Qonda ukuba Ziziphi, Ziyintoni Ezikwenzayo, kwaye Zininzi Kangakanani Okufanele Ube nazo
Kwiiyunithi zenkqubo yokuzala , inkohlakalo ye-ovari isigxoba esigcwele amanzi esineqanda elincinci, okanye i- oocyte . Ezi follicle zifumaneka kwiiyunithi. Ngethuba lokuvuthwa , iqanda elivuthiweyo likhutshwa kwi-follicle. Nangona iifolli eziliqela ziqala ukuphucula umjikelo ngamnye, ngokuqhelekileyo kuphela enye iya kuvula iqanda. Emva kwe-ovulation, i-follicle iya kuba yirepus luteum .
Iifolli ezingakhupha iqanda elivuthiweyo lidibanisa, inkqubo eyaziwa ngokuba yi-atresia enokuthi yenzeke nayiphi na inqanaba lophuhliso lobuqili. Phantse iipesenti ezingama-99 ze-ovarian follicles ziya kutshabalalisa kwaye azize zikhule ngokwaneleyo ukukhulula iqanda.
Ukukhula kwenkoliso kunye nophuhliso lulandelwa ngexesha lokunyanga . Ngexesha lokugqithisa (elisetyenziselwa unyango lwe-IVF ), umgomo kukukhuthaza ama-ovari ukuphuhlisa iifollic ezininzi ezivuthiweyo kanye kanye. Uvavanyo lwe-ultrasound, olubizwa ngokuba yi-antral follicle count (AFC), lunokwenziwa njengenxalenye yokuvavanya . Olu vavanyo lwenziwe ukuvavanya iindawo zokugcina ii-ovari.
Ziziphi Ii-Folral Follicle kwaye Ziyayifuma Njani Ukuzala?
Ngokwemfundiso, ukuba unokwazi ukuba ziphi iifolli ezingaphakathi kwiiyunithi zakho, unokuba neengcamango zingaphi amaqanda owashiye. Akunakwenzeka ukubala ukuba zininzi iintlobo zee-follicle ezingama-ovari ngenxa yokuba zincinane kakhulu ukuba ziboniswe.
Nangona kunjalo, emva kokuba isilulo sifinyelela kwisigaba esithile, singabonwa nge-ultrasound.
Iifolumu ziqala kakhulu, zincinci kakhulu. Zonke iifollic e-ovary ziqala njengeentlobo eziphambili. I-follicle ehamba phambili yimizuzu engama-25 engama-millimitha angu-0.025. Akunakwenzeka ukubona ngeaso iso, vumela kuphela kwi-ultrasound.
Nsuku zonke, iifolli eziphambili "zivuswa" ngempawu ze-hormonal kwaye ziqala ukuvuthwa. Ngethuba nje baqhubeka besinda kwaye baphumelela kwisigaba esilandelayo, bakhula bakhulu kwaye baninzi.
Enye yalezi zigaba yinqanaba eliphakamileyo. Ngeli xesha, i-follicle izuza umgudu ogcwele amanzi obizwa ngokuba yi-antrum. Iifolumu ezinomtsalane zibhekiswa njengezifo zengqungquthela. Bayalinganisa phakathi ko-2 no-10 mm ububanzi. Ngomnye umbono, ulandelelwano lwentambo engama-5 mm liphindwe ngama- 200 ubukhulu kunokuba lwaluyinto yobuqili obuphambili.
I-antrum follicles ekugqibeleni ibonakala kwi-ultrasound. Uphando lufumene ukuba inani leentlobo ezinobunzima zomsebenzi kwii-ovari zihambelana nenani elinokuthi linamaqanda asele. Usenako ukwazi ukuba ziphi na iintlobo zepollicle zikhoyo, kodwa xa ibhinqa lincinci elincinci ludla olukhulayo kwiiyunithi, uyakrokreka ukuba iindawo zakhe zokugcina i-ovarian ziphantsi.
Ii-follic follicles zivelisa amanqanaba aphezulu e-hormone eyaziwa ngokuba yi-hormone yokulwa ne-mullerian (AMH). Le hormone ijikeleza ngegazi lakho. Ukulinganisa ama-AMH ngokusebenzisa umsebenzi wegazi ngenye indlela yokuvavanya iindawo zokugcina ii-ovari.
Uphi uvavanyo lwe-Antral Follicle Count (AFC)?
Inani lokulandelelana kwintambo yolu vavanyo lokuzala. Yenziwe nge-ultrasound yangaphandle, ngamanye amaxesha phakathi komjikelezo wosuku 2 no-5.
Inkqubo ye-ultrasound tech iya kujonga kwi-ovary nganye kwaye ibale inani leepolisi ezilinganisa phakathi kwe-2 no-10 mm.
Ugqirha wakho unokuyalela lo vavanyo
- Hlola iindawo zokugcina ii-ovarian
- Yenza ukuxilongwa kwe-primary ovarian insufficiency
- Uncedo ukuxilonga i- polycystic ovarian syndrome
- Ukunika ingcamango yokuba indawo yakho yokuzala imi ngokumalunga nobudala bakho (unayo ngaphezulu, ngaphantsi, okanye inani eliqhelekileyo lezintluli xa kuthelekiswa nabanye ubudala bakho)
Uvavanyo luya kwenziwa njengenxalenye yempembelelo yokuzala. Okanye, ingahle ilandelwe ngaphambi komjikelo wonyango wokuzala.
Zingaphi Iifolongo Zase-Antral Ziqhelekile?
Khumbula ukuba kuqhelekile ukuba iindawo zokugcina ii-ovarian zihla phantsi njengoko uneminyaka yobudala.
Ngoko, into eqhelekileyo kumntwana oneminyaka engama-25 akuyinto eqhelekileyo kumntu oneminyaka engama-38 ubudala. Ngaloo nto yathi, inani le-folral follicle lika-3 ukuya kwe-6 libhekwa liphantsi.
Olunye uphando lwama-classic lwaluqhutywe ngoluhlu lwabafazi abanobuchule bokuvelisa (uphando oluninzi lwe-AFC lwenziwe kwabasetyhini abangenabantwana). Ukuze kufakwe kule sifundo, abafazi babefanele
- Yenza imijikelezo yimihla ngemihla, ihluke kwiintsuku ezingama-21 ukuya kwii-35 ubude
- Yenza i-ovulating , ibonakaliswe ngokunyuka kweqondo lokushisa kwi- chart ye-basal
- Ukhulelwe ubuncinane umntwana omnye kwixesha elidlulileyo, ngexesha lonyaka omnye
- Akunakho i-hormonal okanye i-endocrinological disease
- Ukuyeka ukulawula ukuzala ubuncinane ubuncinane kweenyanga ezimbini ngaphambi kokufunda
Nayi i-counter follicle counts (AFC), kunye nebala elibonwayo (ukusuka ngaphantsi ukuya ku-AFC count).
| Umda wobudala | Umyinge we-AFC | AFC ephantsi | I-AFC ephezulu |
| 25 ukuya ku-34 | 15 | 3 | 30 |
| 35 ukuya ku-40 | 9 | 1 | 25 |
| 41 ukuya ku-46 | 4 | 1 | 17 |
Ukuba neendawo ezincinci zokugcina ii-ovarian akuthethi ukuba awukwazi ukukhulelwa. Kodwa kuthetha ukuba ama-ovari akho angaphenduli kwimichiza yokuzala kunye nomfazi onamaqondo angcono okugcina ama-ovarian. Ubungcali be-ultrasound technician kunye nezixhobo ze-ultrasound ngokwayo ziyakuchukumisa iziphumo. Ukuba esinye isikhungo sifumana umphumo ombi, cinga ukufumana umbono wesibini.
Abafazi abanezibalo ezingaphantsi kwe-antral ngaphambi kokudala iminyaka engama-40 banokufumanisa ukuba abanako ukuphelelwa kwe-ovarian eyinqobo, eyaziwa ngokuba yi- ovarian premature failure . I-folral follicle ibalwa ngokwemvelo njengowesifazane osemdala. Isibalo esingaqhelekanga sokulandelelana kwesifo singabonisa i-polycystic ovarian syndrome (i-PCOS) .
Iyiphi Indima Ngaba Iifolda Zidlala Kwixesha Eliya Kwimihla?
Umjikelezo wakho wokuya esikhathini uyahlukana zibe ziingxenye ezibini eziphambili, isigaba sokulandelana, kunye nesigaba esilandelayo .
Ngexesha lokulandelana, iifolli kwizinga eliphezulu lokuphuhliswa ziyaqashwa kwaye ziqalise inkqubo eya ekugqibeleni iholele ekuhambeni. Nangona iifolli eziliqela ziqala kulo mkhosi, omnye kuphela (okanye ezimbini) uya kufumana ukukhula okupheleleyo kwaye akhululwe iqanda. Ukuba uthatha izidakamizwa zokuzala , iifolli eziliqela zingasifumana kwisigaba esineqanda.
Iifollicle ngokwazo zinoxanduva loku:
- Ukutya nokukhusela i-oocyte, njengoko ihamba nge-oogenesis
- Ukukhulula ama-hormone okuzala abalulekileyo, kuquka i-estradiol kunye ne-inhibin B, ebonisa uphawu lwe-pituitary kunye ne-hypothalamus gland ukwenyuka okanye ukunciphisa ukukhululwa kwe- GnRH , i- FSH , ne- LH
- Ukuguqulwa kwi- corpus luteum emva kwe-ovulation, ekhupha ii-hormone ze-progesterone kunye ne-estrogen
Yintoni eyenzekayo kwiSigaba seNkcazo seNyanga yokuHamba?
Isigaba esilandelayo somjikelezo wakho siqala ngosuku lokuqala lwenyanga yakho. Ukuya kwinyanga kukukhutshwa komzimba wee-tissue ze-endometrial eziphezulu, ezakhiwa ngokulindela ukukhulelwa. Ekupheleni kwexesha lakho, i-uterine lining will be thin. Ubuncwane buya kukhula kwaye bube buncipha emva kokuvutha.
Kodwa ngaphambi kokuba kwenzeke, njengokuba uhlala kwixesha lakho, amaqanda akho awalungiselela iqanda elilandelayo ukunyuka. Phakathi kweesithathu ezintandathu ezintollicle ziya kuqala ukukhula kwi-ovary yakho. I-hormone ye-FSH-follicle evuselela i-hormone-ikhiqizwa kwaye ikhutshwe yi-pituitary gland. Yiyo hormone edala iifollic ukukhula.
Njengoko iifolli zanda ngobukhulu, zikhulula i-estrogen ngakumbi. Amanqanaba aphezulu ye-estrogen isalathisi ye-pituitary gland yokunciphisa umveliso we-FSH. Nangona uqale ngeentlanu ezintlanu okanye ezintandathu, iinye (kunye ngamanye amaxesha) ziya kwenza ukuba zikhule. Amanqanaba angaphantsi kwe-FSH enza ukuba iifollic ezincinci zikhule ngokukhawuleza okanye ziyeke ukukhula, ngelixa ipolisi ekhulayo iyaqhubeka nokukhula kwayo.
Ekugqibeleni, isitho esinye sinobugqwetha obuphambili. Abanye bayeke ukukhula bafe. Xa ulandelelwano lufikelela kufutshane nobukhulu becala, lukhupha i-estrogen ngakumbi. Ngethuba langaphambili, amazinga okwandiswa kwe-estrogen ekhokelela kumanqanaba ekunciphisa ama-FSH, xa amanqanaba e-estrogen ephakamileyo kakhulu, kukho umtshintsho kwindlela i-pituitary gland ithatha ngayo i-hormone.
Amanqanaba aphezulu kakhulu e-estrogen enza ukuba i-pituitary gland ivelise kwaye ikhulule i-LH okanye i-hormone ye-luteinizing. Oku kuqhubezela ulandelelwano ukugqiba amanqanaba ayo okugqibela okuphuhliswayo, kwaye ekugqibeleni, i-follicle iya kuvula kwaye ikhulule iqanda. Lo ngumzuzwana we-ovulation.
Folliculogenesis: Amanyathelo okuPhuhliswa koLuntu
Unokucinga ukuba uphuhliso lwentoloko luqala kwaye luphela ngexesha lesigxina somjikelezo wesini, kodwa uya kuphutha malunga naloo nto.
I-lifecill follicular lifeciccle iqala phambi kokuba intombazana izalwe, xa i-ovari iqala ukuphuhliswa. Ngeli xesha, ii-ovari ziqulethe kuphela iifollicle eziphambili. Iifolda zihlala kule "kubuthwa" kwimizuzu engama-50 ngaphambi kokuba 'ivuke' kwaye ihambe kwizigaba zophuhliso. Kuthatha naliphi na ukuya kwiinyanga ezintandathu ukuya komnye ukuhamba ukusuka kwintolli ehamba phambili kwi-follicle ekulungele ukuvuthwa.
Kuzo zonke izigaba zophuhliso lwentando, ezininzi zee-follicle ziyayeka ukuphuhlisa nokufa. Akusiyo yonke intolongo ehamba phambili iya kuhamba nganye kwisigaba. Cinga nje ngolu khuphiswano ukuze ufike kwii-Olimpiki ze-ovulation. Ezinye iifollic ziya kuphuma, kwaye ezinye ziya kuqhubeka. Ngaphantsi kwepesenti enye yenzeke i-oocyte.
Izigaba ze-folliculogenesis zi:
- Inkoliso yokuqala (isigaba zonke iifollicle zingaphakathi kwiiyunithi zentombazana esanda kuzalwa)
- Iifolanda zaseprayimari (ukuqashwa kwamathambo ambalwa ambalwa kwisigaba esilandelayo esilandelayo senzeke imihla ngemihla, ukususela ekutshatsheni nasekuqhubekeni kuze kube yimihla yokuyeka umva)
- Iifolumu zesekondari (ezibandakanya ukongezwa kwamaseli e-theca, okuya kubeka i-hormone)
- I-follicles ephakamileyo, eyaziwa nangokuthi i-antral follicles (ezo zizinto ezinobungqina obuqulethe umzila ogcwele amanzi obizwa ngokuba yi-antrum, iifollicle kweli nqanaba zibonakala nge-ultrasound yangaphakathi)
- I-folale ye-Graafian (i-follicle enkulu ngokwaneleyo ukuba yenze i-ovulate, kuphela enye okanye ezimbini zezinto eziphakamileyo zemfundo emjikelezweni ngamnye ziya kukhula zize zivuthwe)
- I-Corpus luteum (engeyiyo yimibuzo yobugcisa, i-corpus luteum ivela kwi-follicle evulekile evulekileyo iqanda.)
Ubungakanani Okufunekayo Kwiifolda?
Ukuba ufumana unyango lwezityalo, ugqirha wakho unokugada ukuphuhliswa kobugqwetha nge-ultrasound. Ngethuba lala ma-ultrasounds, inani lezinto eziphuhliswayo ziza kubalwa. Baya kulinganiswa.
Iifolumu zilinganiswa kwiimitha (mm). Ngokuqhelekileyo, ugqirha wakho uya kufuna ukucwangcisa i-injection yakho okanye i-hCG / LH injection-xa iifolli zakho ziphantse ukufikelela ubungakanani obuvuthiweyo. Lo malunga ne-18 mm.
I-follicle evuthiweyo ezayo malunga nokukhupha izakulinganisa naphi na phakathi kwe-18 no-25 mm.
Zingaphi Iifolda Ngaba Ndifanele Ngifumane Ngexesha leComidid Cycle?
Eyona ndlela, ufuna kuphela enye okanye ezimbini eziqhelekileyo zobugqwetha ngexesha lomjikelezo weCommid . Unokuziva udidekile xa ufumanisa i-follicle eyodwa okanye ezimbini zikhulu ngokwaneleyo ukuze zenze i-ovulate. Nangona kunjalo, khumbula ukuba okungakumbi akunjalo into enhle. Yonke into ekhulile elandelwayo ingasikhulula iqanda, kwaye loo iqanda lingacetyiswa.
Ukuba unemibuzo emibili, ungakhulelwa ngamawele . Okanye, ungeke ukhulelwe. Okanye, unokukhulelwa umntwana omnye. Ukuvuthwa akuqinisekisi ukukhulelwa.
Zingaphi Iifolumu Eziqhelekileyo kwi-IUI okanye i-Gonadotropins Cycle?
NjengoComomid, ngokuqinisekileyo, ufuna kuphela ukuba omnye okanye iifolli ezimbini zikhule ukuze zikhule. Iziyobisi ezinobungozi (i-gonadotropins) ziza nomngcipheko ophezulu wokukhulelwa okubanzi. Kunokwenzeka ukuphuhlisa iintollicle ezintathu, ezine, okanye ngaphezulu.
Ukuba ufumana ezine iifolli ezine okanye ngaphezulu, ugqirha wakho unokurhoxisa umjikelo wakho wonyango. Oku kunokuthetha ukukhansela inkqubo ehleliweyo ye- IUI , ukukhansela umtsalane wokudubula, kunye / okanye ukuxelela ukuba ubaleke ukulala ngesondo.
Ukuba ugqirha wakho akuxelela ukuba ungalalani ngesondo, kuyimfuneko ukuphulaphula. Umngcipheko wokukhulelwa kathathu okanye i-quadruplets iphakamileyo kunye neentlobo ezininzi ezivuthiweyo. Ukukhulelwa okubanzi kuza kukubeka ubomi bakho engozini . Kungcono ukulinda nokuzama kwakhona kwenye umjikelo.
Zingaphi Iifolda Ukuba Ndibe Nako Ngethuba le-IVF Cycle?
Ngexesha lokunyanga kwe-IVF , ugqirha wakho ufuna ukuvuselela amaqanda akho ukuba aqokelele iifollic eziningana. Naluphi na phakathi kwe-follicle ye-8 ne-15 ithathwa njengemali eyamkelekileyo.
Ngexesha lokubuyiswa kwamaqanda, ugqirha wakho uya kufisa iifollicle ngenaliti ekhokelwa yi-ultrasound. Zonke iifolthi aziyi kuba neqanda eliphezulu. Ngoko, ungamangalisi ukuba inani leeqanda elifunyenwe liphantsi kwenani lezilwanyana ezinobomi obuqatshelwe ukuba unayo.
Igama elivela kwi-Verywell
Ubungakanani befolumu kunye nokubala kunokubangela ukuba uxinzelelo. Ngethuba lokuvavanya, ukufunda ukuba inani lakho lokulandelelana kwezinto eziphambeneyo alinakuphakama njengoko linethemba lokubangela ukhathazeka. Ukuxilongwa kweendawo ezincinci ze-ovarian ziyakunzima kakhulu ukujamelana nazo. Ugqirha wakho angancoma i- IVF kunye nomnikeli weqanda , umendo ongekho zonke izibini ezikwazi ukuzenza okanye ezikulungele ukuthatha.
I-Follicle yokubala kunye nemilinganiselo ngexesha lotyando lwezonyango lingakuthumela kwakhona kwi-roller-coaster of emotions. Ngaba ii-ovari zakho zivelisa kakhulu? Abaninzi kakhulu? Kuthetha ukuthini oko?
Nangona ukubala kobugqwetha kubonakaliso obalulekileyo bokuzala-kwaye ngexesha lokunyanga, ukubala kobugqwetha kunokwazi ukuba umjikelo uya kuqhubeka okanye ukhanseke-khumbula ukuba inombolo enye ayikuchazi, okanye iyakulingela kwangaphambili ukuba uza kuzalisa.
Abasetyhini abaneenkcukacha ezingaphantsi kwamathambo bangakwazi ukukhulelwa, ngamanye amaxesha ngamaqanda abo. Enye ye-ultrasound ngethuba lomjikelo wonyango alukwazi ukuzisa iindaba ezilungileyo, kodwa ukulungiswa kwemichiza yakho yokuzala kungenza ukuba iziphumo ezilandelayo zibe ngcono.
Ukuba awuqinisekanga ukuba intolli yakho ibaluleke ntoni, xela ugqirha wakho. Ungesabi ukufumana uluvo lwesibini malunga novavanyo lokuvuna kunye neziphumo zokuxilonga. Yaye qi ni sekise ukufumana inkxaso . Ukuvavanywa kwenzalo kunye nokonyango kunzima . Awudingi ukwenza oku wedwa.
> Imithombo:
> Antral Follicle Count. USC Fertility. http://uscfertility.org/fertility-treatments/antral-follicle-count/.
> Jayaprakasan K, Campbell B, Hopkisson J, Johnson I, Raine-Fenning N. "Uhlalutyo olulinganiselayo lwe-anti-Müllerian hormone, i-inhibin-B, kunye neendlela ezintathu zokumelana ne-ultrasound ye-ovarian reserve ekupropheni kokuphendula okungalunganga ukuvuselela i-ovarian. "UFertil Steril. 2010 Feb; 93 (3): 855-64. i-doi: 10.1016 / j.fertnstert.2008.10.042.
> Scheffer GJ, Broekmans FJ, Looman CW, Blankenstein M, Fauser BC, teJong FH, teVelde ER. "Inani leentlobo ezinobungqingili kubasetyhini abaqhelekileyo abanezityalo ezibonakalisiweyo kubonakaliso obuhle kakhulu beminyaka yobudala." Hum Reprod. 2003 kuMatshi; 18 (4): 700-6. i-doi: 10.1093 / i-humrep / deg135