Ukuqonda i-GnRH Agonists ye-IVF, i-Endometriosis, ne-Fibroids
I-Lupron, i-GnRH agonist, yenye yezona zinto ziyaziwayo kwaye zizondwayo kakhulu zonyango lwe- IVF olungenayo inkunkuma. Oku kubangelwa yimiphumo emibi engathandekiyo: ukuguquka kwemizwelo, iintloko, kunye nokutshisa okutshisa.
I-GnRH i-agonists njenge-lupron isetyenziselwa kakhulu ukunyanga kwe- endometriosis kunye ne-fibroids. Ngokuqhelekanga, i-agnist ye-GnRH ingasetyenziselwa ukuvuselela i-ovulation endaweni ye-hCG evamile yokudubula ngexesha lomjikelezo we- IUI .
Ukusebenzisa i-lupron ukwenzela unyango olunjenge-IVF lubonwa "ngaphandle kwelebuli." Oko kwathiwa, i-lupron ibe yinxalenye yonyango lwezonyango kwiminyaka emininzi. Igama elithi "off-label" lukuthi akufanele likukhathaze.
Kwixesha elide, iziphumo zempembelelo ze-lupron zingaba zinzulu. Ukwelashwa kwe-lupron yexesha elide kwenzeka nge-endometriosis okanye unyango lwe-fibroid.
Xa zisetyenziselwa unyango lwe-fertility, i-lupron iyisisetyenziswa sexesha elifutshane.
Ziyiphi iMilisi e-GnRH Agonists?
I-Lupron yinto enye kuphela ye-GnRH agnoists.
I-acetate ye-Leuprolide, ithengiswa phantsi kwegama lophawu lweLupron Depot, ithathwa nge-injections, ngokuqhelekileyo iqalisa kumjikelezo ngaphambi kokuba unyango lwe-IVF luqale.
Xa zisetyenziselwa i-IVF, i-Lupron inokunikezwa njengejoyi enye okanye ijoyizi zansuku zonke.
I-Nafarelin acetate, ithengiswa phantsi kwegama legama elithi Synarel, kunye ne-buserelin, ithengiswa phantsi kwegama elibizwa ngokuba yi-Suprecur, i-GnRH i-agonists ezithathwe nge-spray day spray.
Kananjalo baqalwa ngenyanga ngaphambi kokuba i-IVF ihlelwe.
I-Goserelin, ithengiswa phantsi kwegama legama elithi Zoladex, i-GnRH i-agonists ithunyelwa nge-encinci, i-biodegradable implant, injected nje phantsi kwesikhumba.
Ukufakelwa komnye kuthatha inyanga enye.
Imiphumo emibi yeLupron
I-Lupron ibonisa ukuba umzimba ube yindawo eguquguqukayo yesikhashana. Uninzi lweempembelelo ezifanayo zifana nento abafazi abava ngayo ngexesha lokuphumula.
Iindaba ezilungileyo kukuba xa kuqalisiwe unyango lwe-gonadotropin , ezininzi iziphumo zecala ziya kuncitshiswa. (Nangona kunjalo, uya kujongana neempembelelo zegonadotropin kunye neengozi .)
Qaphela: Zingaphi iziphumo ezichaphazelekayo ozifumanayo ziya kuxhomekeka ekubeni kutheni kwaye uhlala ixesha elingakanani uthabatha i-GnRH agonists. Ngenxa yokuba i-Lupron yindlela esetyenziswa rhoqo kwi-GnRH ye-agonist ngexesha lonyango lwezonyango, iipesenti zempembelelo ezingezantsi zibhekisela kuphando olwenziwa ngokukodwa kwiLupron xa kuthathwa iiveki ezimbalwa. Nangona iipesenti zingahluka phakathi kweendlela ezahlukeneyo ze-agnist GnRH, uluhlu olubanzi lweempembelelo ezinokwenzeka ezifanayo.
Iziphumo eziqhelekileyo zeLupron ziquka:
- Ukutshisa okutshisa (i-70 ukuya kuma-80 ekhulwini)
- Intloko (ama-25 ukuya kuma-32 ekhulwini)
- I-Mood ishintsho kunye nokuxinezeleka (ama-10 ukuya kuma-22 ekhulwini)
- Ubume obumile kunye nentlungu (i-11 - 28 ipesenti)
- Acne (10 ekhulwini)
- I-body body aches (i-8 ukuya kwe-19 ekhulwini)
- I-nausea (i-8 ukuya kuma-13 ekhulwini)
- Intlungu ehlangeneyo (i-7 - 8 ekhulwini)
- I-Edema (amaphesenti ama-5 ukuya kuma-7)
- Ukukhathazeka (ama-4 - 6 ekhulwini)
- Ngokubanzi isisu esiswini (ama-3 ukuya kuma-7 ekhulwini)
- Ukuzuza ubunzima (ama-3 ukuya kuma-13 ekhulwini)
- Ukunciphisa i-libido (i-2 ukuya kwe-11 ekhulwini)
- Uxinzelelo (i-2 - 11 ekhulwini)
- Ukulinganisa ("izikhonkwane kunye neenaliti") kwiingalo nasemilenzeni (i-1 - 7 ekhulwini)
- Ubumnene besisu (iipesenti ezi-2 ukuya kuma-6)
Xa kuthathwa ixesha elide, njengokuba kunjalo xa unyanga i-endometriosis okanye i-fibroids, unokuyeka ukufumana ixesha lakho.
Oku akusiyo i-technical effect effect ukususela kwisiphumo esicetywayo sesilwanyana (ukuvala ama-hormone abangela ukuya esikhathini).
Xa i-GnRH i-agonists ithathwa nge-injection, ubuhlungu kunye nokubomvu kwisayithi yokungenwa kungenzeka.
Xa kuthathwa njengesipopu sosizi, ukucaphuka kwee sinus kungenzeka.
Inqaku elibalulekileyo! Azikho zonke iziphumo ezichaphazelekayo kunye nezingozi ezidweliswe. Ukuba ufumana imiphumo emibi, iimpawu ezingavamile, okanye uxhalabele ngesizathu, qhagamshelana nogqirha wakho. Ingcaciso ekweli nqaku ayifaki indawo yokubonisana nochwepheshe bezonyango.
Ziziphi i-GnRH Agonists? Ziyasetyenziswa Njani Nge-IVF?
Uhlobo oluthile lweziyobisi, i-GnRH i-horonone i-hormone ebonakalayo eyenza i-hormone ye- gonadotropin-ukukhulula i-hormone (GnRH) yomzimba.
I-GnRH agonist kuqala ibangela ukunyuka ngokukhawuleza kwimveliso ye-hormones FSH ne- LH . Nangona kunjalo, emva kokukhula okufutshane, i- pituitary gland iyeka ukuvelisa i-hormone , ukukhusela i- ovulation .
Okokunyusa okokuqala kwi-FSH kunye ne-LH kutheni i-GnRH i-agonists ingasetyenziswa ngamanye amaxesha ukudala i-ovulation.
Kungenxa yoko, xa isetyenziselwa ukunyanga i-endometriosis, iimpawu zingadluka ekuqaleni. (Jonga ngezantsi ukuze uthole ulwazi oluninzi ngale nto.)
Kwonyango lwe- IVF , iziyobisi ezifana ne-lupron zisetyenziswa kunye ne- gonadotropins . I-agonists inqanda ukuvuthwa kwemvelo.
Endaweni yoko, ugqirha wokuzala uza kuvuselela i-ovulation kunye neminye imichiza yokuzala, ngendlela elawulwayo ebizwa ngokuba yi- superovulation .
Isilwayo sithintela ukunyuka kwe-LH yesendalo. Ukunyuka kwe-LH yemvelo kunokukhokelela kumaqanda ovulisa phambi kokuba afunyanwe kwii-ovari.
(Ukuba amaqanda avuliwe ngaphambi kokuba athathwe, "alahleka" ngaphakathi kwintambo yeplavic. Ayikwazi ukusetyenziswa kwonyango lwe-IVF ukuba oko kwenzeka.)
I-GnRH Agonists isetyenziselwa njani ukuphatha i-Endometriosis ne-Fibroid?
Xa zisetyenziselwa ukwelapha i-endometriosis , i-GnRH i-agonists ithathwa rhoqo kwiinyanga ezintathu ukuya ezintandathu. Ngakanani na oya kufumana iilisi kunye / okanye ukutshiza kwe-nasal kuxhomekeke kwiyeza elisebenzisa.
Injongo ekupilweni kwe-endometriosis kukuyeka ukuveliswa kwe-estrogen, edla ukutya kwe-endometrial. Ngoku "ukulambile" ezi ntlawulo, intlungu iyancitshiswa.
Ngexesha lokuqala ezimbini kwiiveki ezintathu zonyango, iimpawu zakho ziba nzima. Oku kwenzeka ngenxa yokunyusa kokuqala kwi-FSH ne-LH. Kufuneka uxoxe nodokotela wakho ukuba unomdla.
Emva kweeveki ezine ukuya kweebhozo, iimpawu zakho ze- endometriosis kufuneka ziphucule.
Xa zisetyenziselwa ukuphatha i-fibroids, iinjongo ngokuqhelekileyo ukunciphisa ubungakanani be-fibroid ngaphambi kokuhlinzwa. Ngoku "kulambile" i-fibroid ye-estrogen, ubunzima bunzima. Unyango lunokuthi luqhutywe iinyanga ezintathu okanye ezine phambi kokuhlinzwa okucwangcisiweyo.
Ngenxa yokuba ezi ziyobisi zidala urhulumente wesigxina samadoda, kubalulekile ukwazi ukuba awukwazi ukukhulelwa ngelixa uthatha i-GnRH agonists ye-endometriosis okanye i-fibroids.
Akunjalo unyango lwe-endometriosis okanye i-fibroids, kwaye abayi kuphucula ukuzala kwakho.
Ukuba ufuna ukukhulelwa, kuya kufuneka unqande unyango.
Ngokuxhomekeke kumachiza othabathayo, kunokuthabatha kwiiveki ezine ukuya ezintandathu (kunye ne-spon agrayists) okanye iiveki ezilishumi ukuya kwelishumi (kunye neenjini) ukuze ubuyele.
Inqaku elibalulekileyo : akufanele uxhomekeke kwi-GnRH agonists ukukhusela ngokupheleleyo ukhuselo. Xa kuthathwa ngokuqhubekayo, ukuba uyakhulelwa, i-GnRH igonists ingalimaza umntwana okhulayo.
Ngenxa yesi sizathu, unokufuna ukusebenzisa indlela yokukhawulela yokuzalwa (njengamakhondom okanye i-diaphragm) ukuqinisekisa ukuba awukhulelwa.
Njengoko kunjalo, xela ugqirha wakho.
Izingozi ze-GnRH Agonists
I-FDA ayifumananga ngokusemthethweni i-Lupron kunye nezinye i-agonists ze-GnRH zokusetyenziswa kwizibonelelo zonyango. Ukusetyenziswa kwayo ngexesha le-IVF kuthathwa ngokuba "yi-off-label". Ngoko ke, akuyazi ngokwenene ukuba yintoni na ingozi xa isetyenziselwa unyango lwezityalo.
Ngaloo nto kuthiwa, le yimiba eyaziwayo xa isetyenziselwa ukwelapha i-endometriosis, i-fibroids, okanye umdlavuza wesi-prostate. Ingozi ngexesha lonyango lwe-IVF lingafana.
Ukudandatheka : Ukuba unembali yokudakumba , i-GnRH igonists ingakhokelela ekudakaleni okukhulu.
Musa ukugcina oku kugqirha wakho; ubaxelele ukuba uziva unxinezelekile okanye uxhalabele ngemiphumo echaphazelekayo yeemeko.
Ukunciphisa intlupheko yethambo : Kwabesetyhini abasebenzisa i-Lupron malunga neenyanga ezintathu, ukunyuka kwamathambo kwanciphisa ama-2.7 ekhulwini. Kwiinyanga ezintandathu emva kwonyango, ukuxinwa kwethambo kubonakala kuphucula, kodwa emva kwexesha elide emva kweempembelelo aziyazi kakuhle.
Akukwazanga nokuba yiyiphi inqanaba lokunciphisa ithambo lokunciphisa. Ngenxa yoko, unyango lweenyanga ezingaphezu kweethathu ukuya ezintandathu alukhuthazwa.
I-Lupron ayikhuthazwa ngabasetyhini abasengozini yokunciphisa ithambo. Ukuba unentsapho ye-osteoporosis, khankanya oku ugqirha wakho.
I-pituitary apoplexy : Yilapho i-tumor epituitary (ngokuqhelekileyo ingasayi kufumaniswa) iphuma. Oku kunqabile kakhulu, ngokuqhelekileyo kuvela kwiiveki ezimbini zokuqala unyango, ngamanye amaxesha kwiiyure zokuqala.
Ukuba unamava entloko, ukuhlanza, ukuguqulwa okubonakalayo, ukukhubazeka kwezihlunu ngaphakathi okanye ezungeze amehlo akho, isimo sengqondo esitshintshileyo, okanye iimpawu zesifo senhliziyo, fumana unyango ngokukhawuleza.
Umngcipheko omncinci wokwanda kwesifo sikashukela, ukuhlaselwa yintliziyo, kunye nokushaywa kwesifo : Ezi mngcipheko zifunyanwe ikakhulu kumadoda athatha i-GnRH agonists ukunyanga umdlavuza wesibeletho. Ingaba bayingozi kubafazi ngexesha le-IVF.
Eminye i-GnRH Agonists
Kubalulekile ukwazi ukuba i-GnRH agonist s ayilona khetho kuphela kwi-IVF.
Enye iquka abathinteli be-GnRH, njengo-Antagon (ganirelix acetate) kunye ne-Cetrotide (cetrorelix).
Ngokungafani ne-GnRH, i-GnRH i-FDA ivunyelwe ukusetyenziswa ngexesha lokunyanga kwe-IVF. Uyabathatha ixesha elifutshane. Oku kunokunciphisa inani okanye ubude bexesha ofumana iziphumo zecala.
Abaphikisi be-GnRH banokuphepha, ngokweminye uphando. Xa zisetyenziselwa unyango lwe-fertility, abafazi babenomngcipheko omncinci wokuphucula i- ovarian hyperstimulation syndrome xa kuthelekiswa nama-agonist GnRH.
Izinto ezinokuthi zingaphantsi kwezona zinto zithi i-GnRH izithinteli zibiza kakhulu kwaye akuzona zonke iingcaphephe zokuzala eziqhelekileyo ukuzisebenzisa.
Imithombo:
Al-Inany HG, Youssef MA, Aboulghar M, Broekmans F, Sterrenburg M, Smit J, Abou-Setta AM. "I-GnRH i-Antagonists ikhuselekileyo kuneAgonists: Isibuyekezo seCorgan Review. "Isihlomelo sokuhlaziya. 2011 Julayi-Aug; 17 (4): 435. i-doi: 10.1093 / i-humupd / dmr004.
El-Nemr A, uBhide M, Khalifa Y, Al-Mizyen E, iGillott C, i-AM ephantsi, i-Al-Shawaf, i-Grudzinskas JG. "Uvavanyo lwezonyango ezintathu ze-gonadotrophin-ukukhulula i-hormone efana neprogram ye-IVF: oza kufundelwa. "I- Eur J Obstet Gynecol ihlambalaza i-Biol . 2002 Julayi 10; 103 (2): 140-5.
I-FDA yoKhuseleko loLondolozo lweMithi: Ukuhlaziywa koPhulo oluKhuselekileyo loKhuseleko lwe-GnRH Agonists kunye neNkcukacha kubakhiqizi be-GnRH Agonists ukuKongeza ulwazi olutsha loKhuseleko lokuBhala ngokubhekiselele kwengozini yokunyuka kwesifo sikashukela kunye neeNtsholongwane ezithile zeCardiovascular Diseases. I-FDA: Ulawulo lwe-US nokuLawulwa kweeDrug.
I-Lupron Depot (i-leuprolide acetate ye-depot ukumisa) Ukufakelwa, Ukukhupha, Ukuphilisa, Ukumiswa . Abbott Laboratories.
UMthi, uRoss. GnRH.