IVF inodhura zvakadii?

Dzidzo yehutano

Chii chinonzi IVF? | IVF mutengo | Inishuwarenzi kufukidza | Mari | Chengetedza mari pamishonga yekubereka

Kana iwe uchinetseka kubata pamuviri, hausi wega. Zvikamu gumi nezvitatu kubva muzana yevaroorani muUnited States vane matambudziko ekushaya mbereko. Kushaya mbereko kunowanzoitika uye kunogona kukonzerwa nezvinhu zvinoverengeka zvakasiyana sezera, nguva isina kujairika, kugadzirwa kwembeu isina kujairika, kana huripo huripo hwekurapa.

Neraki, kune nzira dzakasiyana dzekurapa kushaya mbereko asi iyo zvakajairika intrauterine insemination (IUI) uye in vitro fertilization (IVF). Muchokwadi, ndoda piri% yekuzvarwa mhenyu kweU.S. pagore imhedzisiro yehunyanzvi hwekubereka - nzira huru iri IVF. Paive nevana makumi mairi nemakumi masere nevanomwe vakaberekwa mugore ra2018 nekuda kwenzira idzi.

Chii chinonzi IVF?

IVF inzira yematanho erabhoritari inobatsira mukubudirira kwezai kunze kwemuviri, kutevedzera kusangana kwehunhu uye kukurudzira kubata kwakanaka uye kubereka kunoitika.

Nyanzvi yekubereka inogona kukurudzira IVF kuti ibate nhumbu nekuda kwezvikonzero zvakati wandei, kusanganisira nhoroondo yekundikana kwekushaya mbereko kurapwa, kusatsanangurika kushaya mbereko, kana njodzi yehutachiona chirwere.

Dzimwe nguva [vaviri] vanogona kunge vakakundikana kumwe kurapwa, sekumisikidza kwekugadzira, anodaro Lynn Westphal , MD, mukuru wezvekurapa wemakiriniki ekubereka eMoyo. Mukadzi wacho aigona kunge akavharira maFallopian machubhu kana kuti murume anogona kunge aine huwandu husina hurume.Vamwe vakaroorana vanogona kutakura chirwere chemajini (senge cystic fibrosis) uye vanoda kuyedza mazai kuitira kuti vasave nemwana akabatwa. Kana mukadzi asingakwanise kutakura nhumbu, anozoda kuita IVF kuisa mazai muchivande.

Inoshanda sei

1. Nhanho yekutanga yeIVF inowanzo sanganisira kutora mishonga inokurudzira mazai uye inobatsira mazai fomu kuitira maitiro.
2. Kana mazai akura chete, chiremba anozoabvisa kubva mumazai achishandisa tsono. Mazai aya anoiswa mundiro uye akavharirwa.
3. Mukuita kunonzi kuisa mbeu, urume - ingava hurume hunopa kana hunobva kune mumwe wako - huchawedzerwa kumazai uye kucherechedzwa kuona kuti hurume hwabudirira uye nhumbu yakura.
4. Kamwe iyo embryo inonzi yakagadzirira kuendesa, chiremba anoisa iyo embryo muchibereko. Kubva ipapo, iro 'embryo' rinofanira kuiswa mukamuri yechibereko.

IVF yekubudirira mitengo

Chiyero chebudiriro yekubata nhumbu mushure meimwe IVF kutenderera inosiyana uye inoenderana zvakanyanya nezera remukadzi. Kazhinji, zvinopfuura kamwe kutenderera kunodiwa kuti ubudirire. Imwe kiriniki yekubereka inopa inotevera fungidziro neyekutanga kutenderera, zvichienderana nezera:

• Vakadzi vadiki pane makumi matatu vane 46% mukana wekubudirira.
• Vakadzi vane makore makumi matatu kusvika makumi matatu nematatu vane 58% mukana wekubudirira.
• Vakadzi vane makore makumi matatu nemana kusvika makumi mana vane 38% mukana wekubudirira.
• Vakadzi vane makore makumi mana kusvika makumi mana nematatu vane mukana uri pasi pe12% mukana wekubudirira.

Zvakare, mazai evanopa anogona zvakare kushandiswa uye kuburitsa yakakwira yekubudirira mwero ( 55% ) yekuzvitakura kunoguma nekuzvarwa chaiko mukuenzanisa nevazhinji vakaroorana vanoenda kuIVF uye vasingashandisi mupi wezai. Izvi zvingangodaro zvirinani muchikamu nekuda kwevechidiki avhareji zera revanopa mazai: makore makumi maviri nematanhatu. Izvi zvinongosimbisa kuti zera rezai remukadzi rakashandiswa mukushandurwa rinoshandura mukana wekubudirira kwechiitiko ichi. Vanhurume havawanzo kukanganiswa nenyaya dzekushaya mbereko kusvikira vaine makore makumi mashanu ekuberekwa.

IVF mutengo

Ivhareji mutengo weimwe kutenderera kweVF irizvinodarika madhora zviuru makumi maviri, sekureva kwa Chibereko IQ . Iyi nhamba inoverengera iyoMaitiro uye mishonga yekurapa. Nekudaro, avhareji IVF murwere anoenda kuburikidza nemaviri maekisheni, zvichireva kuti mutengo wakazara weIVF unowanzo pakati pe $ 40,000 ne $ 60,000.

Heano kuputsika kweIVF inodhura:

• Pre-IVF kubereka kuyedzwa kana kubvunza:
  • $ 200- $ 400 yekushanya kutsva kune wekubereka endocrinologist
  • $ 150- $ 500 yepilvic ultrasound kuongorora chibereko nemazai
  • $ 200- $ 400 yekuongororwa kweropa kwakanangana nekubereka
  • $ 50- $ 300 yekuongorora urume
  • $ 800- $ 3,000 yeiyo hysterosalpingogram (HSG), inova bvunzo inoshandisa dhayi kuongorora chibereko uye matopu
• $ 3,000- $ 5,000 yemishonga yekubereka
• $ 1,500 yekutarisa kwe ultrasound uye basa reropa
• $ 3,250 yekutora zai
• $ 3,250 yemarabhoritari maitiro anogona kusanganisira zvimwe kana zvese zvinotevera.
  • Andrology kugadzirisa yemurume semuenzaniso
  • Tsika yeOocyte nekusangana
  • Intracytoplasmic jekiseni jekiseni (ICSI)
  • Kubatsirwa kubatira
  • Blastocyst tsika
  • Embryo kuputika
• Genetic kuyedza:
  • $ 1,750 yeiyo embryo biopsy
  • $ 3,000 yekuongorora kwemajini
• $ 3,000 yekuchinjisa embryo:
  • Rabhoritari kugadzirira kwe 'embryo'
  • Maitiro ekuchinjisa, pazvinodiwa kuti uwane nhumbu inobudirira, inosvika kune kuzere kwekuchinjika

Mari yemutengo kubva ku Yunivhesiti yeMississippi Hutano Hutarisiro uye Yepamberi Fertility Center yeChicago . Ongorora: Yako IVF yekurapa chirongwa inogona kusasanganisira zvese zvataurwa pamusoro.

Inishuwarenzi inovhara IVF here?

Kuvhara kweIVF uye nemitengo yayo inowirirana inosiyana pakati pezvirongwa zvakasiyana zveinishuwarenzi, makambani, uye nyika. Semuenzaniso, mamwe makambani einishuwarenzi kufukidza kuongororwa kwekuongorora asi kwete kurapwa. Vamwe vanopa vanovhara kuyedza kushoma kweIVF, uye vamwe havafukidze IVF zvachose.

Ruzhinji rwevanhu vanobhadhara IVF kunze-kwehomwe, anodaro Lev Barinskiy, CEO we SmartFinancial Inishuwarenzi . Zvirongwa zvechinyakare zvekubereka zvinowanzo kufukidza kuongororwa kuongororwa uye kutenderera kumwechete kweIVF kana IUI, zvinoenderana neyeinishuwarenzi.

Izvo zvakakosha kuti uite tsvagiridzo yako uye utaure kune yako inishuwarenzi inotakura uye kiriniki yekuzvara nezve mutengo wemabatiro ako uine uye usina inishuwarenzi.

Parizvino, 18 inoti vakapasisa mitemo inoraira mabhizinesi kuti ape mabhenefiti ekubereka pamwe nematanho akasiyana ekuvhara kune vashandi vavo, Barinskiy anotsanangura. Dzimwe hurumende dzenharaunda dzinoda inishuwarenzi yehutano kubhadhara mari yekushaya mbereko yekuongorora uye kurapwa. Kuvhara kunosiyana pakati penyika, saka iwe uchafanirwa kuverenga iro rehurumende mvumo iko kwaunoshandira.

Iyo International Foundation yeVashandi Kubatsirwa Zvirongwa yakaburitswa mhedzisiro kubva kuongororo ya2018 yakawana 31% yevashandirwi vane mazana mashanu kana vanopfuura vashandi vanopa imwe nzira yekubatsira. Kuburikidza neongororo ivo vakawanawo kuti:

• 23% inovhara in vitro fetiraiza (IVF) kurapwa
• 7% inovhara zai kukohwa / mazai echando masevhisi
• 18% inovhara mishonga yekubereka
• 15% inovhara kuyedzwa kwemajini kuona nyaya dzekushaya mbereko
• 13% inovhara isiri-IVF yekurapa kurapa
• 9% inovhara kushanya nevapi vemazano

Sezvo kushaya mbereko kuchisanganisira vese vaviri, zvakakosha kuti murume nemukadzi vaongorore zvinofungwa nehurongwa hwavo kusanganisira kuongorora urume uye kushaya mbereko yemurume.

Kuwedzera kubereka inishuwarenzi zviwanikwa:

Heano mamwe mapeji ekuwedzera kubva kumakambani epamusoro einishuwarenzi nezvehutano hwekushaya mbereko uye IVF kufukidza:

• Aetna
• Kaiser
• Nhetembo Bhuruu Muchinjikwa
• Cigna
• UnitedHealthcare

Zviri nani kufona uye kutaura neako inishuwarenzi mutakuri zvakananga kuti uwane yakajeka pfungwa yezviri uye zvisina kuvharwa. Mimwe mibvunzo iwe yaungade kubvunza inosanganisira:

• Mutemo wangu unobata kuongororwa kuti uone chikonzero chekushaya mbereko here?
• Ini ndinoda kutumirwa kuti ndione nyanzvi yekushaya mbereko?
• Yangu mutemo inovhara intrauterine insemination (IUI)?
• Yangu mutemo inovhara in vitro fetiraiza (IVF)? Kana zvirizvo, inovhara mamwe maitiro senge intracytoplasmic sperm jekiseni (ICSI), cryopreservation (embryo inotonhora), mari yekuchengetedza mazai akaomeswa nechando, kuendeswa kwemazai akaomeswa nechando?
• Mvumo yepamberi inodiwa here kune chero nzira dzakavharwa?
• Iko kune yakanyanya kushaya mbereko kubatsirwa huwandu?
• Mutemo wangu unobata mishonga inobaya jekiseni here? Kana zvirizvo, zvinoda kupihwa mvumo kana kushandiswa kweane hunyanzvi hwemishonga?
• Ini ndinogona here kuwana tsananguro yakanyorwa yemabhenefiti angu?

Pazasi pane macode ekubhadhara (CPT macode) kureva paunenge uchitaura kune yako inishuwarenzi anotakura:

IVF yekubhadhara makodhi einishuwarenzi
Intrauterine insemination (IUI)	Kugadzikana 58322 Urume kugadzirira kusimbisa 89261
IVF mu vitro fertilization (IVF)	Intrauterine embryo inotamisa 58974 Oocyte (zai) kudzosa 58970 Intracytoplasmic jekiseni jekiseni (ICSI) 89280 Kuchengetedzwa kwemazai 89258 Kuchengetwa kwemazai 89342
Frozen embryo kuendesa (FET)	Kubata mazai akachengeterwa masero 89352 Kugadzirira kwe 'embryo' yekuchinjisa 89255 Intrauterine embryo inotamisa 58974
Mishonga	2 vhiki Lupron Kit J9218 Gonal F S0126 Follistim S0128 Repronex S0122

IVF sarudzo dzemari

Ipo IVF ichiri kudhura kunyangwe neinishuwarenzi, kune dzimwe nzira dzekudzora mari. Semuenzaniso, Reproductive Medical Associates (RMA), iyo ine nzvimbo 19 muU.S., ine chirongwa chakakura cheIVF uye mabasa ekubhadhara mari iyo inobatanidza vakaroorana kune dzakasiyana siyana dzakasiyana dzekukweretesa uye kubhadhara zvirongwa. Zvirongwa zvinowanikwa kuburikidza neRMA zvinosanganisira:

• Kukweretesa Kirabhu Murwere Mhinduro
• ARC Kubereka
• Hutsva Hupenyu Kubereka Zvemari
• WINKubereka Chirongwa
• Prosper Healthcare Kukwereta
• Ramangwana Mhuri
• United Kurapa Kiredhiti

Sangano reNational Infertility rinewo rondedzero yehurongwa hwekushaya mbereko zvirongwa.

Kune akawanda asingabatsiri masangano anopa rubatsiro rwemari kune avo vari kunetseka nekushaya mbereko kuburikidza nezvipo.

Yakawanda (isiri-purofiti) inopa rubatsiro mune imwe nhanho yekurapwa (kureva $ 5,000), asi mari yeVabereki Tariro inovhara mutengo wakazara weIVF, anodaro David bross , muvambi uye mutungamiri weParental Tariro. Iwo makuru asiri mapundutso anotsigira nharaunda yekushaya mbereko ari Tariro Yevabereki , BabyQuest , Cade Foundation , uye Akawanda Makomborero.

Tariro yeVabereki inopa rubatsiro rwemari kune vakaroora vasina kubereka kuburikidza nehurongwa hweVabereki Hupenyu Mhuri Grant, iyo inosanganisira rubatsiro rweVIV. Kune IVF neFET (grants), isu takabatana neInstitute for Reproductive Health uye zvese zvipo zvinofukidza mutengo wakazara weaya marapirwo, Bross anotsanangura.

Kune akawanda emuno neenyika asingabatsiri anopa zvipo. Kunyangwe kupihwa kupihwa rubatsiro hakuna kuvimbiswa sezvo paine nzira yekunyorera, hazvikuvadze kuisa. Ive neshuwa yekuverenga izvo zvinokodzera zvinodiwa usati wanyorera rubatsiro nekuti zvimwe zvikumbiro zvine mari.

Maitiro ekuchengetedza mari pamushonga wekubereka

Mishonga inopa chikamu chakakosha kune yakazara mutengo weIVF.Vakadzi vanoda mishonga yakati wandei panguva yeIVF, Dr. Westphal anodaro. Vakadzi vazhinji vanoiswa mapiritsi ekudzivirira kubereka kutanga vabatsire nenguva yekurapwa kwavo. Kukurudzira ovari, vakadzi vanoita majekiseni e follicle-inomutsa mahormone (semuenzaniso Follistim, Gonal-F) kwemazuva angangoita mapfumbamwe kusvika gumi nemaviri. Sezvo follicles ('mazai emasaga') anokura, mishonga inowedzerwa kudzivirira kutanga ovulation, kazhinji gonadotropin-inosunungura mahormone anopikisa (semuenzaniso Ganirelix, Cetrotide).

Anotsanangura kuti mukutora kwezai uye nekuchinjisa maitiro, mukadzi anowana jekiseni rechorionic gonadotropin (HCG), mishonga inorwisa mabhakitiriya, uye progesterone.

Kuti uchengetedze mari pamishonga yekubereka, tanga wafonera yako inishuwarenzi kambani kana kutumira kune yako chirongwa chemushonga formulary. Kunyangwe kana maitiro eIVF asina kuvharwa neinishuwarenzi, mimwe mishonga inogona kunge iri.

Kana yako copay yemishonga yekubereka ichiri yakanyanya kukwirira kana kana iwe usina inishuwarenzi, uchine sarudzo dzinoverengeka dzekuchengetedza mari. Iwe unogona kutaura nevagadziri vezvinodhaka uye wobvunza nezve zvigadzirwa zvemugadziri kana zvirongwa zvekubatsira varwere. Semuenzaniso, Iyo Tsitsi Kuchengeta Chirongwa na EMD Serono inogona kuchengetedza varwere vanokodzera kusvika pa75% kubva paGonal-F.

SingleCare inodzikisa mutengo wemazhinji emishonga iyi inoshandiswa panguva yeIVF maitiro. Shandisa tafura iripazasi kuwana maconson emahara, ayo vese vatengi veUS chemishonga vanogona kushandisa kana vaine inishuwarenzi kana kwete.

Kubereka zvinodhaka zvinodhaka uye mapikoni
Zita remishonga	Inoshanda sei	Standard muyero	Avhareji yemutengo	Yakaderera Yakasarudzika Mutengo
Lupron (leuprolide acetate)	Inodzivirira ovulation nguva isati yakwana	0.25-1 mg subcutaneous jekiseni zuva nezuva kwe ~ mazuva gumi nemana	$ 880.98 pamutambo wemazuva gumi nemana	$ 364.90 muzana remazuva gumi nemana	Tora coupon
Follistim AQ katuriji (follitropin beta)	Inokurudzira kukura uye kukura kwemazai, inomutsa kugadzirwa kwehurume muvarume	200 unit subcutaneous jekiseni zuva nezuva kwe ~ mazuva manomwe. Dosi inogona kuwedzerwa kusvika pauwandu hwezvikamu mazana mashanu zuva nezuva zvichienderana nemhinduro yeovarian.	$ 2,855.19 pa 900-unit cartridge	$ 2,187.06 pa 900-unit cartridge	Tora Rx kadhi
Ovidrel (choriogonadotropin alfa)	Inokonzeresa kuburitsa mazai kubva mumazai	250 mcg / 0.5 mL subcutaneous jekiseni kamwe chete	$ 267.99 pajekiseni	$ 178.75 pajekiseni	Tora coupon
Ganirelix	Inodzivirira ovulation nguva isati yakwana	250 mcg / 0.5 mL subcutaneous jekiseni zuva nezuva (kusvikira yakarairwa kupa hCG)	$ 512.99	$ 447.03 pa 250 mcg jekiseni	Tora coupon
Cetrotide (cetrorelix)	Inodzivirira ovulation nguva isati yakwana	0.25 mg subcutaneous jekiseni kamwe zuva nezuva (kusvikira yakarairwa kuitisa hCG)	$ 318.99 pa 0.25 mg kit	$ 241.08 pa0.25 mg kit	Tora coupon
Doxycycline	Inoderedza njodzi yekutapukirwa panguva yeVIV kutenderera	100 mg capsule kaviri pazuva kwemazuva mana, kutanga zuva rekudzosa mazai	$ 43.76 pa20, 100 mg mahwendefa	$ 14.31 pa20, 100 mg mapiritsi	Tora coupon
Endometrin (progesterone)	Inoremedza uye inogadzirira iyo uterine lining kuchengetedza kuisirwa kwezai rakaberekwa	100 mg capsules intravaginally 2-3 nguva zuva nezuva kwemavhiki 10-12 nachiremba	$ 373.99 bhokisi	$ 265.32 pabhokisi	Tora coupon
Estrace (estradiol)	Inopa estrogen kumuviri, iyo inobatsira muIVF nezvikonzero zvakasiyana	1-2 mg piritsi nemuromo kaviri pazuva kwemazuva gumi nemana	$ 17.69 pamakumi matatu, 1 mg mahwendefa	$ 6.24 pamakumi matatu, 1 mg mahwendefa	Tora coupon

Pazasi mutsara: Tora nguva yako kuburikidza neyako IVF rwendo

Sezvo varwere vazhinji vachipfuura nenzira dzakawanda dzeVIVF vasati vabata nhumbu, zvinonyanya kukosha kuyera mutengo uye mhando yekiriniki kuti ugone kuwana akawanda macircule kana zvichidikanwa. Heino runyorwa rwemibvunzo uye kufunga paunenge uchisarudza kiriniki yekubereka:

• Kiriniki yako inopa chirongwa chekudzosera IVF?
• Ndeipi inishuwarenzi inogamuchirwa yemitengo yeIVF?
• Ndeapi masevhisi eVF anopiwa kukiriniki?
• Ndekupi kuderera kwemitengo yemasevhisi?
• Iwe unokurudzira chero hupi hupi hwekubhadhara mari masevhisi?
• Iko iko kukiriniki kuri nyore kwandiri neumwe wangu?
• Iyo kiriniki nevashandi vayo vanoongororwa zvakanyanya pakati pevamwe varwere uye nyanzvi?
• Ndeipi yavo yekubudirira? Iyo SART kiriniki yekubereka kiriniki inokutendera iwe kuti uone manhamba ekuzvara ekiriniki nekutaipa mu zip kodhi.

Izvo zvakakoshawo kuti utarise kudiwa kwekutora zororo pakati pematanho eIVF. Iyo yakajairwa nguva yenguva pakati peVIV kutenderera ndeye imwechete yakazara yekuenda kumwedzi, zvinoenderana ne Carolinas Fertility Institute . Izvi zvinowanzo dudzira kusvika kumavhiki mana kusvika matanhatu mushure mekubuditswa kwemwana mudumbu uye nhumbu isina kunaka bvunzo kuti utange imwe kutenderera kweIVF.

Kazhinji kutaura, murwere anofanira kumirira pakati peIVF maitiro kudzamara muviri wake wadzokera kune yake pre-IVF nyika, anodaro Peter Nieves, mukuru wezvekutengeserana ku WINKubereka . Zvichireva kuti anotanga kumwedzi kutsva uye mahormone ake ekutanga uye saizi ovary adzokera kune yake yakajairwa yekuzorora mamiriro.

Zvikonzero zvekutora mabhureki pakati peiyo IVF macircuit zvinogona kusanganisira zvepanyama, zvemari, uye zvemanzwiro zvinodiwa. Mimwe mishonga inogona kukonzera kuzvimba, uko vanachiremba vazhinji vanotenda kuti kunofanira kudzikira vasati vatanga kutenderera kutsva. Mari uye zvemari zvinodhura zveIVF zvinogona zvakare kutora huro pahupenyu hwako uye hukama neumwe wako, nekudaro kutora nguva yekugadzirira imwe kutenderera kwakakosha.