Abaxhamli be-GnRH bangenayo imichiza ejoyiweyo esetyenziswa ngexesha lokunyanga kwe-IVF . Ukuthintela i-ovulation ngaphambi kokuqala, ngoko ugqirha wakho uya kukwazi ukufumana amaqanda kuma-ovari ngaphambi kokuba akhululwe kwaye "alahleke."
Musa ukudibanisa i- GnRH i-agonists - njengoLupron - kunye nabaphikisi be-GnRH. I-GnRH i-agonists yenza ukuba i-hormone yokuzalana iqhubele phambili kwaye, emva kweentsuku ezimbalwa, zivale ezo hormone.
Xa zisetyenziselwa unyango lwe-IVF, kufuneka ziqaliswe ubuncinane iiveki ezimbalwa ngaphambi kokuba umjikelezo wonyango lwe-IVF uqale.
Abaxhasi be-GnRH abayikudala ukuqala kokuqala kwama-hormone. Ziqalisiwe emva kokuba umjikelezo we-IVF uqalile kwaye unokuthathwa kanye okanye imihla ngemihla iintsuku ezimbalwa. Ngenxa yokuba zithathwa ixesha elifutshane, zenza imiphumo embalwa yecala, ixesha elifutshane.
Inqaku elibalulekileyo! Azikho zonke iziphumo ezichaphazelekayo nezingozi ezidweliswe ngezantsi. Ukuba ufumana imiphumo emibi, iimpawu ezingavamile, okanye uxhalabele ngesizathu, qhagamshelana nogqirha wakho. Ingcaciso ekweli nqaku ayifaki indawo yokubonisana nochwepheshe bezonyango.
Ziyiphi imithi e-GnRH Antagonists?
Kukho ababini abathintekayo be-GnRH kwiimarike: i-acetate ye-anirelix kunye ne-acroate ye-cetrorelix.
Amagama ebhanti ye-acetate ye-anirelix iquka i-Antagon, Ganirelix, ne-Orgalutran.
I-Cetrotide ligama legama le-acroate cerorelix.
La mayeza athatyathwa nge-injection. Unyango lunokubandakanya ijoyi enye, iintsholongwane zemihla ngemihla, okanye iintsholongwane ezingathathi iintsuku ezimbalwa. Konke kuxhomekeke kwisicwangciso sakho sokunyanga se-IVF.
Abaxhasi be-GnRH baxabisa kakhulu kune-GnRH agonists, kodwa iindleko ezongezelelweyo zingenako ukwenza impembelelo enkulu kuba abachasayo bathatyathwa ixesha elifutshane.
Kwakhona, abanye besetyhini bakholelwa ukuba iziphumo ezimbi zincinci zifanelekile kwiindleko ezongezelelweyo.
Nangona oogqirha abathile bezityalo bakhetha i-GnRH agonists kuba baye bahlala ixesha elide, uphando alufumananga umehluko kwimilinganiselo yokuphumelela kokukhulelwa phakathi kwe-agonists kunye nabachasayo. Thetha ugqirha ukuba unqwenela ukuqwalasela abaphikisi be-GnRH endaweni ye-GnRH agonist.
Iimpembelelo ezingezantsi ze-GnRH Antagonists
Kowomsebenzi we-cetrorelix ye-acetate kunye ne-anirelix umsebenzi we-acetate ngokuvala umgudu we-pituitary ukukhupha nokukhupha i-FSH ne- LH . Oku kubangelwa ukukhawuleza kwesikhashana, okukhokelela kwimiphumo emibi. Zingaphi iziphumo ezichasayo onokuzijonga kuxhomekeke ekubeni uthabatha ixesha elingakanani leyeza.
Iziphumo eziqhelekileyo zamacandelo e-cetrorelix (Cetrotide) ziquka:
- Iintlungu zesisu kunye nobubele (4.4% xa kuthathwa imihla ngemihla, 2.1% xa kuthatyathwa njengento eyodwa)
- Intloko (1.3% kunye nomthamo wemihla ngemihla, 0% xa kuthatyathwa njengelitha elilodwa)
- I-nausea (1.3% kunye ne dose yemihla ngemihla, i-1.1% kunye nenani elilodwa)
Iziphumo eziqhelekileyo ze-acetate ye-anirelix (Antagon, Ganirelix, i-Orgalutran) ziquka:
- Ukunyamezela ngamathumbu ngamaqanda (4.8%)
- Intloko (3%)
- Ukuphuma kwamagciwane (1.8%)
- Intlungu yesazisi okanye ukubetha (1.1%)
- Isihlunu (1.1%)
- Isisu sesisu (1%)
Izingozi ze-GnRH Antagonists
Ukufa kwe-Fetal : Ngezifundo zonyango, i-3.7% yokukhulelwa ikhulelwe ngenkathi ithatha i-acetate ye-anirelix iphelile ekufeni kokufayo, okanye kusekuzalweni.
Ingaba le nto ixhunyiwe kwi-GnRH ngokuchasene ngqo, okanye kwezinye iziyobisi ze-IVF, okanye i-IVF ngokwayo, okanye ukungabikho komntwana, ayiyazi.
Iingxaki zokuzalwa : Ucwaningo lufumene umngcipheko ophezulu okhuselekileyo wokukhulelwa ekukhulelweni xa uthabatha i-acetate ye-anirelix. Ingaba oku kudibaniswe nale mayeza, ezinye iziyobisi ze-IVF, iinkqubo ze-IVF ngokwazo, okanye ukungabi nantoni.
I-Ovarian hyperstimulation syndrome (OHSS) : Kuqhutywe ngo-2.4% wabasetyhini baphathwa nge-acetate ye-anirelix. I-OHSS ayibangelwa ngabaphikisi be-GnRH, kodwa i-gonadotropins ithathwe ngexesha elifanayo.
Izifundo ziye zafumanisa ukuba umngcipheko wokuphuhlisa ii-OHSS uhlehlise kakhulu kunye nabaxhasi be-GnRN xa kuthelekiswa nonyango kunye ne-GnRH agonists.
I-OHSS ephezulu ivela ngaphantsi kwe-1% yezigulane. Xhalela ugqirha wakho ngokukhawuleza xa ufumana ukuhlanza, ubuhlungu obukhulu besisu okanye i-pelvic intlungu, ukufumana umthwalo ngokukhawuleza, okanye ukubetha okukhulu.
> Imithombo:
I-CETROTIDE cetrorelix (njenge-acetate). Idatha yeDatha. Kufumaneka ngoFebruwari 4, 2014. http://www.medsafe.govt.nz/profs/datasheet/c/Cetrotideinj.pdf
EYurophu naseMbindi Mpuma ye-Orgalutran Group Group. "Isiphumo sekliniki esingalinganiswayo usebenzisa i-GnRH ingxabano i-anirelix okanye umgaqo omde we-GnRH i-triptorelin ye-agonist yokuthintela i-LH ngaphambi kwexesha elingaphantsi kweyabasetyhini abanokuvusa i-ovarian." Hum Reprod . 2001 Apr; 16 (4): 644-51. http://humrep.oxfordjournals.org/content/16/4/644.full?sid=3335d39c-68fd-455f-b948-e4ffa2a70b66
Ganirelix Acetate Injection. Ulwazi lweDrug. Merk. Kufumaneka ngoFebruwari 4, 2014. http://www.merck.com/product/usa/pi_circulars/g/ganirelix/ganirelix_pi.pdf
Ragni G, Vegetti W, Riccaboni A, Engl B, Brigante C, Crosignani PG. "Ukuthelekiswa kwe-GnRH ne-agonists kunye nabachasayo ekuncediseni izijikelezo zokuzalisa izigulane ezisengozini enkulu yokunyuka kwe-ovarian hyperstimulation syndrome." U- Hum Reprod . 2005 Sep; 20 (9): 2421-5. Epub 2005 Meyi 12. http://www.ncbi.nlm.nih.gov/pubmed/15890731