{"id":249,"date":"2024-10-11T11:12:13","date_gmt":"2024-10-11T11:12:13","guid":{"rendered":"https:\/\/vosinhhiemmuon.vn\/?p=249"},"modified":"2024-10-11T11:12:13","modified_gmt":"2024-10-11T11:12:13","slug":"ky-thuat-dong-lanh-va-ra-dong-tinh-trung","status":"publish","type":"post","link":"https:\/\/vosinhhiemmuon.vn\/iui\/2024\/10\/11\/ky-thuat-dong-lanh-va-ra-dong-tinh-trung\/","title":{"rendered":"K\u1ef9 thu\u1eadt \u0111\u00f4ng l\u1ea1nh v\u00e0 r\u00e3 \u0111\u00f4ng tinh tr\u00f9ng"},"content":{"rendered":"
K\u1ef9 thu\u1eadt \u0111\u00f4ng l\u1ea1nh v\u00e0 r\u00e3 \u0111\u00f4ng tinh tr\u00f9ng<\/a><\/div>\n
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CNSH. Tr\u01b0\u01a1ng V\u0103n H\u1ea3i; CNSH. Nguy\u1ec5n Qu\u1ef3nh Nh\u01b0, CNSH. V\u00f5 Minh Tu\u1ea5n – IVFMD T\u00e2n B\u00ecnh<\/strong><\/p>\n

1. <\/strong>T\u1ed5ng quan<\/strong>
\n\u0110\u00f4ng l\u1ea1nh tinh tr\u00f9ng l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt mang l\u1ea1i nhi\u1ec1u l\u1ee3i \u00edch cho \u0111i\u1ec1u tr\u1ecb v\u00f4 sinh c\u0169ng nh\u01b0 b\u1ea3o t\u1ed3n kh\u1ea3 n\u0103ng sinh s\u1ea3n c\u1ee7a nam gi\u1edbi. \u0110\u00f4ng l\u1ea1nh tinh tr\u00f9ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau: t\u00edch l\u0169y tinh tr\u00f9ng khi s\u1ed1 l\u01b0\u1ee3ng tinh tr\u00f9ng t\u01b0\u01a1i kh\u00f4ng \u0111\u1ee7 cho 1 chu k\u1ef3 \u0111i\u1ec1u tr\u1ecb, b\u1ec7nh nh\u00e2n kh\u00f3 l\u1ea5y m\u1eabu, ch\u1ed3ng kh\u00f4ng c\u00f3 m\u1eb7t ng\u00e0y v\u1ee3 ch\u1ecdc h\u00fat, \u0111\u00f4ng l\u1ea1nh \u0111\u1ec3 b\u1ea3o t\u1ed3n kh\u1ea3 n\u0103ng sinh s\u1ea3n tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb ung th\u01b0, ng\u00e2n h\u00e0ng tinh tr\u00f9ng. Hi\u1ec7n nay, \u0111\u00f4ng l\u1ea1nh v\u00e0 r\u00e3 \u0111\u00f4ng tinh tr\u00f9ng \u0111\u00e3 tr\u1edf th\u00e0nh m\u1ed9t quy tr\u00ecnh th\u01b0\u1eddng quy t\u1ea1i c\u00e1c \u0111\u01a1n v\u1ecb h\u1ed7 tr\u1ee3 sinh s\u1ea3n (HTSS). Nguy\u00ean t\u1eafc c\u1ee7a \u0111\u00f4ng l\u1ea1nh l\u00e0 \u0111\u01b0a t\u1ebf b\u00e0o v\u1ec1 ng\u01b0\u1ee1ng nhi\u1ec7t \u0111\u1ed9 r\u1ea5t th\u1ea5p (-196\u00baC), t\u1ea1i \u0111\u00f3, c\u00e1c ph\u1ea3n \u1ee9ng sinh h\u00f3a v\u00e0 ho\u1ea1t \u0111\u1ed9ng trao \u0111\u1ed5i ch\u1ea5t c\u1ee7a t\u1ebf b\u00e0o h\u1ea7u nh\u01b0 \u0111\u1ec1u b\u1ecb d\u1eebng l\u1ea1i, t\u1ebf b\u00e0o s\u1ed1ng \u1edf d\u1ea1ng ti\u1ec1m sinh (H\u1ed3 M\u1ea1nh T\u01b0\u1eddng, Nguy\u1ec5n Th\u1ecb Mai; 2000). Khi c\u1ea7n s\u1eed d\u1ee5ng, tinh tr\u00f9ng s\u1ebd \u0111\u01b0\u1ee3c r\u00e3 \u0111\u00f4ng v\u00e0 qua c\u00e1c b\u01b0\u1edbc x\u1eed l\u00fd chuy\u00ean bi\u1ec7t nh\u1eb1m thu nh\u1eadn tinh tr\u00f9ng s\u1eed d\u1ee5ng cho IVF (In-vitro Fertilization). T\u1ea1i Vi\u1ec7t Nam, t\u1ef7 l\u1ec7 di \u0111\u1ed9ng sau r\u00e3 \u0111\u00f4ng \u0111\u1ed1i v\u1edbi tinh tr\u00f9ng thu nh\u1eadn t\u1eeb c\u00e1c m\u1eabu m\u00f4 tinh ho\u00e0n \u1edf b\u1ec7nh nh\u00e2n v\u00f4 tinh do t\u1eafc \u0111\u1ea1t 30% v\u00e0 t\u1ef7 l\u1ec7 c\u00f3 thai khi th\u1ef1c hi\u1ec7n IVF v\u1edbi tinh tr\u00f9ng n\u00e0y l\u00e0 28% (Tr\u01b0\u01a1ng Th\u1ecb Thanh B\u00ecnh v\u00e0 cs., 2009).<\/p>\n

Trong qu\u00e1 tr\u00ecnh \u0111\u00f4ng l\u1ea1nh v\u00e0 r\u00e3 \u0111\u00f4ng, tinh tr\u00f9ng c\u00f3 th\u1ec3 b\u1ecb t\u1ed5n th\u01b0\u01a1ng do t\u00e1c \u0111\u1ed9ng c\u1ee7a nhi\u1ec7t \u0111\u1ed9. Do \u0111\u00f3, nh\u1eefng ch\u1ea5t b\u1ea3o qu\u1ea3n l\u1ea1nh (CPA) nh\u01b0 glycerol, DMSO, EG hay PROH \u0111\u01b0\u1ee3c th\u00eam v\u00e0o m\u00f4i tr\u01b0\u1eddng \u0111\u00f4ng l\u1ea1nh nh\u1eb1m h\u1ea1n ch\u1ebf nh\u1eefng t\u00e1c \u0111\u1ed9ng x\u1ea5u \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng tinh tr\u00f9ng sau r\u00e3 \u0111\u00f4ng. M\u1ed9t quy tr\u00ecnh \u0111\u00f4ng l\u1ea1nh tinh tr\u00f9ng th\u01b0\u1eddng di\u1ec5n ra theo 3 b\u01b0\u1edbc ch\u00ednh theo th\u1ee9 t\u1ef1: (1) cho tinh d\u1ecbch ti\u1ebfp x\u00fac v\u1edbi m\u00f4i tr\u01b0\u1eddng ch\u1ee9a ch\u1ea5t b\u1ea3o qu\u1ea3n l\u1ea1nh, (2) h\u1ea1 nhi\u1ec7t \u0111\u1ed9, (3) l\u01b0u tr\u1eef trong ni-t\u01a1 l\u1ecfng. Hi\u1ec7n nay, c\u00f3 2 ph\u01b0\u01a1ng ph\u00e1p \u0111\u00f4ng l\u1ea1nh ch\u00ednh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00f4ng l\u1ea1nh t\u1ebf b\u00e0o n\u00f3i chung v\u00e0 tinh tr\u00f9ng n\u00f3i ri\u00eang l\u00e0: \u0111\u00f4ng l\u1ea1nh b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p h\u1ea1 nhi\u1ec7t \u0111\u1ed9 ch\u1eadm v\u00e0 th\u1ee7y tinh h\u00f3a.<\/p>\n

2. <\/strong>\u0110\u00f4ng l\u1ea1nh tinh tr\u00f9ng b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p h\u1ea1 nhi\u1ec7t \u0111\u1ed9 ch\u1eadm<\/strong>
\n\u0110\u00f4ng l\u1ea1nh tinh tr\u00f9ng b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p h\u1ea1 nhi\u1ec7t \u0111\u1ed9 ch\u1eadm (Slow freezing) hay c\u00f2n g\u1ecdi l\u00e0 h\u1ea1 nhi\u1ec7t theo ch\u01b0\u01a1ng tr\u00ecnh l\u00e0 k\u1ef9 thu\u1eadt \u0111\u00f4ng l\u1ea1nh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn hi\u1ec7n nay \u1edf c\u00e1c trung t\u00e2m IVF. Nguy\u00ean t\u1eafc c\u1ee7a qu\u00e1 tr\u00ecnh h\u1ea1 nhi\u1ec7t \u0111\u1ed9 ch\u1eadm l\u00e0 d\u1ea7n d\u1ea7n \u0111\u01b0a tinh tr\u00f9ng v\u1ec1 nhi\u1ec7t \u0111\u1ed9 r\u1ea5t th\u1ea5p (-196\u00baC) theo t\u1eebng ng\u01b0\u1ee1ng nhi\u1ec7t \u0111\u1ed9 kh\u00e1c nhau. Tr\u01b0\u1edbc khi \u0111\u00f4ng l\u1ea1nh, m\u1eabu tr\u1eef s\u1ebd \u0111\u01b0\u1ee3c ti\u1ebfp x\u00fac v\u1edbi ch\u1ea5t b\u1ea3o qu\u1ea3n l\u1ea1nh (cryoprotective agents \u2013 CPA), th\u00f4ng th\u01b0\u1eddng l\u00e0 glycerol 5-10% theo t\u1ef7 l\u1ec7 1:1. CPA \u0111\u01b0\u1ee3c b\u1ed5 sung v\u00e0o m\u1eabu tr\u1eef tinh tr\u00f9ng theo n\u1ed3ng \u0111\u1ed9 t\u0103ng d\u1ea7n, t\u1ed1c \u0111\u1ed9 x\u00e2m nh\u1eadp th\u1ea5p v\u00e0 theo t\u1eebng giai \u0111o\u1ea1n \u0111\u1ec3 gi\u1ea3m thi\u1ec3u s\u1ed1c th\u1ea9m th\u1ea5u cho tinh tr\u00f9ng. B\u00ean c\u1ea1nh \u0111\u00f3, n\u1ed3ng \u0111\u1ed9 CPA th\u1ea5p c\u0169ng h\u1ea1n ch\u1ebf g\u00e2y \u0111\u1ed9c cho tinh tr\u00f9ng.<\/p>\n

Trong k\u1ef9 thu\u1eadt n\u00e0y, n\u01b0\u1edbc ngo\u1ea1i b\u00e0o \u0111\u00f3ng b\u0103ng th\u00e0nh c\u00e1c tinh th\u1ec3 b\u0103ng v\u00e0 t\u1ea1o ra hai pha: tinh th\u1ec3 b\u0103ng c\u1ee7a n\u01b0\u1edbc tinh khi\u1ebft v\u00e0 m\u1ed9t ph\u1ea7n kh\u00f4ng \u0111\u00f3ng b\u0103ng ch\u1ee9a n\u01b0\u1edbc, mu\u1ed1i, \u0111\u01b0\u1eddng v\u00e0 CPA. L\u00fac n\u00e0y, s\u1ef1 thay \u0111\u1ed5i v\u1ec1 nhi\u1ec7t \u0111\u1ed9 s\u1ebd l\u00e0m thay \u0111\u1ed5i t\u00ednh ch\u1ea5t c\u1ee7a m\u00e0ng tinh tr\u00f9ng, c\u00e1c ch\u1ea5t b\u00e9o trong m\u00e0ng s\u1ebd tr\u1ea3i qua m\u1ed9t giai \u0111o\u1ea1n chuy\u1ec3n t\u1eeb tr\u1ea1ng th\u00e1i l\u1ecfng sang d\u1ea1ng gel, c\u00f3 th\u1ec3 l\u00e0m h\u1ecfng m\u00e0ng tinh tr\u00f9ng (Hammerstedt v\u00e0 cs., 1990). Ngo\u00e0i ra, trong qu\u00e1 tr\u00ecnh trao \u0111\u1ed5i n\u01b0\u1edbc, n\u01b0\u1edbc di chuy\u1ec3n ra ngo\u00e0i t\u1ebf b\u00e0o v\u00e0 t\u1ea1o th\u00e0nh tinh th\u1ec3 \u0111\u00e1, l\u00e0m t\u0103ng \u0111\u1ed9 th\u1ea9m th\u1ea5u c\u1ee7a m\u00f4i tr\u01b0\u1eddng \u0111\u00f4ng l\u1ea1nh, c\u0169ng c\u00f3 th\u1ec3 l\u00e0m h\u1ecfng c\u1ea5u tr\u00fac t\u1ebf b\u00e0o c\u1ee7a tinh tr\u00f9ng. Ng\u01b0\u1ee1ng nhi\u1ec7t \u0111\u1ed9 v\u00e0 th\u1eddi gian l\u00e0m l\u1ea1nh c\u0169ng r\u1ea5t quan tr\u1ecdng trong qu\u00e1 tr\u00ecnh \u0111\u00f4ng l\u1ea1nh b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p h\u1ea1 nhi\u1ec7t \u0111\u1ed9 ch\u1eadm. \u0110\u00f4ng l\u1ea1nh \u1edf nhi\u1ec7t \u0111\u1ed9 v\u00e0 th\u1eddi gian th\u00edch h\u1ee3p s\u1ebd l\u00e0m gi\u1ea3m t\u1ed5n th\u01b0\u01a1ng c\u1ee7a tinh tr\u00f9ng do bi\u1ebfn \u0111\u1ed5i v\u1ec1 nhi\u1ec7t v\u00e0 h\u00ecnh th\u00e0nh tinh th\u1ec3 \u0111\u00e1 n\u1ed9i b\u00e0o, t\u1eeb \u0111\u00f3 c\u00f3 th\u1ec3 t\u0103ng t\u1ef7 l\u1ec7 s\u1ed1ng c\u1ee7a tinh tr\u00f9ng sau r\u00e3 \u0111\u00f4ng. \u0110\u1ed1i v\u1edbi k\u1ef9 thu\u1eadt \u0111\u00f4ng l\u1ea1nh tinh tr\u00f9ng b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p h\u1ea1 nhi\u1ec7t \u0111\u1ed9 ch\u1eadm, hi\u1ec7n nay c\u00f3 3 xu h\u01b0\u1edbng l\u00e0 s\u1eed d\u1ee5ng m\u00e1y h\u1ea1 nhi\u1ec7t \u0111\u1ed9 theo ch\u01b0\u01a1ng tr\u00ecnh t\u1ef1 \u0111\u1ed9ng, s\u1eed d\u1ee5ng t\u1ee7 \u00e2m s\u00e2u v\u00e0 kh\u00f4ng s\u1eed d\u1ee5ng m\u00e1y (\u0111\u00f4ng l\u1ea1nh ch\u1eadm c\u1ea3i ti\u1ebfn).<\/p>\n

\u0110\u00f4ng l\u1ea1nh tinh tr\u00f9ng b\u1eb1ng m\u00e1y h\u1ea1 nhi\u1ec7t \u0111\u1ed9 theo ch\u01b0\u01a1ng tr\u00ecnh<\/em><\/strong> t\u1ef1 \u0111\u1ed9ng<\/strong><\/em>
\n\u0110\u00e2y l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u00f4ng l\u1ea1nh truy\u1ec1n th\u1ed1ng, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn nh\u1ea5t. Trong ph\u01b0\u01a1ng ph\u00e1p n\u00e0y, m\u1eabu tinh tr\u00f9ng \u0111\u00e3 x\u1eed l\u00fd v\u1edbi CPA \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o trong khay ch\u1ee9a m\u1eabu \u0111\u00e3 c\u00f3 s\u1eb5n ni-t\u01a1 l\u1ecfng. Trong qu\u00e1 tr\u00ecnh ho\u1ea1t \u0111\u1ed9ng, ni-t\u01a1 l\u1ecfng s\u1ebd \u0111\u01b0\u1ee3c b\u01a1m v\u00e0o m\u00e1y d\u01b0\u1edbi s\u1ef1 ki\u1ec3m so\u00e1t c\u1ee7a c\u1ea3m bi\u1ebfn nhi\u1ec7t \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o ch\u00ednh x\u00e1c t\u1ed1c \u0111\u1ed9 v\u00e0 nhi\u1ec7t \u0111\u1ed9 \u0111\u00e3 c\u00e0i \u0111\u1eb7t. T\u01b0\u01a1ng \u1ee9ng v\u1edbi m\u1ed7i kho\u1ea3ng nhi\u1ec7t \u0111\u1ed9 kh\u00e1c nhau, t\u1ed1c \u0111\u1ed9 h\u1ea1 nhi\u1ec7t c\u0169ng thay \u0111\u1ed5i. Th\u00f4ng th\u01b0\u1eddng, t\u1eeb 25\u00baC \u0111\u1ebfn -7\u00baC, nhi\u1ec7t \u0111\u1ed9 h\u1ea1 3\u00baC\/ph\u00fat; t\u1eeb -7\u00baC \u0111\u1ebfn -50\u00baC, nhi\u1ec7t \u0111\u1ed9 h\u1ea1 0,3\u00baC\/ph\u00fat; t\u1eeb -50\u00baC \u0111\u1ebfn -150\u00baC, nhi\u1ec7t \u0111\u1ed9 h\u1ea1 30\u00baC\/ph\u00fat v\u00e0 sau \u0111\u00f3 \u0111\u01b0a th\u1eb3ng v\u00e0o ni-t\u01a1 l\u1ecfng (-196\u00baC) (WHO 2010).<\/p>\n

\u0110\u1ed1i v\u1edbi ph\u01b0\u01a1ng ph\u00e1p n\u00e0y, qu\u00e1 tr\u00ecnh \u0111\u00f4ng l\u1ea1nh \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ef1 \u0111\u1ed9ng, \u0111\u1ed3ng b\u1ed9 theo ch\u01b0\u01a1ng tr\u00ecnh \u0111\u00e3 c\u00e0i \u0111\u1eb7t s\u1eb5n, do \u0111\u00f3 h\u1ea1n ch\u1ebf \u0111\u01b0\u1ee3c s\u1ef1 t\u1ed5n th\u01b0\u01a1ng c\u1ee7a t\u1ebf b\u00e0o, c\u0169ng nh\u01b0 c\u00e1c m\u1eabu \u0111\u1ec1u \u0111\u01b0\u1ee3c \u0111\u00f4ng l\u1ea1nh d\u01b0\u1edbi \u0111i\u1ec1u ki\u1ec7n gi\u1ed1ng nhau. Tuy nhi\u00ean, h\u1ec7 th\u1ed1ng \u0111\u00f4ng l\u1ea1nh c\u1ea7n chi ph\u00ed \u0111\u1ea7u t\u01b0 ban \u0111\u1ea7u v\u1ec1 m\u00e1y m\u00f3c l\u1edbn (t\u1eeb 10.000 \u0111\u1ebfn 30.000 USD), c\u1ea7n b\u1ea3o d\u01b0\u1ee1ng \u0111\u1ecbnh k\u1ef3 v\u00e0 chi ph\u00ed hao m\u00f2n, s\u1eeda ch\u1eefa thi\u1ebft b\u1ecb cao.<\/p>\n

\u0110\u00f4ng l\u1ea1nh tinh tr\u00f9ng b\u1eb1ng t\u1ee7 \u00e2m s\u00e2u<\/strong><\/em>
\n\u0110\u00e2y l\u00e0 ph\u01b0\u01a1ng ph\u00e1p s\u1eed d\u1ee5ng c\u00e1c h\u1ec7 th\u1ed1ng t\u1ee7 \u0111\u00f4ng c\u00f3 nhi\u1ec7t \u0111\u1ed9 r\u1ea5t th\u1ea5p, t\u1eeb -20\u00baC \u0111\u1ebfn -80\u00baC \u0111\u1ec3 \u0111\u00f4ng l\u1ea1nh tinh tr\u00f9ng. M\u1eabu sau khi ti\u1ebfp x\u00fac CPA s\u1ebd \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o t\u1ee7 -20\u00baC trong v\u00f2ng 30 ph\u00fat, sau \u0111\u00f3 chuy\u1ec3n nhanh v\u00e0o t\u1ee7 -80\u00baC trong 30 ph\u00fat r\u1ed3i nh\u00fang tr\u1ef1c ti\u1ebfp v\u00e0o ni-t\u01a1 l\u1ecfng.<\/p>\n

Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y t\u01b0\u01a1ng \u0111\u1ed1i \u0111\u01a1n gi\u1ea3n, d\u1ec5 th\u1ef1c hi\u1ec7n v\u00e0 ng\u01b0\u1ee1ng nhi\u1ec7t \u0111\u1ed9 l\u00e0m l\u1ea1nh \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c. Tuy nhi\u00ean, c\u00e1c h\u1ec7 th\u1ed1ng t\u1ee7 trang b\u1ecb \u0111\u1eaft ti\u1ec1n, c\u1ea7n b\u1ea3o d\u01b0\u1ee1ng c\u0169ng nh\u01b0 chi ph\u00ed x\u1eed l\u00fd s\u1ef1 c\u1ed1 cao. B\u00ean c\u1ea1nh \u0111\u00f3, ph\u01b0\u01a1ng ph\u00e1p n\u00e0y ch\u1ec9 s\u1eed d\u1ee5ng 2 ng\u01b0\u1ee1ng nhi\u1ec7t \u0111\u1ed9 l\u00e0 -20\u00baC v\u00e0 -80\u00baC n\u00ean c\u00f3 th\u1ec3 g\u00e2y s\u1ed1c nhi\u1ec7t cho tinh tr\u00f9ng do thay \u0111\u1ed5i nhi\u1ec7t \u0111\u1ed9 nhanh.<\/p>\n

\u0110\u00f4ng l\u1ea1nh tinh tr\u00f9ng kh\u00f4ng s\u1eed d\u1ee5ng m\u00e1y (\u0111\u00f4ng<\/strong> l\u1ea1nh ch\u1eadm c\u1ea3i ti\u1ebfn)<\/strong><\/em>
\nPh\u01b0\u01a1ng ph\u00e1p n\u00e0y s\u1eed d\u1ee5ng h\u01a1i ni-t\u01a1 l\u1ecfng \u0111\u1ec3 l\u00e0m l\u1ea1nh l\u1ecd tr\u1eef m\u1eabu tinh d\u1ecbch tr\u01b0\u1edbc khi \u0111\u01b0a v\u00e0o nhi\u1ec7t \u0111\u1ed9 -196\u00baC. \u0110\u1ea7u ti\u00ean, ni-t\u01a1 l\u1ecfng \u0111\u01b0\u1ee3c cho v\u00e0o khay x\u1ed1p \u0111\u00f4ng l\u1ea1nh m\u1eabu (d\u00e0i 80cm x r\u1ed9ng 28,5cm x cao 27cm) \u1edf v\u1ea1ch 3cm t\u00ednh t\u1eeb \u0111\u00e1y th\u00f9ng x\u1ed1p tr\u01b0\u1edbc khi thao t\u00e1c \u0111\u1ec3 h\u01a1i ni-t\u01a1 \u0111\u01b0\u1ee3c \u1ed5n \u0111\u1ecbnh. M\u1eabu tinh d\u1ecbch \u0111\u01b0\u1ee3c cho ti\u1ebfp x\u00fac v\u1edbi CPA, sau \u0111\u00f3 cho v\u00e0o l\u1ecd tr\u1eef v\u00e0 \u0111\u1ec3 \u1ed5n \u0111\u1ecbnh \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng tr\u00ean can nh\u00f4m. Sau 15 ph\u00fat, l\u1ea5y can nh\u00f4m g\u00e1c l\u00ean th\u00f9ng ni-t\u01a1 l\u1ecfng t\u1ea1i v\u1ecb tr\u00ed \u0111\u00e3 \u0111\u00e1nh d\u1ea5u tr\u01b0\u1edbc. Nh\u01b0 v\u1eady, h\u01a1i ni-t\u01a1 th\u0103ng hoa d\u1ea7n l\u00e0m l\u1ea1nh l\u1ecd tr\u1eef c\u00f3 ch\u1ee9a tinh d\u1ecbch. M\u1eabu sau khi \u0111\u01b0\u1ee3c l\u00e0m l\u1ea1nh \u0111\u1ebfn -50\u00baC ho\u1eb7c -80\u00baC s\u1ebd \u0111\u01b0\u1ee3c nh\u00fang tr\u1ef1c ti\u1ebfp v\u00e0o ni-t\u01a1 l\u1ecfng \u0111\u1ec3 b\u1ea3o qu\u1ea3n l\u00e2u d\u00e0i.<\/p>\n

Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y kh\u00f4ng \u0111\u00f2i h\u1ecfi c\u00e1c thi\u1ebft b\u1ecb chuy\u00ean d\u1ee5ng v\u00e0 c\u00f3 th\u1ec3 \u0111em l\u1ea1i t\u1ef7 l\u1ec7 tinh tr\u00f9ng s\u1ed1ng sau r\u00e3 \u0111\u00f4ng ch\u1ea5p nh\u1eadn \u0111\u01b0\u1ee3c. Tuy nhi\u00ean, nh\u01b0\u1ee3c \u0111i\u1ec3m l\u00e0 t\u1ed1c \u0111\u1ed9 l\u00e0m l\u1ea1nh kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t gi\u1eefa b\u00ean trong v\u00e0 b\u00ean ngo\u00e0i m\u1eabu, gi\u1eefa c\u00e1c m\u1eabu tr\u1eef v\u1edbi nhau, v\u00e0 nh\u1eefng kh\u00f3 kh\u0103n trong vi\u1ec7c duy tr\u00ec \u0111i\u1ec1u ki\u1ec7n gi\u1ed1ng nhau gi\u1eefa c\u00e1c l\u1ea7n \u0111\u00f4ng l\u1ea1nh. T\u1ea1i Vi\u1ec7t Nam, quy tr\u00ecnh \u0111\u00f4ng l\u1ea1nh tinh tr\u00f9ng b\u1eb1ng h\u01a1i ni-t\u01a1 l\u1ecfng \u0111\u01a1n thu\u1ea7n \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e2y d\u1ef1ng v\u00e0 cho th\u1ea5y c\u00f3 hi\u1ec7u qu\u1ea3 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi vi\u1ec7c s\u1eed d\u1ee5ng m\u00e1y cho c\u00e1c m\u1eabu tinh tr\u00f9ng c\u00f3 ch\u1ea5t l\u01b0\u1ee3ng t\u1ed1t c\u0169ng nh\u01b0 m\u1eabu tinh tr\u00f9ng \u00edt, y\u1ebfu v\u00e0 d\u1ecb d\u1ea1ng (Nguy\u1ec5n H\u1eefu Duy v\u00e0 cs., 2009). B\u00ean c\u1ea1nh \u0111\u00f3, vi\u1ec7c s\u1eed d\u1ee5ng h\u01a1i ni-t\u01a1 l\u1ecfng \u0111\u01a1n thu\u1ea7n c\u0169ng gi\u00fap gi\u1ea3m chi ph\u00ed \u0111\u1ea7u t\u01b0, chi ph\u00ed v\u1eadn h\u00e0nh cho m\u1ed9t chu k\u00ec \u0111\u00f4ng l\u1ea1nh v\u00e0 r\u00e3 \u0111\u00f4ng tinh tr\u00f9ng.<\/p>\n

3. \u0110\u00f4ng l\u1ea1nh tinh tr\u00f9ng b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p th\u1ee7y tinh h\u00f3a<\/strong>
\nV\u1ec1 m\u1eb7t v\u1eadt l\u00fd, th\u1ee7y tinh h\u00f3a \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh h\u00f3a r\u1eafn dung d\u1ecbch v\u1edbi t\u1ed1c \u0111\u1ed9 l\u00e0m l\u1ea1nh c\u1ef1c nhanh l\u00e0m t\u0103ng r\u1ea5t nhanh \u0111\u1ed9 nh\u1edbt \u0111\u1ec3 dung d\u1ecbch \u0111\u1ea1t \u0111\u1ebfn tr\u1ea1ng th\u00e1i \u1ed5n \u0111\u1ecbnh. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y gi\u00fap lo\u1ea1i b\u1ecf s\u1ef1 h\u00ecnh th\u00e0nh tinh th\u1ec3 \u0111\u00e1 trong h\u1ec7 th\u1ed1ng sinh h\u1ecdc. Khi th\u1ef1c hi\u1ec7n h\u1ea1 nhi\u1ec7t \u0111\u1ed9 v\u1edbi t\u1ed1c \u0111\u1ed9 cao th\u00ec dung d\u1ecbch n\u01b0\u1edbc mu\u1ed1i \u0111\u1eb3ng tr\u01b0\u01a1ng v\u1eabn c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u00f4ng l\u1ea1nh m\u00e0 kh\u00f4ng c\u1ea7n CPA. \u0110i\u1ec1u n\u00e0y gi\u00fap lo\u1ea1i b\u1ecf t\u1ea5t c\u1ea3 c\u00e1c th\u00e1ch th\u1ee9c v\u1ec1 s\u1ed1c th\u1ea9m th\u1ea5u khi s\u1eed d\u1ee5ng CPA n\u1ed3ng \u0111\u1ed9 cao. Tuy c\u00f3 v\u1ebb d\u1ec5 th\u1ef1c hi\u1ec7n nh\u01b0ng th\u1ef1c t\u1ebf g\u1eb7p r\u1ea5t nhi\u1ec1u kh\u00f3 kh\u0103n \u0111\u1ec3 c\u00f3 th\u1ec3 h\u1ea1 nhi\u1ec7t \u0111\u1ed9 m\u1eabu \u0111\u1ee7 nhanh \u0111\u1ec3 x\u1ea3y ra qu\u00e1 tr\u00ecnh th\u1ee7y tinh h\u00f3a.<\/p>\n

\u0110\u1ec3 chu\u1ea9n b\u1ecb cho qu\u00e1 tr\u00ecnh th\u1ee7y tinh h\u00f3a, m\u1ed9t l\u01b0\u1ee3ng l\u1edbn CPA \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong m\u00f4i tr\u01b0\u1eddng \u0111\u00f4ng l\u1ea1nh (30-50%) v\u00e0 l\u01b0\u1ee3ng m\u1eabu kh\u00e1 nh\u1ecf. Tuy nhi\u00ean, tinh tr\u00f9ng l\u00e0 t\u1ebf b\u00e0o d\u1ec5 t\u1ed5n th\u01b0\u01a1ng trong m\u00f4i tr\u01b0\u1eddng c\u00f3 n\u1ed3ng \u0111\u1ed9 CPA cao v\u00e0 v\u00ec l\u00fd do n\u00e0y, c\u00f3 nhi\u1ec1u \u00fd ki\u1ebfn cho r\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p th\u1ee7y tinh h\u00f3a kh\u00f4ng \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p c\u00f3 th\u1ec3 b\u1ea3o t\u1ed3n ch\u1ea5t l\u01b0\u1ee3ng tinh tr\u00f9ng. Tr\u01b0\u1eddng h\u1ee3p \u0111\u00f4ng l\u1ea1nh tinh tr\u00f9ng b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p th\u1ee7y tinh h\u00f3a v\u1edbi th\u1ec3 t\u00edch nh\u1ecf (20\u00b5l) \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o th\u00e0nh c\u00f4ng l\u1ea7n \u0111\u1ea7u ti\u00ean v\u00e0o n\u0103m 2002. K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u cho th\u1ea5y tinh tr\u00f9ng v\u1eabn c\u00f3 kh\u1ea3 n\u0103ng th\u1ee5 tinh sau khi r\u00e3 \u0111\u00f4ng (Nawroth F v\u00e0 cs., 2002). Tuy nhi\u00ean, v\u1eabn c\u00f2n m\u1ed9t s\u1ed1 nguy c\u01a1 t\u1ed3n t\u1ea1i nh\u01b0 kh\u1ea3 n\u0103ng l\u00e2y truy\u1ec1n t\u00e1c nh\u00e2n l\u00e2y nhi\u1ec5m khi cho m\u1eabu tinh d\u1ecbch ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi ni-t\u01a1 l\u1ecfng, kh\u00f3 kh\u0103n trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb khi s\u1eed d\u1ee5ng c\u00e1c m\u1eabu tr\u1eef v\u1edbi th\u1ec3 t\u00edch nh\u1ecf, c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u1ee7 cho chu k\u1ef3 h\u1ed7 tr\u1ee3 sinh s\u1ea3n. B\u00ean c\u1ea1nh \u0111\u00f3 nhi\u1ec1u nghi\u00ean c\u1ee9u cho r\u1eb1ng, n\u1ed3ng \u0111\u1ed9 CPA cao c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9c t\u00ednh cho t\u1ebf b\u00e0o. V\u00ec v\u1eady, nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u00e3 v\u00e0 \u0111ang \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 t\u00ecm h\u01b0\u1edbng \u0111i m\u1edbi cho ph\u01b0\u01a1ng ph\u00e1p th\u1ee7y tinh h\u00f3a.<\/p>\n

Theo nhi\u1ec1u nghi\u00ean c\u1ee9u kh\u00e1c nhau, h\u00ecnh d\u1ea1ng v\u00e0 k\u00edch th\u01b0\u1edbc c\u1ee7a \u0111\u1ea7u tinh tr\u00f9ng l\u00e0 y\u1ebfu t\u1ed1 quy\u1ebft \u0111\u1ecbnh t\u00ednh nh\u1ea1y c\u1ea3m c\u1ee7a ch\u00fang \u0111\u1ed1i v\u1edbi m\u00f4i tr\u01b0\u1eddng \u0111\u00f4ng l\u1ea1nh. Theo nh\u00f3m t\u00e1c gi\u1ea3 Isachenko v\u00e0 c\u1ed9ng s\u1ef1, n\u1ebfu kh\u00f4ng s\u1eed d\u1ee5ng CPA th\u00ec vi\u1ec7c th\u1ee7y tinh h\u00f3a tinh tr\u00f9ng ng\u01b0\u1eddi v\u1eabn c\u00f3 kh\u1ea3 n\u0103ng th\u00e0nh c\u00f4ng (Isachenko v\u00e0 cs., 2007). Tuy nhi\u00ean, ng\u01b0\u1eddi ta cho r\u1eb1ng nh\u01b0\u1ee3c \u0111i\u1ec3m c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u00e0y l\u00e0 gi\u1edbi h\u1ea1n th\u1ec3 t\u00edch m\u1eabu tr\u1eef trong m\u1ed9t l\u1ea7n tr\u1eef. C\u0169ng v\u00e0o n\u0103m 2007, nh\u00f3m t\u00e1c gi\u1ea3 Aizpurua v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 ti\u1ebfn h\u00e0nh so s\u00e1nh k\u1ef9 thu\u1eadt tr\u1eef tinh tr\u00f9ng b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p th\u1ee7y tinh h\u00f3a kh\u00f4ng s\u1eed d\u1ee5ng CPA so v\u1edbi ph\u01b0\u01a1ng ph\u00e1p h\u1ea1 nhi\u1ec7t \u0111\u1ed9 ch\u1eadm. K\u1ebft qu\u1ea3 cho th\u1ea5y tinh tr\u00f9ng tr\u1eef b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p th\u1ee7y tinh h\u00f3a c\u00f3 \u0111\u1ed9 di \u0111\u1ed9ng, t\u1ef7 l\u1ec7 s\u1ed1ng, c\u1ea5u tr\u00fac DNA nguy\u00ean v\u1eb9n cao h\u01a1n so v\u1edbi m\u1eabu tr\u1eef b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p h\u1ea1 nhi\u1ec7t \u0111\u1ed9 ch\u1eadm. Do \u0111\u00f3, k\u0129 thu\u1eadt n\u00e0y d\u1ea7n d\u1ea7n tr\u1edf th\u00e0nh ph\u01b0\u01a1ng ph\u00e1p thay th\u1ebf hi\u1ec7u qu\u1ea3 cho ph\u01b0\u01a1ng ph\u00e1p h\u1ea1 nhi\u1ec7t \u0111\u1ed9 ch\u1eadm v\u00e0 s\u1ebd ph\u00e1t tri\u1ec3n h\u01a1n trong t\u01b0\u01a1ng lai.<\/p>\n

4. <\/strong>R\u00e3 \u0111\u00f4ng tinh tr\u00f9ng<\/strong>
\nR\u00e3 \u0111\u00f4ng tinh tr\u00f9ng l\u00e0 qu\u00e1 tr\u00ecnh \u0111\u01b0a tinh tr\u00f9ng t\u1eeb nhi\u1ec7t \u0111\u1ed9 -1960<\/sup>C v\u1ec1 l\u1ea1i nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng. Qu\u00e1 tr\u00ecnh r\u00e3 \u0111\u00f4ng c\u00f3 m\u1ed1i li\u00ean h\u1ec7 ch\u1eb7t ch\u1ebd v\u1edbi qu\u00e1 tr\u00ecnh \u0111\u00f4ng l\u1ea1nh v\u00e0 s\u1ef1 t\u1ed5n th\u01b0\u01a1ng tinh tr\u00f9ng kh\u00f4ng ch\u1ec9 x\u1ea3y ra \u1edf qu\u00e1 tr\u00ecnh \u0111\u00f4ng l\u1ea1nh m\u00e0 c\u00f2n \u1edf c\u1ea3 qu\u00e1 tr\u00ecnh r\u00e3 \u0111\u00f4ng. Trong qu\u00e1 tr\u00ecnh r\u00e3 \u0111\u00f4ng, c\u00e1c tinh th\u1ec3 \u0111\u00e1 tan ra c\u00f3 th\u1ec3 g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nh\u1eefng b\u00e0o quan b\u00ean trong tinh tr\u00f9ng. Qu\u00e1 tr\u00ecnh r\u00e3 \u0111\u00f4ng kh\u00f4ng n\u00ean k\u00e9o d\u00e0i qu\u00e1 l\u00e2u \u0111\u1ec3 tr\u00e1nh hi\u1ec7n t\u01b0\u1ee3ng t\u00e1i k\u1ebft tinh h\u00f3a v\u00e0 c\u0169ng kh\u00f4ng n\u00ean qu\u00e1 nhanh \u0111\u1ec3 n\u01b0\u1edbc c\u00f3 th\u1ec3 k\u1ecbp v\u00e0o l\u1ea1i b\u00ean trong t\u1ebf b\u00e0o \u0111\u1ec3 vi\u1ec7c trao \u0111\u1ed5i CPA v\u00e0 n\u01b0\u1edbc di\u1ec5n ra t\u1eebng b\u01b0\u1edbc. Nh\u1eefng m\u1eabu tinh d\u1ecbch c\u00f3 ch\u1ea5t l\u01b0\u1ee3ng t\u1ed1t s\u1ebd c\u00f3 kh\u1ea3 n\u0103ng th\u00edch \u1ee9ng v\u1edbi qu\u00e1 tr\u00ecnh \u0111\u00f4ng l\u1ea1nh \u2013 r\u00e3 \u0111\u00f4ng t\u1ed1t h\u01a1n so v\u1edbi nh\u1eefng m\u1eabu c\u00f3 ch\u1ea5t l\u01b0\u1ee3ng y\u1ebfu. C\u1ea7n \u0111\u1ea3m b\u1ea3o m\u1eabu tinh d\u1ecbch sau khi r\u00e3 \u0111\u00f4ng \u0111\u00e3 h\u00f3a l\u1ecfng ho\u00e0n to\u00e0n m\u1edbi ti\u1ebfn h\u00e0nh nh\u1eefng k\u1ef9 thu\u1eadt ti\u1ebfp theo. Th\u00f4ng th\u01b0\u1eddng, m\u1eabu tinh tr\u00f9ng \u0111\u00f4ng l\u1ea1nh s\u1ebd \u0111\u01b0\u1ee3c \u0111\u1ec3 \u1edf nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng kho\u1ea3ng 15 \u2013 20 ph\u00fat \u0111\u1ec3 r\u00e3 \u0111\u00f4ng ho\u00e0n to\u00e0n tr\u01b0\u1edbc khi l\u1ecdc r\u1eeda ho\u1eb7c s\u1eed d\u1ee5ng.<\/p>\n

5. K\u1ebft lu\u1eadn<\/strong>
\n\u0110\u00f4ng l\u1ea1nh tinh tr\u00f9ng l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt ph\u1ed5 bi\u1ebfn \u1edf c\u00e1c trung t\u00e2m h\u1ed7 tr\u1ee3 sinh s\u1ea3n. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y gi\u00fap l\u01b0u gi\u1eef tinh tr\u00f9ng trong kho\u1ea3ng th\u1eddi gian d\u00e0i \u0111\u1ec3 s\u1eed d\u1ee5ng cho c\u00e1c m\u1ee5c \u0111\u00edch kh\u00e1c nhau trong IVF. Trong qu\u00e1 tr\u00ecnh \u0111\u00f4ng l\u1ea1nh, \u0111\u1ec3 h\u1ea1n ch\u1ebf t\u00e1c \u0111\u1ed9ng x\u1ea5u c\u1ee7a nhi\u1ec7t \u0111\u1ed9 \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng tinh tr\u00f9ng \u0111\u00f4ng l\u1ea1nh, ng\u01b0\u1eddi ta th\u01b0\u1eddng b\u1ed5 sung c\u00e1c ch\u1ea5t b\u1ea3o qu\u1ea3n l\u1ea1nh (CPA) v\u00e0o m\u00f4i tr\u01b0\u1eddng \u0111\u00f4ng l\u1ea1nh. Hi\u1ec7n nay, c\u00f3 2 ph\u01b0\u01a1ng ph\u00e1p \u0111ang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn l\u00e0 h\u1ea1 nhi\u1ec7t \u0111\u1ed9 ch\u1eadm v\u00e0 th\u1ee7y tinh h\u00f3a.<\/p>\n

T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong>
\n1.     H\u1ed3 M\u1ea1nh T\u01b0\u1eddng, Nguy\u1ec5n Th\u1ecb Mai, L.V.T., (2000). Tr\u1eef l\u1ea1nh tinh tr\u00f9ng trong th\u1ee5 tinh nh\u00e2n t\u1ea1o. Th\u1eddi s\u1ef1 Y d\u01b0\u1ee3c h\u1ecdc, 5, pp.8-13
\n2.    Nguy\u1ec5n H\u1eefu Duy, Tr\u01b0\u01a1ng Th\u1ecb Thanh B\u00ecnh, H.T.Q., (2009). So s\u00e1nh hi\u1ec7u qu\u1ea3 c\u1ee7a 2 ph\u01b0\u01a1ng ph\u00e1p \u0111\u00f4ng l\u1ea1nh th\u1ee7 c\u00f4ng v\u00e0 d\u00f9ng m\u00e1y. NXB Khoa h\u1ecdc v\u00e0 K\u0129 thu\u1eadt, Tuy\u1ec3n t\u1eadp, pp.518-524.
\n3.    Aizpurua, J. et al., (2017). New permeable cryoprotectant-free vitrification method for native human sperm. Human Reproduction, 32(10), pp.2007- 2015.
\n4.    Hammerstedt RH et al. Cryopreservation of mammalian sperm: what we ask them to survive. J Androl. 1990;11(1):73-88
\n5.    Isachenko, V. et al., (2004). Cryoprotectant-Free Cryopreservation of Human Spermatozoa by Vitrification and Freezing in Vapor: Effect on Motility, DNA Integrity, and Fertilization Ability. Biology of Reproduction, 71(4), pp.1167-1173<\/div>\n","protected":false},"excerpt":{"rendered":"

K\u1ef9 thu\u1eadt \u0111\u00f4ng l\u1ea1nh v\u00e0 r\u00e3 \u0111\u00f4ng tinh tr\u00f9ng     CNSH. Tr\u01b0\u01a1ng V\u0103n H\u1ea3i; CNSH. Nguy\u1ec5n Qu\u1ef3nh Nh\u01b0, CNSH. V\u00f5 Minh Tu\u1ea5n – IVFMD T\u00e2n B\u00ecnh 1. T\u1ed5ng quan \u0110\u00f4ng l\u1ea1nh tinh tr\u00f9ng l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt mang l\u1ea1i nhi\u1ec1u l\u1ee3i \u00edch cho \u0111i\u1ec1u tr\u1ecb v\u00f4 sinh c\u0169ng nh\u01b0 b\u1ea3o t\u1ed3n kh\u1ea3 n\u0103ng sinh s\u1ea3n…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"ngg_post_thumbnail":0,"footnotes":""},"categories":[24],"tags":[],"class_list":["post-249","post","type-post","status-publish","format-standard","hentry","category-tinhtrung"],"_links":{"self":[{"href":"https:\/\/vosinhhiemmuon.vn\/iui\/wp-json\/wp\/v2\/posts\/249","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vosinhhiemmuon.vn\/iui\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vosinhhiemmuon.vn\/iui\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vosinhhiemmuon.vn\/iui\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vosinhhiemmuon.vn\/iui\/wp-json\/wp\/v2\/comments?post=249"}],"version-history":[{"count":1,"href":"https:\/\/vosinhhiemmuon.vn\/iui\/wp-json\/wp\/v2\/posts\/249\/revisions"}],"predecessor-version":[{"id":250,"href":"https:\/\/vosinhhiemmuon.vn\/iui\/wp-json\/wp\/v2\/posts\/249\/revisions\/250"}],"wp:attachment":[{"href":"https:\/\/vosinhhiemmuon.vn\/iui\/wp-json\/wp\/v2\/media?parent=249"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vosinhhiemmuon.vn\/iui\/wp-json\/wp\/v2\/categories?post=249"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vosinhhiemmuon.vn\/iui\/wp-json\/wp\/v2\/tags?post=249"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}