Mob txaij tsis yog ib kab lus. Nws yog assumed tias ib tug ntawm tsib tug poj niam uas npaj muaj me nyuam muaj teeb meem nrog qhov pib xeeb tub. Tab sis feem coob ntawm lawv tus thiaj li ua tiav. Kho cov kev kho mob tam sim no thiab kev kho mob zoo los pab daws qhov teeb meem xws li kev tsis taus thiab ntxiv lawm tshob.
Thaum twg yog lub sijhawm mus ntsib kws kho mob?
Raws li txoj cai, ib tug poj niam cev xeeb tub hauv ib xyoos tom qab pib ntawm kev sib deev tsis tas siv cov tshuaj tiv thaiv kab mob. Yog tias lub sijhawm tsis ua haujlwm hauv koj lub siab (koj muaj hnub nyoog tshaj 30 xyoo thiab koj tsis tau xeeb tub, koj tau muaj teebmeem los ua haujlwm rau yav dhau los), tom qab lub sijhawm no, tsis txhob tos mus ntsib ib tus gynecologist specializing rau kev kho mob ntxiv lawm tshob. Yog tias cov poj niam hluas, cov kev sib ntsib tuaj yeem muab ncua sij hawm rau ib xyoos. Ntau cov khub niam txiv ua niam txiv tsis muaj kev pabcuam kev mob nkeeg rau xyoo ob ntawm kev sib koom tes kom tau tus menyuam.
Nco ntsoov tias lub neej yog tsim ua ke, yog li ntawd mus rau tus kws kho mob koj yuav tsum mus nrog tus khub. Yog tias koj tus txiv yaum kom koj hu ua ntej koj tus kheej - yaum kom nws tsis yog. Ntau tus txiv neej txiav txim siab mus rau tus kws kho mob nyuaj heev. Lawv xav txog kev kuaj mob, ntseeg tias qhov no yog ib lub tswv yim phem heev. Raws li kws txawj, txog li 15% ntawm cov niam txiv sib yuav muaj teeb meem los ua cev xeeb tub. Muaj ob peb lub hauv paus rau qhov no, thiab qee zaus qhov laj thawj yog rau ob leeg koom tes. Ib qho ua rau kev kho mob tsis ua hauj lwm yog qhov tseem ceeb ntawm ib qho teeb meem. Tab sis koj yuav tsum nco ntsoov nrhiav cov kev daws tshiab uas tsis muaj teebmeem tomqab kho tas. Lub sijhawm mus, thiab lub sijhawm ntawm tus kabmob no tsis yog infinite.
Txiv neej ntxiv lawm tshooj yog vim li cas thiaj li yuav luag ib nrab ntawm cov khub niam txiv, thiab raws li kws txawj, cov yeeb yam no tseem tuaj yeem pheej loj. Kev kuaj ntawm cov neeg koom tes yuav tsum tau nqa tawm ib txhij. Phem ecology, tsis ncaj ncees lawm txoj sia ntawm lub neej ua rau lub fact tias cov kab mob ntxiv lawm tshua yog nce rau cov neeg sawv cev ntawm ob leeg.
Kuv tuaj yeem tau txais kev pab?
Koj tuaj yeem mus rau lub gynecologist hauv lub tsev kuaj mob, thiab nws yuav, yog tias tsim nyog, coj koj ntxiv. Qhov kev txiav txim siab mus kuaj thiab kho mob ntxiv yog feem ntau yog los ntawm ib tug gynecologist thiab endocrinologist, thiab tus kws kho mob txog hormonal mob rau cov txiv neej andrologist (tus kws kho mob rau cov kab mob ntawm cov txiv neej deev) lossis urologist (tus kws kho mob hauv cov kab mob ntawm cov kab mob genitourinary system).
Yog tias koj muaj lub sijhawm (nrog rau nyiaj txiag) - nws yog qhov zoo tshaj rau kev kho mob ntxiv txog kev mob ntxiv hauv chaw kho mob. Muaj cov kws pab tswv yim tshwj xeeb, kws tshawb fawb thiab tshuaj ntsuam xyuas kev tshawb fawb, txhua tus ntawm ib qho chaw. Kev kuaj mob thiab kev kho mob yuav ua kom zoo dua thiab koj yuav cawm ntau lub sijhawm. Thaum koj pom tias koj txoj hauj lwm tsis tseem ceeb, koj yuav zaum kawg nrog ib lossis ob qho kev mus ntsib ntawm ib qho kev siv nyiaj tsawg. Yog hais tias muaj teebmeem loj, nws yuav ua rau tus kws kho mob siab ntseeg yuav coj koj mus rau txhua theem kev kho mob kom zoo siab kawg.
Cov lus nug ntawm cov peev txheej ntawm qhov kev tshawb fawb thiab kev kho mob yog nce rau hauv cov tsev kawm ntawv ntiav raws li kev pom zoo nrog cov nyiaj. Ntau cov ntaub ntawv tseem ceeb, suav txog qhov chaw zov me nyuam zoo tshaj plaws nyob rau hauv cheeb tsam koj nyob thiab kev xav ntawm cov kws kho mob koj tuaj yeem nrhiav tau hauv lub Koom Haum rau Kev Kho Mob ntawm Kev Tiv Thaiv.
Nco ntsoov tias qhov teeb meem zoo li kev kho mob ntxiv lawm, nws yog ib qho tseem ceeb rau kev ntseeg tsuas yog ib tus kws kho mob uas txawj ntse xwb. Yog li no, txhua yam yog qhov tseem ceeb no - thiab cov tswv yim ntawm lwm tus neeg mob, thiab txawm tias koj lub tswv yim thawj zaug. Tsis txhob tos kom nug tus kws kho mob kom paub txog nws cov kev tsim nyog - qhov no yog koj txoj cai.
Tus poj niam mob li cas?
Cov kws tshaj lij tawm: tsis muaj ib qho laj thawj rau kev ntsuam xyuas ntawm koj tus menyuam qhov kev ua tiav ntev dua li peb lub hlis. Tib lub sijhawm, yog koj nrog cov kws tshaj lij, koj tuaj yeem pom txhua yam thiab txiav txim siab seb yuav ua licas. Cov kws kho mob feem ntau muaj kev sib tham zoo nrog lawv cov niam txiv yav tom ntej kom paub tseeb txog qhov teeb meem. Qhov no tsis hloov lub fact tias qhov tsis txaus. Qhov no yog qhov yuav tsum tau ua kom tiav cov ntsiab theem ntawm kev kuaj mob.
Hauv cov pojniam, tus kuaj xam nrog kev kuaj ginecological, ultrasound xeem ntawm patency ntawm lub plab roj hmab, laparoscopic xeem. Cov tom kawg tau tso cai rau koj xyuas seb qhov ua kom tsis muaj ntxiv lawm yog qee tus mob hnoos qog - qhov muag los yog endometriosis. Yog tias tus kws kho mob soj ntsuam teeb meem hauv lub uterine kab noj hniav, xws li polyps, nws tuaj yeem xav kom tso sonography los yog ultrasound tom qab hno tshuaj los ntawm ib lub catheter. Qhov kev tshawb fawb no yog pheej yig thiab tsis mob.
Ib qho tseem ceeb ntawm kev kuaj mob yog lub ntsiab lus ntawm lub sij hawm ntawm ovulation thiab nws cov kev zoo. Cov kev tshawb nrhiav ntawm ovulation no yog nrov heev, tab sis tsis muaj qhov tseem ceeb yog kev soj ntsuam ntawm ncauj tsev menyuam. Rau lub hom phiaj no, tsis yog tsuas yog ib qho kev ntsuas ultrasound, tab sis, saum toj no tag nrho, kev kuaj ntawm hormonal mus ntsuam xyuas cov kev ua haujlwm ntawm cov thyroid caj pas. Cov theem ntawm androgens, kev ua haujlwm ntawm adrenal thiab kev ua haujlwm ntawm tus pojniam ntawm tus pojniam yog tus xyuas.
Yuav tsum kuaj kab mob bacteriological. Kab mob kis tus kab mob yog ib qho ua rau mob ntxiv, tiam sis tseem tshuav nyob hauv peb lub teb chaws. Nws yog tsim nyog los tshem tawm cov kab mob xws li chlamydia. Lub niaj hnub "smear" tsis txaus - yuav tsum kuaj tshwj xeeb, uas ua rau nws soj ntsuam cov tshuaj tiv thaiv ntawm cov tshuaj microbes.
Tsawg heev, tag nrho cov kev tshawb fawb no tsis muab lo lus teb hais txog qhov ua rau ntxiv lawm tshob. Yog tias koj thiab koj tus khub muaj kev noj qab nyob zoo, cov kws kho mob qee zaum xav kom kawm ntxiv txog kev tshuaj ntsuam genetic and immunological. Tej teeb meem no tshwm sim txij li ib ntus zuj zus, nkag mus rau cov kev tshawb fawb tau yooj yim, thiab lawv cov nqi raug qis dua. Tab sis qhov tshwm sim yog tsim nyog nws.
Qhov feem ntau ua rau poj niam ntxiv lawm tshob
Feem ntau ultrasound thiab kuaj ntshav yuav pab nrhiav tau qhov ua rau mob ntxiv lawm tshob. Nyob rau hauv 30-35% ntawm cov neeg mob, poj niam ntxiv lawm tshuam yog txuam nrog tubal occlusion, thiab lwm 25% yog txuam nrog hormonal ntshawv siab. Qhov ua rau tus kab mob tubal, raws li txoj cai, yog cov kab mob ua rau muaj kab mob venereal, xws li chlamydia los yog gonorrhea. Mob los yog muaj mob muaj peev xwm ua tau rau kev tsim ntawm cirrhosis, qhov tsim tawm ntawm kev mob thiab txawm tias tubal atresia.
Hormonal mob ntawm kev ua rau me nyuam yaus uas muaj kev tsis taus ntawm ovulation los yog tsis tsim nyog ntawm ovulation (lub keeb tsis tawg, lub qe tsis tso tawm thaum lub sijhawm ntawm ovulation). Kuj muaj cov tsos mob ntawm tus kab mob uas muaj kab mob hu ua polycystic syaryrome. Hauv kev zes qe menyuam, muaj ntau tshaj ntawm cov txiv neej cov tshuaj hormones, uas ua rau yus tuag ntawm cov hauv paus thiab tsim cov hlwv. Lwm qhov teeb meem yog hyperprolactinemia (qib siab prolactin theem), uas tuaj yeem ua rau amenorrhea. Nws kuj tseem tuaj yeem cuam tshuam rau qog qog nqaij tawv, txo kev tso pa ntawm progesterone rau cov poj niam, tiv thaiv kev loj hlob ntawm lub embryo.
Hormonal tsis txaus ua rau ntau yam, feem ntau txuam nrog kev ua neej. Kev noj haus, nyhav nyhav, kev nyuab siab, kev quav dej caw thiab kev ua kis las yuav ua rau txhua tus "ua kom tsis muaj nuj nqis" tshiab rau cov menyuam. Kev tsis zoo kuj tseem ua rau kev cuam tshuam rau kev ua haujlwm ntawm cov thyroid caj pas, pituitary gland thiab adrenal qog.
Cov neeg ua haujlwm ntawm lub cev tsis muaj zog (lossis lwm yam hauv kev txo cov txiaj ntsig qis) yog qee zaum endometriosis. Tus kab mob no yog txuam nrog lub implantation ntawm tawg tsam ntawm qhov kawg ntawm lub plab (qhov mucous membrane ntawm lub tsev menyuam) rau hauv nruab nrog cev ntawm lub plab kab noj hniav. Endometrium nyob rau hauv qhov chaw thiab tib txoj kev raws li kev hloov pauv hauv lub tsev menyuam. Nws nthuav, ua rau mob thiab caws pliav. Nws yog qhov nyuaj tshaj plaws kom cev xeeb tub yog tias qhov mob ntawd ntsig txog kev lag luam ntawm lub zes qe menyuam los yog cov hlab ntaws.
Qee lub sij hawm qhov ua rau ib ntus kis mus rau lwm tus yog cov kws kho mob ntau yam tshuaj siv los kho cov kab mob, tshwj xeeb yog tshuaj tua kab mob, cov tshuaj hormones, thiab cov tshuaj tua kab mob thiab kev quav tshuaj. Ntawm lawv yog cov uas tsis muaj daim ntawv sau tshuaj (xws li tshuaj aspirin thiab ibuprofen, yog hais tias noj hauv nruab nrab ntawm ovulation). Qee zaus ntxiv lawm tshob yog ua los ntawm cov tshuaj tua kab mob thiab cov tshuaj antitumor uas tuaj yeem ua rau hauv cov hauv paus.
Lwm yam ua rau mob ntxiv rau cov poj niam, raws li txoj cai, yog ib co mob nyob rau hauv qhov tsim tawm ntawm cov plab hnyuv siab raum. Cov no muaj xws li cov teeb meem ntawm lub tsev menyuam thiab ntawm chaw mos, nrog rau txhua hom mob hauv hlwb thiab postoperative adhesions hauv plab kab noj hniav thiab plab mog. Tiag tiag tsim nyog saib xyuas lub ncauj tsev me me. Qhov sib npaug ntawm qhov kev mob hnyav nyob rau hauv cov poj niam yog feem ntau txuam nrog kev hloov hauv lub cev ntawm lub tsev menyuam. Feem ntau ib qho kev sib thooj muaj feem cuam tshuam nrog txoj haujlwm ntawm lub ncauj tsev menyuam. Nyob rau hauv ib txwm ua, nws yog tsom tom phab ntsa tom qab ntawm lub paum. Cov kev hloov nyob rau hauv txoj hauj lwm ua rau nws nyuaj rau kev hu rau cov txiv neej poj niam ncauj tsev menyuam.
Qhov ua kom tsis ntog yog qee zaum mob ntawm ncauj tsev menyuam. Nws cuam tshuam cov khoom ntawm ncauj tsev menyuam hnoos, ua nws yog "tus yeeb ncuab" ntawm cov phev. Qhov no feem ntau yuav hloov pauv acidity thiab muaj cov phev ntau qhov tua kab. Yog li ntawd, lawv tsis muaj caij nyoog los ua tiav lawv lub hom phiaj.
Ntev txog kev kho mob
Nws yog lub tswvyim hais ua dabneeg hais tias cov kws kho mob yuav luag txhua tus me nyuam los ntawm kev sim tshuaj. Hom no yog suav tias yog kev ntsuas huab. Feem ntau cov tshuaj siv yog tsim los tshem tawm hormonal ntshawv siab, los yog tua tus kab mob. Qee zaus kev kho mob yog tsim nyog: feem ntau yog laparoscopic, uas txawm kho los ntawm kev kho mob ntawm zes qe menyuam yaus lossis lub tsev menyuam, qog nqaij hlav endometrial, los yog kom tshem tawm lwm qhov kev cuam tshuam hauv cov kev ua me nyuam.
Thaum kuaj "kev puas hlwb ntawm kev ua rau me nyuam yaus" tsis tuaj yeem qhia qhov ua rau tsis zoo, thiab qhov kev txhawb nqa yog qhov tsim nyog (piv txwv li, thaum yug yav tom ntej yog thaum muaj hnub nyoog laus) - tom qab ntawd yuav tau siv tshwj xeeb. Koj yuav tsum tau mus ntsib kws kho mob los soj ntsuam qhov ua tau zoo ntawm txoj kev kho mob. Yog tias tsis muaj dab tsi pab, txhais tau tias kim tsis muaj zog - koj tuaj yeem tham txog qhov xav tau IVF.
Nyob rau qib no, qee cov kws kho mob qhia txog ib qho kev ua kom tsis haum. Phev txhaj tshuaj ntawm tus khub yog siv lub catheter tshwj xeeb, ncaj qha rau hauv tsev menyuam. Nws yog pheej yig dua nyob rau hauv vitro, thiab yog ncajncees thaum muaj teebmeem nrog lub ncauj tsev menyuam thiab phev ntawm tus khub. Nyob rau tib lub sijhawm, nws yuav tsum nco ntsoov tias nws qhov kev ua tau zoo, txawm nyob hauv cov kev tshawb fawb zoo tshaj plaws, tsis pub tshaj 15%.
Txoj kev ntawm IVF
Qhov kev txiav txim siab siv nyob rau hauv vitro fertilization yuav tsum yog raws li qhov tseeb mob. Yog hais tias qhov kev pabcuam thaum ub tau ua dhau ntawm qhov kev txwv rau cov neeg koom tes, nrog rau cov pojniam uas muaj hnub nyoog tshaj li ntawm 35 xyoos, yuav ua phem rau qhov kawg ntawm kev yug menyuam. Feem ntau, txoj kev IVF tsis pom zoo rau cov poj niam hnub nyoog yau dua 35 xyoos nrog kev tsis taus thiab ntxiv lawm tshob.
Qhov no yog raws li xaiv nyob rau hauv lub kuaj ntawm artificially impregnated ovules thiab lawv qhia txog rau hauv lub tsev menyuam. Yog li ntawd, yuav tsum tau npaj kom muaj embryo rau hauv lub tsev menyuam, bypassing txhua theem ntawm natural fertilization. Cov hauj lwm zoo ntawm txoj kev kwv yees kwv yees txog 30% piv nrog cov qauv kev cai ntawm kev cai.