Ukungabi nenzalo

**Ukungabi nenzalo** ukwehluleka komuntu, isilwane noma isitshalo ukuzala ngezindlela zemvelo.Kuvamise hhayi isimo engokwemvelo umuntu omdala onempilo enhle, ngaphandle ephawuleka phakathi ezithile eusocial zinhlobo (ikakhulukazi haplodiploid izinambuzane). Kodwa-ke yisimo esinempilo sengane yomuntu noma enye inzalo encane, ngoba abakakutholi ukuthomba, isiqalo somzimba samandla okuzala .

## Incazelo

### eMelika
Enye incazelo yokungazali okuvame ukusetshenziswa kakhulu e-United States ngochwepheshe be-endocrinologists bokuzala, odokotela abasebenza ngokungabi nenzalo, ukubheka imibhangqwana efanelekile ukwelashwa yile:

* owesifazane ongaphansi kweminyaka engama-35 akakhulelanga ngemuva kwezinyanga eziyi-12 zokuya ocansini ngaphandle kokukhulelwa. Izinyanga eziyishumi nambili umkhawulo ophansi wesethenjwa we- *Time to Pregnancy* (TTP) yi-World Health Organisation. 
* owesifazane ongaphezu kweminyaka engama-35 akakaze akhulelwe ngemuva kwezinyanga eziyisithupha zokuya ocansini ngaphandle kokukhulelwa.

Lezi zikhathi zingabonakala ziguqulwa; lena yindawo lapho inqubomgomo yomphakathi ishaya khona isayensi.Umqondo ngukuthi kwabesifazane abangaphezu kweminyaka yobudala engama-35, njalo ngenyanga kubalwa futhi uma kwenziwa ukulinda ezinye izinyanga eziyisithupha ukufakazela isidingo sokungenelela kwezokwelapha, inkinga ingaba yimbi kakhulu.Okuhambisana nalokhu ukuthi, ngencazelo, ukwehluleka ukukhulelwa kwabesifazane abangaphansi kweminyaka engama-35 akubhekwa ngokuphuthuma okufanayo nakulabo abangaphezu kweminyaka engama-35.

### i-United Kingdom
E-UK, imihlahlandlela yangaphambilini ye-NICE ichaze ukungazali njengokuhluleka ukukhulelwa ngemuva kocansi olungavikelekile iminyaka emibili lapho kungekho khona i-pathology yokuzala eyaziwayo.Imihlahlandlela ebuyekeziwe ye-NICE ayifaki incazelo ethile, kepha incoma ukuthi "Owesifazane oseminyakeni yobudala yokuzala ongakhulelanga ngemuva konyaka ongu-1 wokuya ocansini lwesitho sangasese sowesifazane okungavikelekile, lapho kungekho sizathu esaziwayo sokuzala, kufanele anikezwe ukuhlolwa okuqhubekayo komtholampilo nophenyo kanye nomlingani wakhe, ngokudluliselwa phambilini kochwepheshe uma owesifazane engaphezu kweminyaka engama-36 ubudala. " 

### Ezinye izincazelo
Abaphenyi bavamise ukusungula izifundo zabantu ngokwanda kokungazali esikhathini esiyiminyaka emihlanu.  Izinkinga zokulinganisa ezisebenzayo, noma kunjalo, zikhona kunoma iyiphi incazelo, ngoba kunzima ukukala ukuvezwa okuqhubekayo engcupheni yokukhulelwa esikhathini seminyaka.

### Ukungabi nenzalo okuyisisekelo
Ukungabi nenzalo eyinhloko kuchazwa njengokungabikho kokuzalwa okuphilayo kwabesifazane abafisa ingane futhi asebevele benyunyana okungenani izinyanga eziyi-12, lapho bengasebenzisanga noma yiziphi izindlela zokuvimbela inzalo. I-World Health Organisation ibuye yengeze ukuthi 'abesifazane abakhulelwa ngokuzenzekelayo baphuphunyelwa yizisu, noma abakhulelwa okuholela enganeni ezelwe isanda kuzalwa, ngaphandle kokuthola ukuzalwa bukhoma kungabonisa ukungabi nenzalo'. 

Ukungabi nenzalo kwesibili kuchazwa njengokungabikho kokuzalwa okuphilayo kwabesifazane abafisa ingane futhi asebevele benyunyana okungenani izinyanga eziyi-12 selokhu bazalwa okokugcina, lapho bengasebenzisanga izinto zokuvimbela inzalo. 

Ngakho-ke isici esihlukanisayo ukuthi ngabe lo mbhangqwana wake wakhulelwa yini noma cha okwaholela ekuzalweni bukhoma.

### Abesilisa
Ukungabi nenzalo kowesilisa kuchazwa njengokwehluleka kowesilisa ukukhulelisa owesifazane okhulelwe, okungenani unyaka owodwa wokuya ocansini olungavikelekile.Kunezimbangela eziningi zokuzala kwabesilisa.Lokhu kufaka phakathi iziyaluyalu ze-endocrine (imvamisa ngenxa ye-hypogonadism) elinganiselwa ku-2% kuya ku-5%), ukuphazamiseka kokuthuthwa kwesidoda (njenge-vasectomy) ku-5%, ukukhubazeka okuyisisekelo kwamasende (okubandakanya amapharamitha wesidoda angajwayelekile ngaphandle kwembangela ebonakalayo) kuma-65% kuya I-80% ne- idiopathic (lapho owesilisa ongazaliyo enamapharamitha ejwayelekile wesidoda kanye nesidoda) ku-10% kuya ku-20%. 

### Ukungazali okuhlanganisiwe
Kwezinye izimo, bobabili owesilisa nowesifazane bangase bangabi nenzalo noma babe nenzalo encane, kanti ukungabi nalutho kwalaba bashadikazi kuvela ekuhlanganisweni kwalezi zimo.Kwezinye izimo, imbangela kusolwa ukuthi ingamasosha omzimba noma izakhi zofuzo; kungenzeka ukuthi umlingani ngamunye uzimele ngokuzimela kepha abashadayo abakwazi ukukhulelwa ndawonye ngaphandle kosizo.

### Imithi yokwelashwa
Uma izindlela zokwelashwa ezilondolozayo zihluleka ukufeza ukukhulelwa okugcwele, udokotela noma i-WHNP ingaphakamisa ukuthi isiguli singene kwi-vitro fertilization (IVF).I-IVF namasu ahlobene nayo (i- ICSI, ZIFT, GIFT ) abizwa ngamasu okusiza ubuchwepheshe bokuzala (i-ART).

Amanye amasu ezokwelapha isib. I-tuboplasty, ukusizwa okusizwayo, nokuxilongwa kofuzo kusengaphambili kokufakelwa.

#### Ukukhulelwa kwe-in vitro

IVF yi-ART esetshenziswa kakhulu. Kutholakale ukuthi kulusizo ekunqobeni izimo zokungazali, njengamashubhu avinjiwe noma alimele, i-endometriosis, ukwehluleka okuphindaphindiwe kwe-IUI, ukungazali okungaqondakali, ukugcinwa kwesibeletho okungafanele, isibalo sesidoda esibi noma esingelona neze.

#### Umjovo wesidoda se-Intracytoplasmic
Inqubo ye-ICSI isetshenziswa uma ngabe ikhwalithi yesidoda imbi, ukubalwa kwesidoda okuphansi noma imizamo yokukhulelwa ehlulekile phakathi nemijikelezo ye-IVF yangaphambilini.Le ndlela ifaka umjovo wesidoda esisodwa esinempilo esifakwe ngqo eqandeni elivuthiwe.Umbungu okhulelisiwe ube usudluliselwa esibelethweni.

### Ezokuvakasha
*Ukuvakasha kwenzalo* kungumkhuba wokuhambela kwelinye izwe ukuthola imishanguzo yenzalo.  Kungathathwa njengendlela yokuvakasha kwezokwelapha.izizathu eziyinhloko zokuvakasha kwenzalo yimithetho esemthethweni yenqubo efunwayo ezweni lasekhaya, noma intengo ephansi.Ukuvundiswa kwe-in-vitro nokusatshalaliswa kwabaxhasi yizinqubo ezinkulu ezihilelekile.

### Ukwelashwa kwe-stem cell
Kulezi zinsuku, kunezindlela zokwelapha eziningana (ezisahlolwa) ezihlobene nokwelashwa kwe- stem cell.Kuyithuba elisha, hhayi kuphela labalingani abanokushoda kwama-gametes, kepha futhi nakwabashadile bobulili obufanayo nabantu abangashadile abafuna ukuthola inzalo.Ngokwethiyori, ngalokhu kwelashwa, singathola ama-gametes okufakelwa *ku-vitro.*Kunezifundo ezahlukahlukene zabesifazane nabesilisa. 

* Ukufakelwa kwamaseli we-Spermatogonial stem: kuthatha indawo ku-tubul seminiferous. Ngalokhu kwelashwa, isiguli sizwa i-spermatogenesis, ngakho-ke, sinethuba lokuthola inzalo uma sifuna. Iqondiswe ngokukhethekile ezigulini zomdlavuza, isidoda sazo esonakaliswe ngenxa yokwelashwa kwe-gonadotoxic abakuthunyelwa. 
* Amaseli we-ovarian stem: kucatshangwa ukuthi abesifazane banenani elilinganiselwe lama-follicles kusukela ekuqaleni. Yize kunjalo, ososayensi bathole la maseli angama-stem, angaveza ama-oocyte amasha ezimweni zangemva kokubeletha.  Ngokusobala bangu-0.014% kuphela (lokhu kungaba yincazelo yokuthi kungani bengatholakalanga kuze kube manje).Kusekhona impikiswano mayelana nokuba khona kwabo, kepha uma okutholakele kuyiqiniso, lokhu kungaba yindlela entsha yokwelapha ukungabi nenzalo.

Ukwelashwa kwama-stem cell kusha ngempela, futhi konke kusaphenywa.Ngokwengeziwe, kungaba ikusasa lokwelashwa kwezifo eziningi, kufaka phakathi ukungatholi abantwana.Kuzothatha isikhathi ngaphambi kokuthi lezi zifundo zitholakale emitholampilo nasezigulini.