Hoʻoipo

ʻO ka infertility ʻaʻole hiki iā ʻoe ke hāpai (hāpai).

Aia he 2 ʻano o ka infertility:

• ʻO ka infertility mua e pili ana i nā kāne i hāpai ʻole ma hope o ka liʻiliʻi o 1 mau makahiki e moekolohe me ka hoʻohana ʻole ʻana i nā hana kaohi hānau.
• ʻO ka infertility kiʻekiʻe e pili ana i nā kāne i hiki ke hāpai i ka manawa hoʻokahi, akā ʻaʻole hiki i kēia manawa.

Hiki i nā kumu o ke kino a me ka naʻau ke hoʻoulu i ka momona. Ma muli paha o nā pilikia i ka wahine, ke kāne, a i ʻole ʻelua paha.

KA INEPANUI WAIWAI

Hiki i ka wahine infertility ke hana i ka wā:

• ʻAʻole ola kahi hua manu a i ʻole embryo ke hoʻopili ʻia i ka uhi o ka ʻōpū (uterus).
• ʻAʻole hoʻopili ka hua manu momona i ka uhi o ka kōpū.
• ʻAʻole hiki i nā hua ke neʻe mai nā ovaries a i ka ʻōpū.
• Loaʻa nā pilikia i nā ovaries i ka hana ʻana i nā hua.

Hoʻokumu ʻia paha ka infertility wahine e:

• Nā maʻi Autoimmune, e like me antiphospholipid syndrome (APS)
• Nā kīnā hānau e hoʻopili i ka tract reproductive
• Ka maʻi ʻaʻai a i ʻole tumo
• Nā maʻi maʻi
• Diabetes
• Ke inu nui nei i ka waiʻona
• Hoʻoikaika nui loa
• Nā maʻi ʻai a i ʻole ka meaʻai maikaʻi ʻole
• Nā ulu (e like me fibroids a i ʻole polyps) i loko o ka kōpū a me ka cervix
• ʻO nā lāʻau e like me nā lāʻau chemotherapy
• Hbalone kaulike ʻole
• Kaumaha a kaupaona ʻole paha
• Makahiki
• Ovarian cista a me polycystic ovary syndrome (PCOS)
• ʻO ka maʻi pelvic e hopena ana i ka scarring a i ʻole ka pehu ʻana o nā paipu fallopian (hydrosalpinx) a i ʻole nā ​​maʻi pelvic inflammatory (PID)
• ʻO ka scarring mai ka maʻi i lawe ʻia i ka moekolohe, ka ʻōpū o ka ʻōpū a i ʻole endometriosis
• Puhipaka
• ʻOki e pale aku hāpai keiki (tubal ligation) a i ʻole hoʻokō ʻole o ka hoʻohuli tubal ligation (reanastomosis)
• Maʻi thyroid

INFERTILITY KANAKA

Pili paha ka male ʻole kāne i:

• Hoʻoemi i ka helu o ka sperm
• Ālai e ālai ai i ka sperm mai ka hoʻokuʻu ʻia
• Nā kīnā i ka sperm

Hiki ke hoʻokumu ʻia ka male kāne ʻole e:

• Hewa hānau
• Nā mālama maʻi ʻaʻai, me chemotherapy a me radiation
• Hōʻike i ka wela nui no nā kau lōʻihi
• Hoʻohana nui i ka ʻalekohola, mariuana, a i ʻole cocaine
• Hormone kaulike ʻole
• Impotence
• Maʻi kīnā
• ʻO nā lāʻau e like me cimetidine, spironolactone, a me nitrofurantoin
• Ka momona
• Makahiki
• Ejaculation hoʻopau
• Scarring mai nā maʻi i loaʻa i ka moekolohe (STI), ʻeha, a ʻokiʻoki paha
• Puhipaka
• Nā Toxin i ke kaiapuni
• Vasectomy a i ʻole kūleʻa o ka hoʻohuli vasectomy
• Mōʻaukala o ka maʻi maʻi testicular mai nā puʻupuʻu mai

ʻO nā kāne olakino ma lalo o 30 mau makahiki i loaʻa ka moekolohe ma kahi o 20% i kēlā me kēia mahina ke hāpai i kēlā me kēia mahina.

ʻOi aku ka momona o ka wahine i 20 mau makahiki. ʻO ka manawa e hiki ai i ka wahine ke hāpai hāpai ke hāʻule nui ma hope o nā makahiki 35 (a ma hope hoʻi o ka makahiki 40). ʻO ka makahiki ke hoʻomaka ka hāʻule o ka momona mai ka wahine a ka wahine.

Hoʻonui nui nā pilikia infertility a me nā helu hāʻule hāʻule ma hope o 35 mau makahiki. Aia i kēia manawa nā koho no ka loaʻa ʻana o ka hua manu mua a me ka mālama ʻana no nā wahine i ko lākou 20 mau makahiki. E kōkua kēia i ka hāpai ʻana i kahi hāpai kūleʻa inā hoʻopaneʻe ʻia ka hānau keiki ʻana a hiki i ka hala ʻana o ka makahiki 35. He koho pipiʻi kēia. Eia nō naʻe, noʻonoʻo paha nā wahine ʻike pono lākou e hoʻopaneʻe i ka hānau keiki ʻana.

Ke hoʻoholo nei i ka manawa e mālama ʻia ai no ka infertility pili i kāu makahiki. Hōʻike nā mea lawelawe olakino i nā wahine ma lalo o 30 e hoʻāʻo e hāpai i kā lākou iho no 1 makahiki ma mua o ka hoʻāʻo ʻana.

Pono nā wahine ma luna o 35 e hoʻāʻo e hāpai no 6 mau mahina. Inā ʻaʻole ia e kū i loko o kēlā manawa, pono lākou e kamaʻilio me kā lākou mea hāʻawi.

Pili ka hoʻāʻo ʻana i ka moʻoʻōlelo olakino a me ka hoʻokolohua kino no nā hoa ʻelua.

ʻO nā hoʻokolohua koko a me nā kiʻi e pono pinepine ai. I nā wahine, komo pū paha kēia mau mea:

• Nā ho'āʻo koko e nānā i nā pae hormone, e like me ka progesterone a me ka follicle stimulate hormone (FSH)
• ʻImi ʻike kime ovulation kit
• Ana o ke ana wela o ke kino i kēlā me kēia kakahiaka e ʻike inā e hoʻokuʻu ana nā ovaries i nā hua
• FSH a me ka hoʻāʻo hoʻopiʻi clomid
• Ke ho'āʻo nei i ka hormone Antimullerian (AMH)
• Hysterosalpingography (HSG)
• Pelvic ultrasound
• Laparoscopy
• Nā hoʻāʻo ʻana o ka hana thyroid

Hoʻokomo ʻia paha nā hoʻāʻo ʻana i nā kāne:

• Hōʻike Sperm
• ʻO ka hoʻāʻo o nā testes a me ka peni
• ʻO Ultrasound o nā genital kāne (hana ʻia i kekahi manawa)
• Nā ho'āʻo koko e nānā i nā pae hormonone
• ʻO ke biopsy testicular (hana pinepine ʻole ʻia)

Kaukaʻi pili i ke kumu o ka infertility. Pili paha ia:

• Ke aʻo a me nā ʻōlelo aʻo e pili ana i ke kūlana
• Nā mālama hānau e like me ka intrauterine insemination (IUI) a me ka vitro fertilization (IVF)
• Nā lāʻau lapaʻau e mālama ai i nā maʻi a me nā maʻi hōʻulu
• ʻO nā lāʻau e kōkua i ka ulu a hoʻokuʻu ʻana o nā hua manu mai nā ovaries

Hiki i nā kāne ke hoʻonui i ka manawa o ka hāpai ʻana i kēlā me kēia mahina e ka moekolohe ma ka liʻiliʻi ma kēlā me kēia 2 lā ma mua a i ka wā o ka ovulation.

Kū ka ovulation ma kahi o 2 mau pule ma mua o ka hoʻomaka ʻana o ka pōʻaiʻe hope (manawa) e hiki mai ana. No laila, inā loaʻa ka manawa i ka wahine i kēlā me kēia lā 28 mau lā e moekolohe ka wahine ma ka liʻiliʻi ma kēlā me kēia 2 lā ma waena o ka 10 a me ka 18th lā ma hope o ka hoʻomaka ʻana o kāna wā.

ʻO ka moekolohe ma mua o ka hanana ʻana he kōkua nui ia.

• Hiki i ka Sperm ke noho i loko o ke kino o ka wahine ma kahi o 2 mau lā.
• Eia nō naʻe, hiki ke hoʻoulu ʻia ka hua manu o ka wahine e ka sperm ma waena o 12 a 24 mau hola ma hope o ka hoʻokuʻu ʻia.

Hiki i nā wahine ma lalo a i ʻole ka paona ke hoʻonui i ko lākou manawa o ka hāpai ʻana ma ke kiʻi ʻana i ke kaupaona olakino.

He nui ka poʻe e ʻike he mea kōkua ke komo pū i nā hui kākoʻo no ka poʻe me nā hopohopo like. Hiki iā ʻoe ke noi i kāu mea hāʻawi e paipai i nā hui kūloko.

ʻO ka nui o 1 i loko o 5 mau kāne i ʻike ʻia me ka infertility e hāpai a hāpai ʻole ʻia.

ʻO ka hapa nui o nā kāne me ka hānau ʻole e hāpai ma hope o ka mālama ʻana.

Kāhea i kāu mea hāʻawi inā ʻaʻole hiki iā ʻoe ke hāpai.

ʻO ka pale ʻana i nā STI, e like me ka gonorrhea a me ka chlamydia, hiki ke hōʻemi i kāu makaʻi o ka infertility.

ʻO ka mālama ʻana i ka papaʻai olakino, ke kaupaona, a me ka nohona e hoʻonui ai i kou manawa o ka hāpai ʻana a me ka hāpai hāpai olakino.

ʻO ka pale ʻana i ka hoʻohana ʻana o nā lubricants i ka wā o ke kāne ke kōkua i ka hoʻomaikaʻi ʻana i ka hana sperm.

Hiki ʻole ke hāpai; ʻAʻole hiki ke hāpai

• Pelvic laparoscopy
• Anatomia hānau wahine
• Anatomia hānau kāne
• Infertility mua
• Sperma

ʻO Barak S, ʻo Gordon Baker HW. Ka hoʻokele hoʻokolohua o ka male ʻole male kāne. I: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Makua a Pediatric. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2016: chap 141.

Broekmans FJ, Fauser BCJM. Hoʻokomo wahine: ka loiloi a me ka hoʻokele. I: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Makua a Pediatric. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2016: chap 132.

ʻO Catherino WH. Endocrinology Reproductive a me infertility. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 223.

Lobo RA. Infertility: etiology, diagnostic loiloi, hoʻokele, wānana. I: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Gynecology Comprehensive. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 42.

Komite Hoʻomaʻamaʻa o ka ʻAmelika Hui Pū ʻIa no ka Laʻi Hana Hou. ʻO ka loiloi diagnostic o ka wahine hū ʻole: ka manaʻo o ke kōmike. Fertil Steril. 2015; 103 (6): e44-e50. PMID: 25936238 www.ncbi.nlm.nih.gov/pubmed/25936238.

Komite Hoʻomaʻamaʻa o ka ʻAmelika Hui Pū ʻIa no ka Laʻi Hana Hou. ʻO ka loiloi diagnostical o ke kāne infertile: kahi manaʻo o ke kōmike. Fertil Steril. 2015; 103 (3): e18-e25. PMID: 25597249 www.ncbi.nlm.nih.gov/pubmed/25597249.