakawanda sezvinodiwa. Chii chinoitika kune mazai ayo akatorwa kubva kumukadzi, akabatana ne spermatozoa, asi asina kutamirwa muchibereko? Nekubvumirwa kwa "madzimadzi" ivo vakaoma uye, kana kuedza kwekutanga kuchikundikana, ita zvinotevera, usingafambisi avo vakasara. Kana nhumbi yacho yapera, nzira yacho inotanga kubva pakutanga.
Iko ECO pamuviri uye kuberekwa kwakasiyana kubva kune "zvekare" here?
Mushure mokuedza kwevanyori vebazi re IVF mukadzi anova nepamuviri, amai vanotarisira vanogona kuramba vachicherechedza munzvimbo ipi neipi yakakodzera (somuenzaniso, mukubvunzurudza kwevakadzi). Kuberekwa kwakadaro kunoda vanachiremba, asi kwete nokuti chimwe chinhu chakasiyana nezvakauya zvakasikwa. Ndizvo zvinowanzoitika kuti vakadzi vanoshandisa IVF (zvinosuruvarisa) panguva iyo vane matambudziko anokwanisa kudzivisa nguva yakadzikama yezviitiko. Ndivanaani? Chokutanga pane zvose, zera, rwechipiri, zvirwere zvisingaperi, kuwedzera kukura. Kuberekwa kuri kuuya hakusi kwakasiyana chaizvo nezvinoitika. Ichokwadi, vakadzi vanobva kuDhipatimendi reECO vanowanzoita chikamu chinorongwa chekudya. Mumagazini ino, zvakafanana zvakataurwa pamusoro apa zvinofungidzirwa: zera, zvinetso zvehutano, huwandu hwepamuviri. Nenzira iyo, kana iri kuuya katatu, saka chero zvakadaro iyo inowanikwa muchiedza nekuvhiyiwa, uye nguva yaamai haina chokuita nazvo.
Vabereki vangabvunza nyanzvi kuti "vadyara" mucheche wemumwe munhu wepabonde here?
Vanokwanisa, asi bedzi kana vakatova nevanasikana vatatu kana vatatu vatatu kana mumhuri yezvakaitika kune zvirwere zvepabonde zvinosangana nehumwe hupombwe, semuenzaniso hemophilia. Mamwe mamwe mamiriro ezvinhu akafukidzwa nekugadziriswa kweWorld Health Organization, iyo isingakurudziri vabereki kuti vasarudze zvepabonde revana vavo remangwana.
Nei IVF inodhura?
Munzira dzakawanda, mutengo unotsanangurwa nemishonga yemadhoni. Mukuwedzera, zvese zvishandiso izvo vanachiremba vanoshandisa zvinoshandiswa uye zvinokoshawo zvakanyanya. Chimwe chiedza chakadaro chinodhura chikamu che $ 3 000. Kuti tariro yehurumende rubatsiro haisati yakakodzera: mutemo wemutemo, maererano neyokutanga yeVF ichave yakasununguka, ichiri kumirira awa yacho.