Ixabisa malini i-IVF?

Imfundo yezeMpilo

Yintoni i-IVF? | Iindleko ze-IVF | Ukuhlawulwa kweinshurensi | Inkxaso mali | Gcina imali kwiziyobisi zokuchuma

Ukuba unengxaki yokukhulelwa, awuwedwa. Iipesenti ezilishumi elinesithathu kwizibini ezitshatileyo eUnited States zineengxaki zokungachumi. Ukungachumi kuqhelekile kwaye kunokubangelwa liqela lezinto ezahlukeneyo ezifana nobudala, ixesha elingaqhelekanga, ukuveliswa kwesidoda okungaqhelekanga, okanye imeko yonyango yokuzala.

Ngethamsanqa, kukho iintlobo ezahlukeneyo zonyango lokungachumi kodwa i ezixhaphake kakhulu I-intrauterine insemination (IUI) kunye ne-vitro fertilization (IVF). Ngapha koko, phantse Mbini% ukuzalwa okuphilayo kwase-U.S ngonyaka kungumphumo wobuchwephesha bokuncedisa ekuzaleni-eyona ndlela iphambili yi-IVF. Kwakukho abantwana abangama-81,478 abazalwa ngo-2018 ngenxa yezi ndlela.

Yintoni i-IVF?

Inkqubo ye-IVF yelebhu eyahlukeneyo enceda ekuchumiseni ngempumelelo kweqanda elingaphandle komzimba, elinganisa ukuchumisa kwendalo kunye nokukhuthaza ukukhulelwa okuqhelekileyo nokubeleka.

Ingcali yezokuzala inokucebisa nge-IVF ukuze ukhulelwe ngenxa yezizathu ezininzi, kubandakanya nembali yonyango olungafakwanga nzalo, ukungachumi okungachazwanga, okanye umngcipheko wesifo semfuzo.

Ngamanye amaxesha [isibini] sinokungaphumeleli kolunye unyango, njengokufakwa amadlozi okungengokwamvelo, utsho ULynn Westphal , MD, igosa lonyango eliyintloko leeklinikhi zokuchuma zoMntu. Umfazi ngewayevale i-fallopian tubes okanye indoda inokuba nenani eliphantsi lobudoda.Abanye abatshatileyo banokuphatha isifo semfuza (njenge-cystic fibrosis) kwaye bafuna ukuvavanya imibungu ukuze bangabi nomntwana ochaphazelekayo. Ukuba owasetyhini akakwazi kuthwala ukukhulelwa, kuya kufuneka enze i-IVF ukubeka iimbumba kwisivumelwano.

Ingaba isebenza kanjani

1. Inyathelo lokuqala le-IVF lihlala libandakanya ukuthatha amayeza avuselela amaqanda kwaye kunceda amaqanda ukuba enze inkqubo.
2. Nje ukuba amaqanda aqole, ugqirha uya kuwakhupha kwii-ovari esebenzisa inaliti. Amaqanda afakwa kwisitya kwaye afukanywe.
3. Kwinkqubo ebizwa ngokuba kukudlulisa, isidoda-nokuba lidlozi elinikelayo okanye kwiqabane lakho-liyakongezwa emaqandeni kwaye lijongwe ukuqinisekisa ukuba isichumiso siphumelele kwaye umbungu sele ukhulile.
4. Nje ukuba umbungu uthathwe njengolungele ukudluliselwa, ugqirha uya kufaka umbungu kwisibeleko. Ukusuka apho, umbungu kufuneka ufakelwe kuludwe lwesibeleko.

Amanqanaba okuphumelela e-IVF

Izinga lokuphumelela kokukhulelwa emva komjikelo omnye we-IVF iyahluka kwaye ixhomekeke kakhulu kwiminyaka yobufazi. Rhoqo, kufuneka ngaphezulu komjikelo omnye ukuze uphumelele. Iklinikhi enye yokuzala ibonelela ngoluqikelelo lulandelayo kumjikelo wokuqala, ngokusekwe kubudala:

• Abasetyhini abangaphantsi kweminyaka engama-30 banamathuba angama-46 ephumeleleyo.
• Abasetyhini abaneminyaka engama-30 ukuya kwengama-33 banethuba lokuphumelela elingama-58%.
• Abasetyhini abaneminyaka engama-34 ukuya kuma-40 banamathuba angama-38 okuphumelela.
• Abasetyhini abaneminyaka engama-40 ukuya kuma-43 banamathuba angaphantsi kwe-12% okuphumelela.

Ngapha koko, amaqanda abaxhasi anokusetyenziswa kwaye avelise inqanaba eliphezulu lempumelelo ( Iipesenti ezingama-55 ) wokukhulelwa okukhokelela ekuzalweni okuphilayo ngokuthelekisa izibini ezininzi ezijika ziye kwi-IVF kwaye zingasebenzisi mnikeli weqanda. Oku kunokwenzeka ubuncinci kwinxalenye ngenxa yobudala beminyaka yobudala yabanikeli bamaqanda: iminyaka engama-26 ubudala. Oku kuqinisa nje ukuba ubudala beqanda lomfazi elisetyenziswe kwinkqubo liguqulela kumathuba okuphumelela kwenkqubo. Amadoda awachaphazeleka rhoqo yimicimbi yokungachumi de abe ubuncinci ubuneminyaka engama-50 ubudala.

Iindleko ze-IVF

Ixabiso eliphakathi lomjikelo omnye we-IVFngaphezulu kwe- $ 20,000, ngokwe Ukuchuma kwe-IQ . Eli nani linika ingxelo ye-Inkqubo kunye neendleko zonyango. Nangona kunjalo, isiguli esiphakathi se-IVF sihamba kwimijikelo emibini, oko kuthetha ukuba indleko iyonke ye-IVF ihlala iphakathi kwe- $ 40,000 kunye ne- $ 60,000.

Nalu ulwaphulo lweIindleko ze-IVF:

• Uvavanyo lwangaphambi kwe-IVF lokuchuma okanye ukubonisana:
  • $ 200- $ 400 yotyelelo olutsha kwi-endocrinologist yokuzala
  • $ 150- $ 500 ye-pelvic ultrasound ukuvavanya isibeleko kunye namaqanda
  • $ 200- $ 400 yovavanyo lwegazi olunxulumene nokuzala
  • $ 50- $ 300 kuhlalutyo lobudoda
  • $ 800- $ 3,000 ye-hysterosalpingogram (HSG), eluvavanyo olusebenzisa idayi ukuvavanya isibeleko kunye neetyhubhu ze-fallopian
• $ 3,000- $ 5,000 yeziyobisi zokuchuma
• $ 1,500 yokujonga esweni kunye nomsebenzi wegazi
• $ 3,250 yokubuyisa iqanda
• $ 3,250 yeenkqubo zelebhu ezinokubandakanya ezinye okanye zonke ezi zinto zilandelayo:
  • Ukucwangciswa kweAndrology yesampulu yamadlozi
  • Inkcubeko ye-Oocyte kunye nokuchumisa
  • Inracytoplasmic sperm injection (ICSI)
  • Ukuqandusela okuncedisiweyo
  • Inkcubeko yeBlastocyst
  • Ukuphuculwa kombungu
• Uvavanyo lwemfuzo:
  • $ 1,750 ye- biopsy ye- umbungu
  • $ 3,000 kuhlalutyo lwemfuza
• $ 3,000 yokuhambisa umbungu:
  • Ukulungiswa kwelebhu yombungu
  • Inkqubo yokuGqithisela, njengoko kufuneka ukufezekisa ukukhulelwa okuyimpumelelo, ukuya kuthi ga kwisambuku sokudluliselwa

Ulwazi lweendleko ezivela kwi- Unonophelo lwezeMpilo kwiYunivesithi yaseMississippi kwaye Iziko lokuChuma eliPhambili laseChicago . Qaphela: Isicwangciso sakho sonyango lwe-IVF sinokungabandakanyi konke oku kungentla.

Ngaba i-inshurensi ikhusela i-IVF?

Umyinge we-IVF kunye neendleko ezihamba nayo ziyahluka phakathi kwezicwangciso zeinshurensi, iinkampani kunye namazwe ahlukeneyo. Umzekelo, ezinye iinkampani zeinshurensi gubungela uvavanyo lokuqonda isifo kodwa hayi unyango. Abanye ababoneleli bagubungela iinzame ezinqunyelweyo ze-IVF, kwaye abanye abayigubungeli i-IVF kwaphela.

Uninzi lwabantu lubhatalela i-IVF ngaphandle kwepokothweni, utshilo uLev Barinskiy, CEO we I-inshurensi ye-SmartFinancial . Izicwangciso zokuzala ngokwesiko zihlala zigubungela ukuhlolwa kovavanyo kunye nokujikeleza okukodwa kwe-IVF okanye i-IUI, kuxhomekeke kwi-inshurensi.

Kubalulekile ukuba wenze uphando lwakho kwaye uthethe nomphathi wakho weinshurensi kunye neklinikhi yokuzala malunga neendleko zenkqubo yakho ngaphandle kweinshurensi.

Okwangoku, I-18 ithi bapasile imithetho egunyazisa amashishini ukuba abonelele ngezibonelelo zokuchuma ngamanqanaba ahlukeneyo okugubungela abasebenzi babo, u-Barinskiy ucacisa. Abanye oorhulumente basekhaya bafuna imigaqo-nkqubo yeinshurensi yezempilo ukuhlawulela iimvavanyo zonyango kunyango. Umyinge wahlukile phakathi kwamazwe, ke kuyakufuneka ufunde isigunyaziso sikarhulumente apho umqeshi wakho asekwe khona.

Kukhutshwe i-International Foundation yeziCwangciso zeZibonelelo zaBasebenzi iziphumo Ukusuka kuvavanyo luka-2018 olwafumana iipesenti ezingama-31 zabaqeshi ezinabasebenzi abangama-500 okanye nangaphezulu zinika uhlobo oluthile lwezibonelelo zokuzala. Ngophando bafumanisa ukuba:

• I-23% igubungela unyango lwe-vitro fertilization (IVF)
• I-7% igubungela iinkonzo zokuvuna amaqanda / zokuqanda iqanda
• I-18% igubungela amayeza okuzala
• I-15% igubungela uvavanyo lwemfuza ukumisela imiba yokungachumi
• I-13% igubungela unyango olungelulo lwe-IVF
• I-9% ifikelela kutyelelo lwabacebisi

Kuba ukungachumi kubandakanya onke amaqabane, kubalulekile ukuba indoda nomfazi baphande malunga nesicwangciso sabo esigubungela uhlalutyo lobudoda kunye nokukhathalela ukungachumi kwendoda.

Izibonelelo ezongezelelweyo zomshuwalense wokuchuma:

Nanga amanye amaphepha ongezelelweyo avela kwiinkampani zeinshurensi yezempilo ephezulu ngokubhekisele kwiinkonzo zokuzala kunye ne-IVF:

• UAetna
• Kaiser
• Umhobe iBlue Cross
• Cigna
• Ukhathalelo lweZempilo

Kungcono ukubiza kwaye uthethe nomphathi wakho weinshurensi ngokuthe ngqo ukuze ufumane umbono ocacileyo wento engekhoyo. Eminye imibuzo onokufuna ukuyibuza ibandakanya:

• Ngaba umgaqo-nkqubo wam ugubungela ukuxilongwa ukuze kufunyaniswe isizathu sokungachumi?
• Ngaba ndifuna ukuhanjiswa ukuze ndibone ingcali yokungachumi?
• Ngaba umgaqo-nkqubo wam ugubungela i-intrauterine insemination (IUI)?
• Ngaba umgaqo-nkqubo wam ugubungela in vitro fertilization (IVF)? Ukuba kunjalo, ngaba iyagubungela iinkqubo ezongezelelekileyo ezinje nge-intracytoplasmic sperm injection (ICSI), cryopreservation (embryo freezing), iifizi zokugcina imibungu efriziwe, ukuhanjiswa kweembumba ezingumkhenkce?
• Ngaba ugunyaziso lwangaphambili luyafuneka kuyo nayiphi na inkqubo egqunyiweyo?
• Ngaba sikhona isixa semali sokungachumi?
• Ngaba umgaqo-nkqubo wam uyagubungela amayeza atofwayo? Ukuba kunjalo, ngaba bafuna ugunyaziso okanye ukusetyenziswa kwekhemesti ekhethekileyo?
• Ngaba ndingayifumana inkcazo ebhaliweyo yezibonelelo zam?

Apha ngezantsi kukho Iikhowudi zokuhlawula (Iikhowudi ze-CPT) ekubhekiswa kuzo xa uthetha nomphathi wakho weinshurensi:

Iikhowudi zokuhlawula ze-IVF zeinshurensi
Ukufakwa ngaphakathi kwi-intrauterine (IUI)	Ungeniso 58322 Isidoda esilungiselela ukumiliselwa 89261
IVF kwi-vitro fertilization (IVF)	Ukudluliselwa kwembungu kwisisu 58974 Ukufunyanwa kwe-Oocyte (iqanda) 58970 Intracytoplasmic sperm injection (ICSI) 89280 Ukugcinwa kwakhona kweembumba ezingama-89258 Ukugcinwa kweembumba ezingama-89342
Ukudluliswa kombungu okubandayo (FET)	Ukutsalwa kweembumba ezigciniweyo ezingama-89352 Ukulungiswa kwesibeleko sokutshintshela i-89255 Ukudluliselwa kwembungu kwisisu 58974
Amayeza	Iiveki ezi-2 zeLupron Kit J9218 IGonal F S0126 Uluhlu lweefollistim S0128 I-repronex S0122

Izinketho zemali ze-IVF

Ngelixa i-IVF isabiza nangona i-inshurensi, zikho ezinye iindlela zokunciphisa iindleko. Umzekelo, ii-Associates Medical Associates (RMA), eneendawo ezili-19 eMelika, inenkqubo ebanzi ye-IVF kwaye Iinkonzo zenkxaso mali Ezidibanisa izibini kwiintlobo ngeentlobo zezicwangciso zokuboleka kunye nokuhlawula. Iinkqubo ezikhoyo nge-RMA zibandakanya:

• Izixazululo zeZigulana eziBolekisayo
• Ukuchuma kwe-ARC
• Imali eNtsha yokuChuma kokuChuma
• Inkqubo ye-WINFertility
• Ukubolekwa kwezempilo
• Usapho lwexesha elizayo
• Ityala leZonyango eManyeneyo

Umbutho weSizwe wokungachumi nawo une uluhlu Iinkqubo zenkxaso mali yokungachumi.

Mininzi imibutho engenzi nzuzo ebonelela ngenkxaso yemali kwabo basokolayo ngokungachumi ngenxa yezibonelelo.

Uninzi (olungenzi nzuzo) lubonelela ngesibonelelo kwinani elithile kunyango (okt $ 5,000), kodwa izibonelelo zeThemba loMzali zigubungela iindleko ezipheleleyo ze-IVF, uthi UDavid bross , umseki kunye nomongameli wethemba labazali. Ezona nzuzo zinkulu zingenzi nzuzo zixhasa abahlali abangachumi Ithemba Lomzali , BabyQuest , Isiseko seCade , kunye Iintsikelelo ezininzi.

Ithemba loMzali libonelela ngoncedo lwezezimali kwizibini ezingazaliyo ngenkqubo yabo yeSibonelelo saBazali seThemba loSapho, ebandakanya isibonelelo se-IVF. Kwi-IVF nakwi-FET (izibonelelo), sisebenzisene neZiko lezeMpilo lokuZala kwaye zombini izibonelelo zigubungela iindleko ezipheleleyo zeenkqubo zonyango, ucacisa uBross.

Zininzi izinto ezingenzi nzuzo zasekhaya nezikazwelonke ezibonelela ngezibonelelo. Nangona ukufumana igranti kungaqinisekiswanga njengoko kukho inkqubo yokwenza isicelo, akuyonzakalisi ukufaka isicelo. Qiniseka ukuba ufunda iimfuno zokufaneleka ngaphambi kokufaka isicelo sesibonelelo kuba ezinye izicelo zinemali.

Uyigcina njani imali kumayeza okuzala

Amayeza afaka igalelo kwinxalenye yeendleko ze-IVF.Abasetyhini badinga inani lamayeza ngexesha lenkqubo ye-IVF, utshilo uGqirha Westphal. Abasetyhini abaninzi banikwa iipilisi zokuthintela inzala kuqala ukunceda ngexesha lonyango lwabo. Ukukhuthaza ii-ovari, abasetyhini benza inaliti yehomoni ekhuthazayo (umz.I-Follistim, Gonal-F) malunga neentsuku ezilithoba ukuya kwi-12. Njengokuba iifollic ('iisaka zeqanda') zikhula, amayeza ayongezwa ukuthintela ukuphuma kweqanda kwangaphambi kwexesha, ikakhulu i-gonadotropin-ekhulula i-hormone antagonist (umzekelo, Ganirelix, Cetrotide).

Ucacisa ukuba ekubuyiseni iqanda kunye nenkqubo yokudlulisa, umfazi ufumana inaliti ye-chorionic gonadotropin (HCG), i-antibiotics kunye neprogesterone.

Ukugcina imali kwiziyobisi zokuchuma, qala ufowunele inkampani yakho yeinshurensi okanye ubhekise kwifomula yamayeza akho esicwangciso. Nokuba iinkqubo ze-IVF azigutyungelwanga yi-inshurensi, amanye amayeza anokuba njalo.

Ukuba ikopi yakho yamachiza okuzala isephezulu kakhulu okanye ukuba awunayo i-inshurensi, usenokhetho oluninzi lokonga imali. Ungaqhagamshelana nabenzi beziyobisi kwaye ubuze malunga neekhuphoni zomenzi okanye iinkqubo zoncedo lwesigulana. Umzekelo, i Inkqubo yoKhathalelo ngu-EMD Serono angasindisa abaguli abafanelekileyo ukuya kuthi ga kwiipesenti ezingama-75 kwi-Gonal-F.

I-singleCare yehlisa ixabiso kuninzi lala mayeza asetyenziswa ngexesha lenkqubo ye-IVF. Sebenzisa le theyibhile ingezantsi ukufikelela amakhuphoni asimahla, anokuthi basebenzise bonke abathengi basekhemesti baseMelika nokuba banayo i-inshurensi okanye abanayo.

Iindleko zokuchuma iziyobisi kunye namakhuphoni
Igama leziyobisi	Ingaba isebenza kanjani	Umthamo osemgangathweni	Ixabiso eliphakathi	Elona xabiso liphantsi leSpecialCare
ILupron (leuprolide acetate)	Ithintela i-ovulation ngaphambi kwexesha	I-0.25-1 mg yenaliti yenaliti mihla le ~ 14 yeentsuku	$ 880.98 ngeentsuku ezili-14 zekiti	$ 364.90 ngekiti yeentsuku ezili-14	Fumana isigqebhezana
Ifollistim AQ iCartridge (follitropin beta)	Khuthaza ukukhula kunye nokukhula kwamaqanda, kukhuthaza imveliso yesidoda emadodeni	Iyunithi engama-200 yenaliti engaphantsi mihla le ~ iintsuku ezisi-7. Idosi inokunyuswa iye kwiiyunithi ezingama-500 ubuninzi bemihla ngemihla ngokusekwe kwimpendulo ye-ovari.	Iidola ezingama-2,855.19 nge-900-unit cartridge nganye	I-2,187.06 yeedola kwi-cartridge yeeyunithi ezingama-900	Fumana ikhadi le-Rx
I-Ovidrel (choriogonadotropin alfa)	Kubangela ukukhutshwa kwamaqanda kwii-ovari	250 mcg / 0.5 mL inaliti yangaphantsi enye	$ 267.99 ngenaliti nganye	$ 178.75 ngenaliti nganye	Fumana isigqebhezana
Ganirelix	Ithintela i-ovulation ngaphambi kwexesha	I-250 mcg / 0.5 mL yenaliti yangaphantsi yemihla ngemihla (de kube kuyalelwe kulawulo lwe-hCG)	$ 512.99	$ 447.03 nge-250 mcg yenaliti	Fumana isigqebhezana
ICetrotide (cetrorelix)	Ithintela i-ovulation ngaphambi kwexesha	I-0.25 mg yenaliti yangaphantsi kanye yonke imihla (de kube kuyalelwa kulawulo lwe-hCG)	$ 318.99 nge 0.25 mg yekhithi	$ 241.08 nge 0.25 mg yekhithi	Fumana isigqebhezana
Uncedo	Ukunciphisa umngcipheko wosulelo ngexesha lomjikelo we-IVF	I-100 mg capsule kabini ngemini kangangeentsuku ezi-4, ukuqala komhla wokufunyanwa kwakhona kweqanda	$ 43.76 nge-20, 100 iipilisi mg	$ 14.31 nge-20, 100 iipilisi mg	Fumana isigqebhezana
Endometrin (iprogesterone)	Ukuqina kunye nokulungisa umgca wesibeleko ukugcina ukumiliselwa kweqanda elichunyisiweyo	100 mg njengezingxobo intravaginally amaxesha 2-3 yonke imihla iiveki 10-12 ngugqirha	$ 373.99 ngebhokisi nganye	$ 265.32 ngebhokisi nganye	Fumana isigqebhezana
Umtya (estradiol)	Unika i-estrogen emzimbeni, eluncedo kwi-IVF ngezizathu ezahlukeneyo	Ithebhulethi ye-1-2 mg ngomlomo kabini ngemini kangangeentsuku ezili-14	$ 17.69 nge-30, 1 iipilisi mg	$ 6.24 nge-30, 1 iipilisi mg	Fumana isigqebhezana

Okukwintsusa: Thatha ixesha lakho kuhambo lwakho lwe-IVF

Kuba uninzi lwezigulana zihamba kwiinkqubo ezininzi ze-IVF ngaphambi kokukhulelwa ngempumelelo, kubaluleke ngakumbi ukulinganisa iindleko kunye nomgangatho weklinikhi ukuze ube nakho ukufikelela kwimijikelezo emininzi xa kufuneka. Nalu uluhlu lokutshekisha lwemibuzo kunye nokuqwalaselwa xa ukhetha ikliniki yokuzala:

• Ngaba iklinikhi yakho iyayibonelela ngenkqubo yokubuyiselwa kwemali ye-IVF?
• Yeyiphi i-inshurensi eyamkelweyo kwiindleko ze-IVF?
• Zeziphi iinkonzo ze-IVF ezinikezelwa ekliniki?
• Athini amaxabiso enkonzo?
• Ngaba ucebisa naziphi na iinkonzo zenkxaso mali?
• Ngaba indawo ekliniki ikulungele mna neqabane lam?
• Ngaba iklinikhi kunye nabasebenzi bayo baphononongwa kakhulu phakathi kwezinye izigulana kunye neengcali?
• Lithini inqanaba labo lokuphumelela? Inkqubo ye- Umfumani weklinikhi yokuzala ikuvumela ukuba ujonge ubalo lwenzalo yekliniki ngokuchwetheza kwi-zip khowudi.

Kukwabalulekile ukuqaphela isidingo sokuthatha ikhefu phakathi kwemijikelo ye-IVF. Ixesha eliqhelekileyo phakathi kwemijikelezo ye-IVF ngumjikelo opheleleyo wokuya exesheni, ngokwe IZiko laseCarolinas lokuchuma . Oku kuhlala kuguqulela kwiiveki ezine ukuya kwezintandathu emva kokudluliselwa kombungu kunye novavanyo lokukhulelwa olubi ukuqala omnye umjikelo we-IVF.

Ngokubanzi, isigulana kufuneka silinde phakathi kweenkqubo ze-IVF de umzimba ubuyele kwimeko yangaphambi kwe-IVF, utshilo uPeter Nieves, igosa eliyintloko kwezorhwebo WIN Ukuchuma . Ithetha ukuba uqala umjikelo omtsha wokuya exesheni kwaye iihomoni zakhe ezisisiseko kunye nobukhulu be-ovary zibuyile kwimeko yakhe yesiqhelo yokuphumla.

Izizathu zokuthatha ikhefu phakathi kwemijikelo ye-IVF zinokubandakanya iimfuno zomzimba, ezezimali kunye neemvakalelo. Olunye unyango lunokubangela ukuvuvukala, oogqirha abaninzi bakholelwa ukuba kufuneka banciphise ngaphambi kokuqala umjikelezo omtsha. Iindleko zemali kunye neemvakalelo ze-IVF zinokuthatha intlawulo kwintlalontle yakho kunye nobudlelwane neqabane lakho, ke ngoko ukuthatha ixesha ukulungiselela omnye umjikelo kubalulekile.