PMA (medical assisted procreation) kana kuti AMP (medical assisted procreation) zvinoreva nzira dzese dzinoshandiswa kubereka murabhoritari chikamu chechisikigo chekusangana uye kukura kwe embryo. Vanoita kuti zvibvire kubhadhara kushaya mbereko kunoitwa nemishonga kana kuti kudzivirira kutapurirwa kwezvimwe zvirwere zvakakomba.

Nhanho yekutanga mukubatsira kubereka nhanho ndeyekuita ongororo yekushaya mbereko kuitira kuona chingave chikonzero (s) chekushaya mbereko muvarume ne/kana vakadzi.

Panhanho yevaviri, iyo Hühner bvunzo (kana post-coital bvunzo) ndiyo yekutanga bvunzo. Inosanganisira kutora cervical mucus 6 kusvika 12 maawa mushure mekuita zvepabonde panguva ye ovulation uye kuiongorora kuti ive nechokwadi chehutano hwayo.

Muvakadzi, kuongororwa kwekutanga kunosanganisira:

• tembiricha curve yekuongorora nguva uye kujairana kwekutenderera pamwe nekuvapo kweovulation
• ongororo yekiriniki yekuona chero kukanganisa kwenhengo yesikarudzi
• kuongororwa kwehomoni kuburikidza nekuongorora ropa kuongorora kunaka kweovulation
• kuongororwa kwezvekurapa kwekufungidzira kucherechedzwa kwakasiyana-siyana (chibereko, machubhu, mazai). Ultrasound ndiyo yekuongorora mutsara wekutanga, asi inogona kuwedzerwa nedzimwe nzira (MRI, laparoscopy, hysteroscopy, hysterosalpingography, hysterosonography) yekuongorora kwakawanda.
• kuongororwa kwekiriniki kuti vaone kuvepo kwevaricocele, cysts, nodules uye zvimwe zvisiri izvo pamatanho akasiyana.
• kuongorora urume: kuongorora nhamba, kufamba uye kutaridzika kwembeu), tsika yembeu (kutsvaga utachiona) uye kutama kwembeu uye ongororo yekurarama.

Dzimwe bvunzo dzakadai sekaryotype kana endometrial biopsy inogona kuitwa mune mamwe mamiriro.

Muvarume, kuongororwa kwekushaya mbereko kunosanganisira:

 Zvichienderana nemigumisiro, mamwe mimwe miedzo inogona kurongerwa: hormone assays, ultrasound, karyotype, genetic examinations. 

Zvichienderana nechikonzero (s) chekushaya mbereko chawanikwa, nzira dzakasiyana dzekubatsira kubereka dzichapihwa kune vaviri ava:

• nyore ovarian kukurudzira kukurudzira zvirinani kunaka ovulation
• Kuiswa urume nembeu yemumwe (COI) kunosanganisira kubaya urume hwagara hwakagadzirirwa mugomba rechibereko pazuva rekuzvara. Iyo inowanzotangirwa nekukurudzira ovarian kuitira kuti uwane maoocyte emhando. Inopiwa mumamiriro ezvinhu ekushaya mbereko kusingatsananguriki, kukundikana kwekukurudzira ovarian, njodzi yehutachiwana, cervicalo-ovulatory infertility yemukadzi kana kushaya mbereko kwevarume.
• in vitro fertilization (IVF) inosanganisira kuberekazve nzira yekuberekesa muchubhu yebvunzo. Mushure mekusimudzirwa kwehomoni uye kutanga kwekuvhiya, follicles dzakawanda dzinoputirwa. Maoocyte uye spermatozoa anobva agadzirirwa murabhoritari uye anobva aiswa mundiro yetsika. Kana zvabudirira, embryo imwe kusvika kuviri inobva yaendeswa kuchibereko. IVF inopihwa kune nyaya dzekushaya mbereko kusingatsananguriki, kutadza kubereka, kusanganisa mbereko, zera raamai rakura, kuvharika kwechubhu, kutadza kwembeu.
• ICSI (intracytoplasmic jekiseni) inosiyana yeIVF. Fertilization inomanikidzwa ipapo: korona yemasero akapoteredza oocyte inobviswa kuitira kuti ijekese zvakananga mbeu yakasarudzwa kare mu cytoplasm yezai. Iyo micro-injected oocytes inozoiswa mundiro yetsika. Iyi nzira inopiwa mumamiriro ezvinhu ekushaya mbereko kwevarume.

Aya maitiro akasiyana anogona kuitwa nemupiro wemagametes.

• Kupihwa kwembeu kunogona kupihwa kana paine chechokwadi chekushaya mbereko kwechirume mumamiriro ekuiswa kwekugadzira nedonor sperm (IAD), IVF kana ICSI.
• Oocyte donation inogona kupihwa kana ovarian kutadza, kusarongeka mumhando kana kuwanda kwemaoocyte kana njodzi yekutapurirwa kwechirwere. Zvinoda IVF.
• Kugamuchira embryo kunosanganisira kuendesa embryo imwe kana anopfuura kubva kune vakaroorana vasisina chirongwa chevabereki, asi vanoda kupa "embryo" yavo. Mupiro uyu unogona kutariswa kana pakaitika kushaya mbereko kaviri kana njodzi yakapetwa kaviri yekutapurirwa genetic anomaly.

MuFrance, kubatsira kubereka kunodzorwa nemutemo webioethics n ° 2011-814 waChikunguru 7, 2011 (1). Inoisa pasi misimboti mikuru inotevera:

• AMP inochengeterwa vakaroorana vanoumbwa nomurume nomukadzi, vezera rokubereka vana, vakaroorana kana kuti vanokwanisa kuratidza kuti vakagara vose kweanenge makore maviri.
• gamete donation haizivikanwe uye yemahara
• kushandiswa kwe "amai vanotsiva" kana kuti kaviri gamete donation inorambidzwa.

Health Inishuwarenzi inovhara rubatsiro rwekubereka pasi pemamwe mamiriro:

• 
  mukadzi anofanira kunge ari pasi pemakore makumi mana nematatu ekuberekwa;
• kuvharika kunogumira ku4 IVF uye 6 inseminations. Muchiitiko chekuzvarwa kwemwana, kaunda iyi inodzoserwa kune zero.

MuQuebec, kubetserwa kubereka kunotongwa neFederal Law on Procreation ya20042 iyo inoisa pasi misimboti inotevera.

• vasina mbereko, vanhu vasina kuroora, ngochani, ngochani kana vanhu vakatapurirana vanogona kubatsirwa nekubatsirwa kubereka
• gamete donation ndeyemahara uye isingazivikanwe
• kuberekera mwana hakuzivikanwi nebumbiro remutemo. Munhu anozvara mwana anobva angove amai vemwana uye vanyoreri vanofanirwa kuita nzira yekurerwa kuti vave vabereki vepamutemo.

The Quebec Assisted Procreation Programme, iyo yakatanga kushanda muna August 2010, yakagadziridzwa kubva pakugamuchirwa, muna 2015, yemutemo wehutano unozivikanwa seLaw 20. Uyu mutemo unogumisa kuwanika kwekusununguka kwepurogiramu yekubatsira kubereka uye inotsiva iyo. ine mari shoma yemhuri yemutero wechikwereti system. Kuwanikwa kwemahara iko zvino kunochengetedzwa chete kana mbereko yakanganiswa (semuenzaniso kutevera chemotherapy) uye yekugadzira insemination.