Nekuti mapatya anonakidza, kune vamwe vakaroora, nemapatya kurota. Asi zvinogoneka here kupesvedzera zvisikwa uye kuwedzera mikana yako yekuve nepamuviri paviri?

Tinofanira kusiyanisa marudzi maviri epamuviri epamuviri, anoenderana neaviri akasiyana biological phenomena:

• mapatya akafanana kana monozygotic mapatya kubva pazai rimwe chete (mono zvichireva kuti “rimwe”, zyogote “zai”). Zai rakasangana nembeu rinozvara zai. Zvakadaro, zai iri, nekuda kwezvikonzero zvisati zvazivikanwa, richapatsanurwa kuita maviri mushure mekusangana. Mazai maviri anobva akura, achipa vana vaviri vanenge vari mudumbu vakatakura mageneti akafanana. Vacheche vachave vepabonde uye vachataridzika zvakafanana, saka izwi rokuti "mapatya chaiwo". Nechokwadi misiyano mishomanana nekuda kweizvo masayendisiti anodana phenotypic mismatch; pachayo mhedzisiro ye epigenetics, kureva nzira iyo nharaunda inopesvedzera nayo kutaura kwemajini;
• mapatya ehama kana dizygotic mapatya kubva mazai maviri akasiyana. Panguva imwe cheteyo, mazai maviri aibudiswa (anopesana nerimwe chete) uye rimwe nerimwe remazai aya rinosangana panguva imwe chete nembeu yakasiyana. Kuva mhedzisiro yekusangana kwemazai maviri akasiyana uye maviri akasiyana spermatozoa, mazai haana genetic nhaka. Vacheche vanogona kunge vakafanana kana kuti vakasiyana pabonde, uye vanotaridzika zvakafanana sevana vanobva kune vamwe vanin'ina.

Chikamu chimwe kubva muzana chenhumbu dzepanyama imimba yemapatya (1). Zvimwe zvikonzero zvinogona kuita kuti nhamba iyi isiyane, asi zvakare, zvakakosha kusiyanisa pakati pe monozygous pamuviri uye dizygotic pamuviri.

Monozygous pamuviri kashoma: inobata 3,5 kusvika 4,5 pa1000 yekuzvarwa, zvisinei nezera raamai, kurongeka kwekuzvarwa kana nharaunda. Pamavambo enhumbu iyi pane kupera simba kwezai iro rinozopatsanurana mushure mekusangana. Ichi chiitiko chinogona kunge chakabatana nekuchembera kweiyo ovum (iyo, zvisinei, haina hukama nezera raamai). Inocherechedzwa pamatanho marefu, nekunonoka ovulation (2). Saka hazvibviri kutamba pachinhu ichi.

Sezvineiwo, zvinhu zvakasiyana zvinokanganisa mukana wekuita dizygotic nhumbu:

• Zera raamai: chikamu che dizygotic twin pamuviri chinowedzera zvishoma nezvishoma kusvika pazera remakore 36 kana 37 kana rasvika pakakwirira. Inobva yadzikira nekukurumidza kusvika pakuguma. Izvi zvinokonzerwa nehuwandu hwehomoni yeFSH (follicle stimulating hormone), iyo inowedzera zvishoma nezvishoma kusvika kumakore 36-37, ichiwedzera mukana wekuwandisa ovulation (3);
• kurongeka kwekuzvarwa: pazera rimwe chete, chiyero chemapatya ehama chinowedzera nenhamba yemimba yapfuura (4). Kusiyana uku hakukoshi pane kuya kwakabatana nezera raamai;
• kusarongeka: kune mhuri uko mapatya anowanzoitika, uye mapatya ane mamwe mapatya kupfuura vakadzi muhuwandu hwevanhu;
• dzinza: iyo dizygotic twinning rate yakapetwa kaviri muAfrica kumaodzanyemba kweSahara kupfuura muEurope, uye yakapetwa kashanu kusvika kuChina kana Japan (5).

Nekukwira kweART, chikamu chenhumbu dzemapatya chakawedzera ne70% kubva kutanga kwema1970. Zvikamu zviviri muzvitatu zvekuwedzera uku kunokonzerwa nekurapa kushaya mbereko uye chetatu chasara kuderera kwepamuviri. zera rekusununguka kwekutanga (6).

Pakati pemaitiro eART, akati wandei anowedzera mukana wekuwana mapatya pamuviri nenzira dzakasiyana:

IVF Kuendesa mazai akawanda panguva imwe chete kunowedzera mikana yekuva nemimba yakawanda. Kuti kuderedze njodzi iyi, kuderera kwehuwandu hwema embryo anotamiswa nekutamiswa kwave kuchicherechedzwa kwemakore akati wandei. Nhasi, chibvumirano ndechekuendesa huwandu hwema embryos maviri - kashoma matatu kana paine kutadza kudzokororwa. Nokudaro, kubva ku34% muna 2012, chiyero chemono-embryonic transfers mushure meIVF kana ICSI yakasimuka kusvika ku42,3% muna 2015. Zvisinei, mapatya ekuzvitakura pamuviri mushure meIVF anoramba akakwirira kupfuura mushure mekuita pamuviri. zvakasikwa: muna 2015, 13,8% yemimba inotevera IVF yakatungamirira kuberekwa kwemapatya ehama (7).

L'induction d'ovulation (iyo isinganyatso kuwira pasi pe AMP) Iyo yakapfava ovarian induction inotemerwa mune mamwe maovulation kusagadzikana ine chinangwa chekuwana nani emhando yekuzadza. Mune vamwe vakadzi, zvinogona kutungamirira kukusunungurwa kwemazai maviri panguva yekuvhara, uye kutungamirira kumimba yemapatya kana mazai ose ari maviri akabatanidzwa nembeu imwe.

Insemination yekugadzira (kana kuti intrauterine insemination IUI) Iyi nzira inosanganisira kuisa mbeu yakaorera zvakanyanya (kubva kune mudiwa kana kubva kune donor) muchibereko panguva yekuburitsa. Inogona kuitwa pachigadziro chechisikigo kana pamhepo inokurudzirwa ine ovarian stimulation, iyo inogona kutungamirira kune akawanda ovulation. Muna 2015, chikamu chegumi kubva muzana chenhumbu dzakatevera UTI zvakakonzera kuzvarwa kwemapatya ehama (10).

Frozen embryo transfer (TEC) Sezvakaita IVF, kudzikira kwenhamba yemaembryo anotamiswa kwakaonekwa kwemakore akati wandei. Muna 2015, 63,6% yeTECs yakaitwa ne embryo imwe chete, 35,2% nema embryo maviri uye 1% chete ne 3. 8,4% yenhumbu dzakatevera TEC zvakakonzera kuberekwa kwemapatya (9).

Mapatya anobva mumimba achitevera nzira dzeART mapatya ehama. Zvakadaro, pane zviitiko zvemapatya akafanana anokonzerwa nekupatsanurwa kwezai. Panyaya yeIVF-ICSI, zvinotoita sekuti mwero wepamuviri wemonozygous wakakwira kupfuura mukuzvara kwega. Shanduko nekuda kwekukurudzira kweovarian, in vitro tsika mamiriro uye kubata iyo zona pellucida zvinogona kutsanangura chiitiko ichi. Chidzidzo chakawanawo kuti muIVF-ICSI, mwero wepamuviri wemonozygous waive wakakwira nemaembryos akaendeswa kuchikamu cheblastocyst, mushure menguva refu (10).

• Idya zvigadzirwa zvemukaka Chidzidzo cheAmerica pamusoro pekugona kwepamuviri mapatya muvakadzi vegan kwakaratidza kuti vakadzi vanodya zvigadzirwa zvemukaka, kunyanya mhou dzakagamuchira majekiseni ekukura kwehomoni, dzaive dzakapetwa ka5 mukana wekuita mapatya kupfuura vakadzi. vakadzi vanodya miriwo (11). Kushandiswa kwezvigadzirwa zvemukaka kwaizowedzera kuvanzika kweIGF (Insulin-Like Growyh Factor) iyo inosimudzira maovulation akawanda. Yamu nembatatisi zvaizoitawo izvi, izvo zvinogona kutsanangura chikamu chepamusoro chepamuviri pemapatya pakati pevakadzi vemuAfrica.
• Tora vitamini B9 supplementation (kana folic acid) Iyi vhitamini inokurudzirwa pamberi-pamuviri uye pamuviri pekutanga kudzivirira musana bifida inogonawo kuwedzera mikana yekuva nemapatya. Izvi zvinoratidzwa neongororo yeAustralia iyo yakaona kuwedzera kwe4,6% mumapatya ekuzvitakura kwevakadzi vakatora vitamin B9 supplementation (12).