Inkqubo ikwandisa ukuveliswa kwamaqanda asebenzayo
Umgaqo-phantsi ligama apho ososayensi basebenzise ukuchaza inkqubo yokunciphisa okanye yokunciphisa impendulo yomzimba kwimimiselo ethile.
Xa isetyenziswe ngokubhekiselele kwi-vitro fertilization (IVF) , phantsi-umgaqo-siseko "uguqula" ii-ovari ukulawula kangcono i-ovulation kunye nokuvuthwa kwamaqanda ngexesha lotyando.
Kukho iintlobo ezimbini zeziyobisi ezisetyenziselwa le njongo: GnRH agonists kunye nabaphikisi be-GnRH.
I-agonist ngumhlobo weziyobisi ezivuselela impendulo, ngelixa umchasene luhlobo oluvimba iimpendulo.
Nangona iindlela zokusetyenziswa kwezidakamizwa zimbini ziyahlukana, zombini zisebenza ngokunciphisa imveliso yomzimba yee-hormone ezahlukahlukeneyo ezibangela ukuphuhliswa kweqanda kunye nokuvuthwa kwe-ovulation. Ngale ndlela, bahlehla-balawula umsebenzi wezobuko bama-ovari.
Kutheni Umgaqo-phantsi Usetyenziselwa Ngonyango lwe-IVF
Ii-ovari zakho ziqukethe amawaka eentlanga . I-follicle nganye iqukethe iqanda elincinci okanye i-oocyte.
Ekuqaleni komjikelo wakho, i-hormone ye-hormone (LH) kunye ne-follicle evuselela i-hormone (FSH) inokuqalisa inkqubo yokuvuthwa kwiqela leentolisi ezikhuphisanayo. Njengoko iifolli ziqala ukukhula ngobukhulu, ziza kukhupha amanye amahomoni ukulawula ukuhamba kwe-LH kunye ne-FSH-ngamanye amaxesha, ngezinye izikhathi phantsi-kude kube yenzeke i-ovulation.
Ukuvuthwa ngokuqhelekileyo kubandakanya enye iqanda. Emva kokuba iqanda likhutshwe, zonke ezinye iifolliki kulelo qela ziyabuna zize zife.
Nge-IVF, ugqirha wakho akafuni ukuba oku kwenzeke. Kunoko, injongo yayiza kuba phantsi-lawula loo mpendulo ukuze:
- Iifolumu ezininzi ziyakwazi ukuvelisa iqanda elisebenzayo, elivuthiweyo.
- Amaqanda ahlala kwiifollic ukuze bakwazi ukuvuna lula.
Iziyobisi ezisetyenziselwa ulawulo oluphantsi
Kukho isibalo sezilwanyana ezisetyenziswa kwi-IVF ukuze siphumelele Sibonakaliswe ngokubanzi njengendlela elandelayo:
- I-GnRH i-agonists zibandakanya ezo zonyango njengeLupron (leuprolide) , i-Synarel (nafarelin) kunye ne-Zoladex (goserelin). I-GnRH i-agonists ifana ne-hormone eyenziwa ngokwemvelo ebizwa ngokuba yi- gonadotropin-release hormone (GnRH) . Eli yi-hormone ephakamisa ukuveliswa kwe-FSH ne-LH. Ngokukhukula umzimba nge "GnRH" inkohliso, ii-ovari ziyanda kakhulu kwaye ekugqibeleni zivale imveliso ye-LH ne-FSH emva kweeveki ezintathu.
- Abaxhasi be-GnRH baquka iziyobisi uAgonagon (ganirelix) kunye ne-Cetrotide (cetrorelix). Abaphikisi be-GnRH basebenze ngokubophelela kwi-receptor kwi-GnRH kwaye banqanda amandla abo okufumana iimpawu zaluphi na uhlobo. Ngokwenza njalo, ukuveliswa kwe-FSH kunye ne-LH kuvaliwe ngokukhawuleza.
Emva kokuthatha izidakamizwa ze-GnRH iintsuku eziliqela okanye iiveki, i-ultrasound iya kusetyenziswa ukuqinisekisa ukuba i-uterine ibincibilike kwaye amaqanda alungele ukuvunwa. Ukusetyenziswa kweziyobisi kuya kubakho ukunyusa ama-ovari, emva koko amaqanda aya kuvuna ngaphantsi kwe-anesthesia yendawo.
Iindlela eziNye zoMgaqo-phantsi
Nangona i-down-regulation yindlela ephumelelayo yokunciphisa ama-ovari ngexesha le-IVF, ayisebenzi kakuhle kubo bonke abafazi.
Oku kunjalo ngokukodwa kubasetyhini abaneendawo zokugcina ii-ovarian (inani elincinci lamaqanda).
Kungenxa yokuba kuya kuba neepolisi ezimbalwa zokusebenza kunye, izidakamizwa ze-GnRH zinokusebenza kakuhle. Esikhundleni sokuphulukisa ama-ovari, bangagqiba ukukhansela umjikelezo ngokupheleleyo.
Kula mabhinqa, kukho ezinye iindlela zobuchwepheshe bezityalo eziza kusebenzisa ukuphumeza-umgaqo:
- Ukuqala iipilisi zokulawula ukuzalwa ngokukhawuleza kwinyanga ngaphambi kwe-IVF kwaye ke ukuyehla ukunyuka kwamanani ukutshisa ukukhula nokuvuthwa kwenkqubo
- Ukunika izidakamizwa ze-GnRH ezantsi okanye iintsuku ezimbalwa
- Ukuqala unyango lwe-GnRH kakhulu emva kwexesha eliqhelekileyo
- Ukuqala kwaye emva kokuyeka ii-injini ze-GnRH kwizigaba ezahlukeneyo
- Ukongeza i-hormone eyongezelelweyo kunyango
Ngeli xesha, ugqirha uya kusebenzisa iimvavanyo zegazi kunye ne-ultrasound ukuvavanya nokuphucula ukuphuhliswa kwentando.
Imithombo:
> Badawy, A .; Wageah, A .; El Gharib, M. et al. "Amacandelo okuPhumela umgaqo-nkqubo wokuThuthukisa ukuThuthukisa i-IVF / ICSI IsiPhumo kwi-Oversan Responders." UJ Reprod Infertil. 2012; 13 (3): 124-30.
> Magon, N. "I-gonadotropin-ukukhulula i-hormone agonists: Ukwandisa i-vistas." Ind J Endocrinol Metab. 2011; 15 (4): 261-7; INGXELO: 10.4103 / 2230-8210.85575.