Izidakamizwa Zempilo Eziqhelweyo Ngokuqhelekileyo + Ezinye Iimithi Zonyango Lokunyanga
Ngexesha lokunyanga ukuzala , iziyobisi ongazithatha ukuwa kweyinye yeendidi ezine eziqhelekileyo:
- Amachiza okujoliswe ekuvuseleleni i- ovulation (iziyobisi zonyango)
- Imithi ejoliswe ekunciphiseni okanye ukulawula umjikelezo wesini (esetyenziswe kwi-IVF )
- Amayeza ayenzelwe ukuphatha ezinye iinkalo zokuzala
- Amachiza ayenzelwe ukunyanga imeko yezobuchopho echaphazela ukuzala kwakho
Amayeza kuphela angasetyenziselwa, okanye angasetyenziswa kunye ne- intrauterine insemination (i-IUI) , unyango lwe-IVF, okanye ukungenelela okucwangcisiweyo.
Nangona ukungabikho kwengqondo kuthinta amadoda nabasetyhini ngokulinganayo, abasetyhini basenokuba banako ukufumana unyango lwezonyango kunamadoda. Oku kungenxa yokuba iingxaki ezininzi ezingenakunyanga ezingenako ukuphathwa ngamachiza. Nangona kunjalo, kwezinye iimeko, amadoda angathatha ama-hormone okanye ezinye iziyobisi njengenxalenye yokonyango.
Iyona ndlela ixhaphakileyo kakhulu yonyango: iClomid
Mhlawumbi uvile ngeComomid ngaphambili. I-Clomid, okanye i-clomiphene citrate , idlalwa yiyobisi yokuqala xa iphathwa kakubi kwi- ovulatory . Kungaphakanyiswa kwakhona kumanyathelo okuqala enyango kwizibini ezixilongwa ngokungenakuchazwa.
I-Clomid ithebhulethi ithathwa ngomlomo. Uninzi kuninzi, iComomid imiselwe yedwa. Kodwa kunokwenzeka ukudibanisa iClomid kunye neminye imichiza, izidakamizwa zokuzala, okanye unyango lwe-IUI .
Iziphumo eziqhelekileyo ezichaphazelekayo ziyintloko, ukutshisa okutshisa kunye nokuguquka kwemizwelo . Ezinye izingozi ze-Clomid unyango ziquka ukukhulelwa amawele okanye ukukhulelwa okuphezulu, ukukhulelwa kwe- ovari kunye nokuphazamiseka kombono.
Iziphumo ezinobungozi kunye nobungozi buncinane xa kuthelekiswa neziyobisi ezinamandla ezinokukhusela.
Ngelixa lingaqhelekanga, ezinye iimeko zokungabikho kwamadoda zingaphathwa ngeComomid.
U-Femara (i-Letrozole): I-Alternative ukuya kwiComomid
I-Femara, okanye i-letrozole, yayingajoliswe ukuba ibe yiziyobisi. Enyanisweni, isifo somhlaza webele.
Nangona kunjalo, ngoku sele isetyenziselwa ngaphandle-ilebula ukuphatha iingxaki ze-ovulation .
NjengaClomid, u-Femara uthathwa ngomlomo. Ingasetyenziselwa yedwa, kunye namanye amayeza okanye iziyobisi zonyango, okanye njengenxalenye yonyango lwe-IUI.
Ngokomnye uphando, i-Femara inokusebenza ngakumbi kuneComomid kubasetyhini abane-PCOS kunye nabasetyhini abangenalo i- Clomid resistant . (Ukunganyangeki kwe-Clomid kuthetha nje ukuba iClomid ayifuni ukukhuthaza i-ovulation njengoko kulindeleke.)
Imiphumo emibi kunye neengozi zifana kakhulu neClomid.
U-Femara akakhuselekanga ukusebenzisa ngexesha lokukhulelwa. Oko kwathiwa, ngokuba u-Femara uthathwa kusasa kwinqanaba lokuya esikhathini-ngaphambi kokuba uqalise ukukhulelwa-oogqirha bawucinga ukuba ukhuselekile xa kusetyenziselwa injongo yokuzala.
I-Gonadotropins: Ukuvuthwa kwe-Ovulation nge-Drugs
I-Gonadotropins yilezi ziyobisi ezinamandla kakhulu. Ziqulethe i-hormone yokuvuselela i-folmony (FSH) efana ne- biologic efanayo, i-hormone ye-lithini (LH) okanye inhlanganisela yeebini. Kuzaliswa kwamabhinqa, ezi zi-hormone ezikhuthaza ama-ovari ukukhula nokukhulula amaqanda.
Ezi zi yobisi zithathwa nge-injection, ngokuqhelekileyo zibe zizicubu ezinamafutha (nazo ziyaziwa njengezigciwane zangaphantsi.) Iiklinikhi yakho yokuzala iya kukufundisa ngendlela yokuzifaka ezi ngxowuni ekhaya.
I-Gonadotropins ingasetyenziselwa yodwa okanye eceleni kwezinye iyeza kunye nexesha lesondo lokulala ngesondo ekhaya. Ziye zisoloko zisetyenziselwa ngonyango lwe- IUI okanye i- IVF .
Iziphumo eziqhelekileyo ezichaphazelekayo ze-gonadotropins ziquka intloko, isicathulo, isithintelo, ukunyamezela isisu, ukuguquka kwemizwelo, kunye nokucasula kwisayithi yokujova.
Umngcipheko wakho wokukhulelwa amawele, i-triplets, okanye i-multiples order multiples iphezulu kakhulu kunye ne-gonadotropin kunezidakamizwa zomlomo njengeClomid.
Ingozi yakho yokuphuhlisa i-ovarian hyperstimulation syndrome iphezulu kakhulu.
Nangona i-gonadotropin isetyenziswe ikakhulukazi kwabasetyhini, amadoda anesifo sengqondo se- hypogonadotrophic hypogonadism angachazwa ngamachiza okuvelisa inkunkuma ukuphucula amanqanaba e-testosterone kwaye uphucule impilo yempilo.
I-Gonadotropins ugqirha wakho unokuyalela ...
I-follistim (i-follitropin beta) kunye ne-Gonal-F (i-follitropin alpha): ezi ziyobisi zifanisa i-hormone ye-FSH emzimbeni wakho. Ziyadalwa ebhobhu usebenzisa ubuchwepheshe be-DNA obunokutsha, obenza ukuba zifane neehomoni zakho zendalo.
I-Bravelle, i-Fertinex : Ezi ziyobisi ze-hormonal ze-fertility nazo zi-FSH, ngaphandle kokuba zenziwe ngokukodwa kwibhuyibhile, i-hormone ikhutshwe kwaye ihlanjululwe kumchamo wamakhosikazi angama-post-menopausal.
Ezi zi yobisi zibhekwa njengento enamandla kunokuba i-FSH idalwe usebenzisa i-DNA ye-recombinant technology, kodwa ayibiza.
I-ovidrel (i-choriogonadotropin i-alpha), i-Novarel, i-Pregnyl, i-APL: Ezi zi yobisi zenziwe ngeHCG, i-hormone yokukhulelwa . IHHM yeHHM ifana ne-LH emzimbeni.
Unokukhumbula i-LH yi-hormone ebangela ukuvuthwa .
I-Novarel, i-Pregnyl, ne-APL ihlambulukile kumchamo wabasetyhini abakhulelweyo, ngoxa i-Ovidrel ibhanti yenziwe ngokusebenzisa i-DNA technology recombinant.
I-Luveris (i-lutropin alpha) : Lona i-hormone ye-LH, eyenziwa kwibhuleji usebenzisa ubuchwepheshe be-DNA.
I-Repronex, i-Menopur, i-Pergonal, i-Humegon : Ezi ziyobisi zenzalo zihlanganiswe i-LH ne-FSH, eyaziwa ngokuba yi-gonadotropins yabantu. Azisetyenziswa rhoqo kodwa zingasetyenziswa kwezinye iimeko ezithile.
Izidakamizwa ezisetyenziselwe ukuLawula okanye ukuKhusela ukuVuthwa ngexesha leMpilo ye-IVF
Amanye amayeza asetyenziswe ngexesha lokunyanga ukunyanga.
Ngoba? Izizathu ezibini ezibalulekileyo:
- Ngexesha lokunyanga kwe-IVF, ukukhusela i-ovulation phambi kokuba amaqanda angathatyathwa. Xa amaqanda aphethwe emzimbeni, azifumaneki okanye zisetyenziswe kwi-IVF.
- Ukulungelelanisa imijikelezo kunye nomntu onokuthiwa ngamaqanda okanye umxhasi.
Iipilisi zolawulo lokuzalwa : Ezi zinokumiselwa kwinyanga ngaphambi kokunyanga kwe-IVF.
Ulawulo lokuzalwa lungasetyenziselwa ukwelapha.
Ngokomzekelo, abafazi abane-PCOS abangaphenduli kwiCommid banakho ukuphendula ngokubhekiselele kwiyeza ukuba ngaba bathabatha iipilisi zokulawula iinyanga ezimbini ngaphambi kokunyanga.
Antagon, Ganirelix, Cetrotide, i- Orgalutran (i- acreate i-acreate kunye ne-cetrorelix acetate): Ezi ziyobisi zenzalo ziyi-GnRH. Oku kuthetha ukuba basebenzisana namaHhomoni i-LH kunye ne-FSH emzimbeni, ukucima i-ovulation. Zithathwa nge-injection.
Iimiphumo eziqhelekileyo eziqhelekileyo ziquka ukuphuza kwesisu, intloko yesifo, kunye nentlungu yecala.
Lupron, Synarel, Suprecur, Zoladex (i-leuprolide acetate, nafarelin acetate, buserelin, goserelin): Ezi nyeza ziyi- GnRH i-agonists okanye i-gonadotropin-ikhipha i-hormone agonists.
I-Lupron ithathwa ngamagciwane. I-Synarel kunye ne-Suprecur i-spray. I-Zoladex ithunyelwa nge-implant encinci.
Zibangela ukuqhuma kokuqala kwi-FSH kunye ne-LH ukuvelisa kodwa kubangela ukuba umzimba uyeke ukuvelisa i-FSH ne-LH. Oku kukuthintela i-ovulation kunye nokunciphisa inani le-estrogen.
Ezi ziyobisi zivame ukusetyenziswa ngexesha lotyando lwe-IVF, ukuvumela ugqirha ukuba alawule i-ovulation ne-gonadotropins. Zingasetyenziselwa ukuphatha i- endometriosis okanye i-fibroids.
Iimpawu eziqhelekileyo eziqhelekileyo zitshisa, zithintekile, ziguquke, kwaye zome.
Amachiza okunyanga ezinye iingxaki zokuzala
Ukusetyenziswa kweziyobisi ngamachiza anenjongo yokukhuthaza ama-ovari. Nangona kunjalo, oku akuyena kuphela imithi ugqirha wakho angayichaza ngexesha lokunyanga.
I-Aspirin okanye i-heparin : Ukuba uye wafumana ukuphuphuma kwesisu ngokuqhelekileyo, okanye ufumene ukuba unesifo se-thrombophilia yegazi (imeko apho i-blood clots encinci ingakhokelela ekulahlekeni kokukhulelwa), ugqirha wakho unokumisela umntwana we-aspirin okanye iintsholongwane zegazi- utywala i-heparin.
Iprogesterone : Ugqirha wakho unokumisela i-progesterone supplementation, njengokuba i-vaginal suppository okanye nge-injections.
I-progesterone ye-progesterone i-suppositories ingacetyiswa ukuba ufumana ukuphuphuma kwesisu okanye ufumane isicatshulwa sesigaba sokukhangela . Iprogesterone engasenayo iyasetyenziswa rhoqo ngexesha lonyango lwe-IVF .
I-Estrogen : Ugqirha wakho unokumisela i-estrogen yangasese ifowuni xa i- endometriyamu yakho yincinci kakhulu , ukuba unamava okomama okanye intlungu ngexesha lokwabelana ngesondo , okanye ukuphucula umgangatho wengqumbo yakho yomlomo wesibeleko .
Isiphumo esisecaleni sokusebenza seComomid sinomkhuhlane womlomo wesibeleko , ongaphazamisa ukukhulelwa. Ukusetyenziswa kweComidid eyongeziweyo kungakhokelela ekubambeni kwe-endometrial. I-Estrogen inokunceda kule miba.
Amachiza okuPhatha iiMiqathango zonyango
Ngamanye amaxesha, imeko yezokwelapha iyancipha ukuzala kwakho. Kule meko, lo mbandela kufuneka uphathwe kuqala.
Ukunyanga umba ongundoqo kunokunokwanela ukuphucula ukuzala kwakho. Emva kokonyango, unokukwazi ukukhulelwa ngokwakho.
Nangona kunjalo, kwezinye iimeko, idibanisombululo zifunekayo. Unokudinga ukuba unyango lwengxaki yezokwelapha ngaphezu kokusetyenziswa kweziyobisi okanye ukungenelela okucwangcisiweyo.
I-glucophage (i-metformin): I- Metformin isishukela se-diabetes, esenzelwe ukuphatha abo abane-insulin ukumelana. Abasetyhini abane-PCOS bahlala bexilongwa nge-insulin.
Olunye uphando luye lwabonisa ukuba unyango lwe-metformin lunokunceda ukuqala kwakhona okanye ukulawula i-ovulation kubasetyhini abane-PCOS. Olunye uphando lufumene ukuba lunokunciphisa izinga lokuphuphuma komzimba kwaye luncedise umsebenzi waseComomid kwabasetyhini abangenako ukuvuthisa kwiComomid yedwa.
I-Antibiotics : Ukunyanga kwendlela yokuzala kunokunciphisa ukuzala kumadoda nabasetyhini. Kwezinye iimeko, intsholongwane ingakhokelela ekubambeni. Oku kunqanda kunokuthintela iqanda kunye nesidoda ekuhlanganisweni.
Ngethuba nje kungabikho nxeba, i-antibiotics yedwa yanele ngokwaneleyo ukuphucula ukuzala. Nangona kunjalo, ukuba izigulane ze-fallopian zivaliwe okanye zizaliswe ngonyango, ukuhlinzwa okanye unyango lwe-IVF kufuneka kwakhona.
I-Parlodel kunye ne-Dostinex (i-bromocriptine kunye ne-cabergoline): La mayeza anesifo se-dopamine. Ziyakunikwa i-hyperprolactinemia.
I-Hyperprolactinemia yimeko apho ama-hormone amanqanaba eprolactin aphezulu kakhulu. Iprolactin yi-hormone enoxanduva lokuphuhlisa isifuba kunye nokuhlamba. Amanqanaba aphakamileyo e-prolactin angabangela ukugqithisa okungaqhelekiyo okanye ukungabikho kwamabhinqa kwaye kubangele ukubalwa kwamabhinqa aphantsi kwamadoda.
I-Parlodel ne-Dostinex inokunciphisa amanqanaba eprolactin. Iziphumo ezichaphazelekayo ziquka intloko yesifo, ukudibanisa kwendoda, intloko yesifo, kunye nesisu. Akukho mngcipheko okhulayo wokukhulelwa amawele ngamayeza ngaphandle kokuba inkunkuma yezilwanyana ezinjengeClomid isetyenziswe kunye nonyango.
Ngamanye amaxesha, oku kunokubuyisela ukuvuthwa okanye ukuveliswa kwemveliso yesilisa. Kwezinye iimeko, utyando okanye iinkonzo ezongezelelweyo zonyango ziyafuneka.
Iyeza ye-Thyroid yokulawula imithi ye-hypothyroidism okanye i-hyperthyroidism : Ingaphantsi okanye ngaphezulu kwe-thyroid yokusebenza ingabangela iingxaki zokuzala kubesilisa nabasetyhini.
Abasetyhini banokuba neengcambu ezingaqhelekanga, ngelixa amadoda enokuba nezibalo eziphantsi zentlobo. Ukwehlulwa kwe-thyroid kungabangela ukukhathala nokuzuza ubunzima. Ukunyanyiswa komzimba kungaphaya kwefuthe lokuzala.
Imithombo:
Elzbieta Krajewska-Kulak1 kunye noPallav Sengupta. Umsebenzi we-Thyroid kwi-Inferential Male. "I- Endocrinol yangaphambili (iLausanne) . 2013; 4: 174. Ishicilelwe kwi-intanethi ngo-2013 uNks. 13. ityala: 10.3389 / fendo.2013.00174 I-PMCID: PMC3826086
UGrene, uRobert A. noTarken, uLaurie. (2008). IHormone egqibeleleyo Ukulinganisa Ukunyusa. I-United States yaseMelika: I-Press Rivers.
Amachiza okuKhuthaza ukuThengisa: Isikhokelo sabathinteli. Umbutho waseMelika weMithi yokuzala.
I-Ovarian Hyperstimulation Syndrome. I-Medical Encyclopedia, i-MedlinePlus.
Pratibha Singh, Manish Singh, 1 uGoutham Cugati, 2 kunye no-Ajai Kumar Singh. "I-Hyperprolactinemia: Isihlandlo esingazange siphuthelwe nguMntu ongenzi lutho." J Hum Reprod Sci . NgoMeyi-Meyi 2011; 4 (2): 102-103. i-doi: 10.4103 / 0974-1208.86094 i-PMCID: PMC3205532