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bUQfVZfyVh (Infertility) D;k gS \
tc unprotected intercourse ds ,d lky ckn Hkh xHkZ u Bgj ik;sA
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D;k bUQfVZfyVh vkSjrksa dh ijs'kkuh gS \
ugha] ;g ifr&ifRu nksuksa dh ijs'kuh gSA 35% vkSjrksa esa dkj.k gksrs gS vkSj 35% vkneh esa dkj.k gksrs gS 30% dk dkj.k irk ugha gksrkA
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MkWDVj dks fn[kkus ls igys fdrus le; rd dksf'k'k djuh pkfg;s \
;fn vki de ls de ,d lky rd xHkZ/kkj.k ugha dj ikrh gSA ijUrq ;fn vkidh mez 30 lky ls Åij gS] vkidks egkokjh nnZ iw.kZ gksrh gS ;k xHkZikr gksrk gS ;k egkokjh pØ vfu;fer gS ;k vkids ifr ds 'kqØk.kq la[;k de gSa rks vkidks MkWDVj ls igys lykg ysuh pkfg;sA
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egkokjh ds dkSu ls fnuksa esa L=h ds xHkZ/kkj.k gksus dh vf/kd lEHkkouk gksrh gS \
egkokjh (Period) dk 'kq: fnu igyk ¼1½ fnu gksrk gSA blds 14 osa fnu 14$/&2 fnu ij v.Mk cu tkrk gS tks fd 24 ?kaVs rd ftUnk (Active) jgrk gSA ;gh le; xHkZ/kkj.k ds fy;s cgqr mfpr jgrk gSA
• 'kqØk.k dh mez yxHkx 48 ls 72 ?kaVs gksrh gSA
• ekgokjh ds 10 osa ¼nlosa½ fnu ls 16 fnu rd xHkZ/kkj.k ds fy, laHkksx mfpr jgrk gSA
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IUI D;k gksrk gS vkSj bldh t:jr dc gksrh gSA
• Bhd vkSj vf/kd xfr okys 'kqØk.kqvksa dks IUI iz;ksx'kkyk esa concentrate djds L=h ds xHkkZ'k; esa igqapkukA
• bldh vko';drk ml le; gksrh gS
(a) tc 'kqØk.kqvksa d la[;k ;k xfr de gksrh gS ;k oh;Z ds ckgj vkus esa iq#"k esa dksbZ #dkoV gksA
(b) xHkkZ'k; ds eq¡g ij ikuh Bhd uk curk gksA
(c) L=h esa 'kqØk.kqvksa ds fo#) antibody cu x;s gksA
(d) vaMk cuus esa deh gksA
(e) L=h&iq#"k nksuksa dh tk¡ps Bhd gks (unexplained infertility)
IUI rHkh fd;k tk ldrk gS tc L=h esa de ls de ,d fallopian tube [kqyk gksA
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VsLV V~Vwc csch (IVF) D;k gksrk gS vkSj bldh vko';drk dc iM+rh gS \
• VsLV V~Vwc csch esa L=h ds vaMksa dks vYVªklkm.M e'khu ds lgkjs ckgj fudky dj mlds ifr ds 'kqØk.kqvksa ls 'kjhj ds ckgj Hkzw.k (Embryo) cukrs gSa vkSj nks ;k rhu fnu ckn fQj L=h ds xHkkZ'k; esa cSBk nsrs gSaA
• bldh vko';drk rc iM+rh gS %
(a) L=h ds nksuks uysa ¼¶yksfi;u V~Vwc½ cUn gksA
(b) xHkZ/kkj.k rhu ;k ckj ckj IUI djus ds ckn ugha gqvk gksA
(c) L=h&iq#"k nksuksa dh tk¡p Bhd gksA
(d) efgyk;sa tks izkS koLFkk ij gksa ;k ftudh ekgokj can gks pqdh gksA
(e) iq#"k esa 'kqØk.kqvksa dh xfr ,ao cukoV Bhd uk gksA
(f) L=h ,oa iq#"k ds 'kjhj esa 'kqØk.kqvksa ds fo#/k antibodies gksA
(g) Unexplained infertility
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IVF L=h dh dkSu lh mez esa lEHko gS \
IVF oSls rks fdlh Hkh mez esa mez fd;k tk ldrk gS ijUrq loksZÙke ifj.kkeksa ds fy;s 18 ls 40 lky dh mez es lgh gSA ¼mfpr mez 35 lky rd dh gksrh gS½ 38 lky dh mez ds ckn L=h esa v.Ms cuus de gks tkrs gSa vksj vPNs xq.koŸkk (Quality) okys v.Ms ugha curs gSA ijUrq vf/kd mez esa vFkok Menopause ds ckn Donor egge dk bLrseky fd;k tk ldrk gSA
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IVF fdruh ckj fd;k tk ldrk gS \
IVF oSls rks fdruh Hkh ckj djk;k tk ldrk gS tc rd nEifr mldk [kpZ lgu dj ldrd gSaA bldk [kpkZ izR;sd ckj yxHkx cjkcj gh iM+rk gSA ysfdu IVF de ls de yxHkx rhu ckj djkuk pkfg;s] ftlls fd xHkZ/kkj.k dh lEHkkouk c<+ tkrh gSA izFke ckj 20 ls 40 izfr'kr dh] nwljh ckj esa 35 ls 50 izfr'kr vkSj rhljh ckj yxHkx 60 izfr'kr rd xHkZ/kkj.k dh lEHkkouk gks tkrh gSA
¼uksV % lQyrk dk izfr'kr L=h dh mez ij T;knk fuHkZj djrh gS vxj mez de gksrh gS rks xHkZ/kkj.k dh izfr'kr T;knk gksrh gS vkSj T;knk mez esa de izfr'kr gksr gSA 40 lky dh mez ds ckn xHkZ/kkj.k dh izfr'kr 10 ls 15 izfr'kr rd jg tkrh gS½
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ICSI D;k gksrh gS vkSj bldh vko';drk fdlds fy, gS \
• bl VSfDud esa ,d vPNs xq.kork okys 'kqØk.kq dks ekbØkseSuhiqySVj }kjk ,d vPNs xq.korksa okys v.Ms ds vanj Inject fd;k tkrk gSA
• ;g esy bUQfVZfyVh dk fo'ks"k ikVZ gSA ftu iq#"k ds oh;Z esa 'kqØk.kqvksa dh la[;k ,oa xfr de gksrh gS] ijUrq budh cukoV Bhd gksrh gS
• nks ;k rhu ckj yxkrkj IVF djus ds ckn xHkZ/kkj.k u gksA
• blds Suces rate izFke ckj esa yxHkx 35 ls 50 izfr'kr gksrs gSA
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Hkzw.k (Embryo) dk Øk;ksfiztjos'ku D;k gksrk gS \
blesa cps gq;s vPNs xq.kork okys Embryo dks &1960 ij Store fd;k tkrk gS vkSj bUgsa ckn esa vxyh IVF cycle esa mlh L=h ¼;k vU; L=h bl Process dks djkuk pkfgrh gS½ ds xHkkZ'k; esa cSBk fn;k tkrk gSA ;k budks Embryo mu L=h ds xHkkZ'k; eas cSBk fn;k tkrk gS ftudh mez dkQh gksrh gS ;k v.Ms cuus cUn gks tkrs gSA
Step for IVF
1. Hormonal Treatment
(a) Down regulation : (Hormonal secretion from Hypothalamus & Pituitary gland are almost completely suppressed)
(b) Stimulation : (Stimulation Ovaries for formation of multiple eggs.)
2. TVS (USG) - Monitoring of growth of follicles for seeing the response of treatment.
3. Ovum pickup:
(a) Under short GA ¼csgks'kh esa½ (For 10 to 20 mts.)
(b) TVS USG. dh enn ls v.Ms Ovary esa ls Vagina ds jkLrs ls fudkys tkrs gSaA
Semen Sample collected and prepared and incubated withh eggs. (Eggs+Sperm.)
¯
Kept in CO2incubator for 2 to 3 days for Embryo development
4. Embryo Tramsfer (ET) :
vPNs xq.kork okys Embryo ¼2 ;k 3½ L=h ds xHkkZ'k; esa cSBk fn;s tkrs gSA
5. Pregnancy Testing : 14 ls 16 fnu ckn [kwu HCG dh ek=k ns[kh tkrh gSA