Qonda ukuthi ziyini, ukuthi zenzani, nokuthi ziningi kangakanani okufanele uzibe nazo
Emaqanda omzimba wesimiso sokuzala , i-follicle ye-ovari yesikhwama esigcwele amanzi oqukethe iqanda elivundiwe, noma i- oocyte . Lezi follicles zitholakala kuma-ovari. Ngesikhathi sokuvuthwa , iqanda elivuthiwe likhishwa ku-follicle. Ngenkathi izintambo eziningana ziqala ukuthuthukisa umjikelezo ngamunye, ngokuvamile kuphela eyodwa izokhipha iqanda. Ngemuva kwe-ovulation, i-follicle iphenduka i- corpus luteum .
I-follicles engavumeli iqanda elivuthiwe lihlukane, inqubo eyaziwa ngokuthi i-atresia engenzeka kunoma yisiphi isigaba sokuthuthukiswa kwezintambo. Cishe amaphesenti angu-99 ama-ovarian follicles azohlakazeka futhi angalokothi akhule ngokwanele ukukhulula iqanda.
Ukukhula kwe-Follicle nokuthuthukiswa kulandelwa ngesikhathi sokwelapha . Ngesikhathi sokuqothulwa (okusetshenziselwa ukwelashwa kwe-IVF ), umgomo ukugqugquzela ama-ovari ukuthuthukisa follicle eziningana ezivuthiwe ngesikhathi esisodwa. Ukuhlolwa kwe-ultrasound, eyaziwa nangokuthi i-antral follicle count (AFC), ingenziwa njengengxenye yokuhlolwa kokuzala . Lokhu kuhlolwa kwenziwa ekuhloleni ama-ovarian reserves.
Yiziphi Izintambo Ze-Antral Futhi Zibikezela Kanjani Ukuzala?
Ngokwemfundiso, uma ukwazi ukuthi zingaki izinhlobo ze-follicles ezingaphakathi kwama-ovari wakho, ungaba nomqondo wokuthi mangaki amaqanda owashiye. Akunakwenzeka ukubala ukuthi zingaki izinhlobo ze-follicles ezingama-ovari ngoba zingaphansi kakhulu ukuba zingabonakali.
Kodwa-ke, uma i-follicle ifinyelela esiteji esithile, ingabonakala nge-ultrasound.
Izintambo ziqala kakhulu, ezincane kakhulu. Zonke izintambo ezise-ovary ziqala njengezintambo eziyinhloko. I-follicle eyinhloko ingamamitha ama-25 amancane- ayi-millimitha angu-0.025. Akunakwenzeka ukubona nge-iso iso, ungabi yedwa kwi-ultrasound.
Nsuku zonke, ama-follicle amakhulu "avuse" ngamasignali e-hormone futhi aqale ukuvuthwa. Uma nje beqhubeka besinda futhi beqedela esigabeni esilandelayo, bayakhula futhi bakhule.
Enye yalezi zigaba isiteji esiphakeme. Ngalesi sikhathi, i-follicle ithola igumbi eligcwele amanzi eyaziwa ngokuthi i-antrum. Izintambo ezine-antrum zibizwa ngokuthi yi-antral follicles. Zilinganisa phakathi kuka-2 no-10 mm ububanzi. Ngombono othile, i-antrum follicle manje engama-5 mm iphindwe izikhathi ezingu-200 kunokuba ibe njengepollicle eyinhloko.
Ama-antrum follicles ekugcineni abonakala ku-ultrasound. Ucwaningo luye lwabona ukuthi inani lama-antrum follicles asebenzayo kuma-ovari ahambisana nanyana inani elingaba khona lamaqanda asele. Namanje awukwazi ukuthi zingaki izinhlayizi ze-follicles ezikhona, kepha uma owesifazane enamaphrofolli ambalwa kakhulu asathuthuka kuma-ovari, uyasola ukuthi izindawo zakhe zokugcina ama-ovari ziphansi.
I-Antral follicles ikhiqiza amazinga aphezulu we-hormone eyaziwa njenge-anti-mullerian hormone (AMH). Le hormone ijikeleza egazini lakho. Ukulinganisa amazinga e-AMH ngegazi ngezinye izindlela zokuhlola ama-ovarian reserves.
Kuyini Ukuhlolwa Kwe-Antral Follicle Count (AFC)?
I-antral follicle count kuyinto yokuhlolwa kokuzala. Yenziwe nge-ultrasound ye-transvaginal, ngezinye izikhathi phakathi komjikelezo wosuku 2 no-5.
I-ultrasound tech izobuka i-ovary ngayinye futhi ibale inani lezintambo ezilinganisa phakathi kuka-2 no-10 mm.
Udokotela wakho angalawula lokhu kuhlolwa
- Hlola ama- ovarian reserves wakho
- Yenza ukuxilongwa kwe-primary ovarian insufficiency
- Siza ukuhlonza i- polycystic ovarian syndrome
- Ukunikeza umqondo wokuthi ukuzala kwakho kume kuphi uma kuqhathaniswa neminyaka yakho (unayo ngaphezulu, engaphansi, noma inombolo ejwayelekile yezintambo eziqhathaniswa nabanye ubudala bakho)
Isivivinyo singenziwa njengengxenye yokubamba ukuzala. Noma, kungase kulandelwe ngaphambi komjikelezo wokunakekelwa kokuzala.
Zingaki Izintambo Zase-Antral Zivamile?
Khumbula ukuthi kuvamile ukuthi izindawo zakho zokugcina ama-ovari ziwe phansi uma ukhula.
Ngakho-ke, okuvamile kumuntu oneminyaka engu-25 akuyona into evamile kumuntu oneminyaka engu-38 ubudala. Ngalokho kusho, inani le-antral follicle lika-3 kuya ku-6 libhekwa liphansi.
Olunye ucwaningo lwama-classic lwenza u-antral follicle kubalwa kwabesifazane abanesizalo esivunyiwe (izifundo eziningi ze-AFC zenziwa kwabesifazane abangenalutho). Ukuze kufakwe kulolu cwaningo, abesifazane babefanele
- Yiba nemijikelezo ejwayelekile yokuya esikhathini, ehluka ezinsukwini ezingu-21 kuya kwezingu-35 ubude
- Yiba ne-ovulating , eboniswe ngokuba nokushisa kwezinga lokushisa kwi- basal lokushisa lomzimba ishadi
- Ukhulelwe okungenani ingane eyodwa esikhathini esidlule, kungakapheli isikhathi sonyaka owodwa
- Ungenalo isifo se-hormonal noma se-endocrinological
- Ukuyeka ukulawula ukubeletha okungenani izinyanga ezimbili ngaphambi kokucwaninga
Lapha kwakuyizibalo zabo ezilinganiselwe ze-antral follicle (AFC), kanye nobubanzi obubonwe (kusukela ekuphansi kuya ku-AFC count count).
| Ibanga lobudala | Isilinganiso se-AFC | I-AFC ephansi kakhulu | I-AFC ephakeme kakhulu |
| 25 kuya ku-34 | 15 | 3 | 30 |
| 35 kuya ku-40 | 9 | 1 | 25 |
| 41 kuya ku-46 | 4 | 1 | 17 |
Ukuba nezindawo eziphansi ze-ovarian akusho ukuthi awukwazi ukukhulelwa. Kodwa kusho ukuthi ama-ovarie akho angeke aphendule imithi yokuzala kanye nowesifazane onokugcina ama-ovarian angcono. Ikhono lomchwepheshe we-ultrasound kanye nemishini ye-ultrasound ngokwayo ingathinta imiphumela. Uma isikhungo esisodwa sithola imiphumela embi, cabanga ukuthola umbono wesibili.
Abesifazane abane-count low follic count count ngaphambi kweminyaka engu-40 bangatholakala ukuthi bane-primary ovarian insufficiency, eyaziwa nangokuthi ukwehluleka kwe-ovarian ngaphambi kwesikhathi . I-Antral follicle ibheka ngokwehla ngokwemvelo njengowesifazane oseminyaka . Ukubalwa kwamaphilisi okungajwayelekile okungavamile kungabonisa i- polycystic ovarian syndrome (i-PCOS) .
Iyiphi Indima Yenza Izintambo Zidlale Ekupheleni Kwesikhashana?
Umjikelezo wakho wokuya esikhathini uhlukaniswa zibe izingxenye ezimbili eziyinhloko, isigaba se-follicular, kanye nesigaba salo luteal .
Ngesikhathi sesigaba se-follicular, i-follicles esigabeni esiphakeme sezokuthuthukiswa siyathathwa futhi iqale inqubo ezogcina ekuholeni ekuvuthweni. Nakuba izintambo eziningana ziqala kulo mhlanga, eyodwa kuphela (noma ezimbili) izofinyelela ekuvuthweni okugcwele futhi ikhulule iqanda. Uma uthatha izidakamizwa zokuzala , izintambo eziningana zingase zifinyelele esigabeni se-ovulatory.
I-follicles ngokwazo inesibopho se:
- Ukudla nokuvikela i-oocyte, njengoba ihamba nge-oogenesis
- Ukukhulula ama-hormone okuzala abalulekile, kuhlanganise i-estradiol ne-inhibin B, ebonisa ukuthi i-pituitary ne-hypothalamus gland ukwenyuka noma ukunciphisa ukukhululwa kwe- GnRH , FSH , ne- LH
- Ukuguqula ngaphakathi kwe- corpus luteum ngemuva kokuvuthwa, okhipha ama-hormone progesterone ne-estrogen
Kwenzekani Ngenkathi Isigaba Esilandelayo Sezinyanga Zokuya esikhathini?
Isigaba esilandelayo somjikelezo wakho siqala ngosuku lokuqala lwenkathi yakho. Ukuya esikhathini kungukukhululwa komzimba kwesikhumba esiphezulu se-endometrial, esakhiwa ngokulindela ukukhulelwa. Ekupheleni kwesikhathi sakho, i-uterine lining will be thin. I-lining izokhula futhi ibe yinkimbinkimbi futhi emva kokuvuthwa.
Kodwa ngaphambi kokuba kwenzeke lokho, njengoba usesikhathini sakho, ama-ovari akho alungiselela iqanda elilandelayo lokuvota. Phakathi kwama-follicles amahlanu noyisithupha uzoqala ukukhula ku-ovary yakho. I-hormone i-FSH-follicle evuselela i-hormone-ikhiqizwa futhi ikhishwe yi-pituitary gland. Yile hormone edala izintambo ezivuthiwe.
Njengoba i-follicles ikhula ngesayizi, ikhulula isrogen. Amazinga aphakeme esigneni ye-estrogen i-pituitary gland yokunciphisa ukukhiqizwa kwe-FSH. Ngisho noma uqale nge-follicles emihlanu noma eyisithupha, eyodwa kuphela (futhi ngezinye izikhathi ezimbili) izokwenza ukuthi ikhule. Amazinga aphansi e-FSH enza ukuthi izintambo ezincane zikhule kancane noma ziyeke ukukhula, kanti i-follicle enkulu iyaqhubeka nokuthuthukiswa kwayo.
Ekugcineni, i-follicle eyodwa iba ipolisi eyinhloko. Abanye bayeke ukukhula bafe. Uma u-follicle ufinyelela eduze nosayizi ophezulu, ukhulula i-estrogen eyengeziwe. Ngenkathi ngaphambili, amazinga e-estrogen enyuke emazingeni aphansi we-FSH, lapho amazinga e-estrogen ephakeme kakhulu, kunomshini wokuthi umgogodla we-pituitary uphatha kanjani i-hormone.
Amazinga aphakeme kakhulu e-estrogen aqala i-pituitary gland ukukhiqiza nokukhulula i-LH noma i-hormone yokuqondisa. Lokhu kudonsa u-follicle ukuqeda izigaba zayo zokugcina, futhi ekugcineni, i-follicle izovuleka futhi ikhulule iqanda. Lesi yisikhathi sokuvuthwa.
Lalela Funda Kudivayisi kuphela Kwengeziwe Buka Kufakiwe Folliculogenesis: The Stages of Follicular Development
Ungase ucabange ukuthi intuthuko ye-follicular iqala futhi iphela ngesikhathi sesilandelayo sokujikeleza kokuya esikhathini, kodwa ngabe ungalungile ngalokhu.
I-follicular lifecycle egcwele iqala ngaphambi kokuba intombazane izalwe, lapho ama-ovari eqala ukuthuthukiswa. Ngalesi sikhathi, ama-ovary aqukethe kuphela ama-follicle amakhulu. I-follicles ingasala kulokhu "ukulala" isimo iminyaka engaba ngu-50 ngaphambi kokuthi 'ivuke' futhi ihambe ngezinyathelo zokuthuthukiswa. Kuthatha noma yikuphi kusukela ezinyangeni eziyisithupha kuya konyaka ukuhamba kusuka ebuhlotsheni obunzima kumbukiso ovuthiwe ovulation ovulation.
Kuzo zonke izigaba zokuthuthukiswa kwe-follicular, eziningi ze-follicle zizoyeka ukuthuthukiswa futhi zife. Akuzona zonke izintambo eziyinkimbinkimbi ezizodlula esigabeni ngasinye. Cabanga ngakho njengomncintiswano wokufinyelela kuma-Olimpiki we-ovulation. Amanye ama-follicles azokwehla, kanti amanye azoqhubeka. Amaphesenti angaphansi kweyodwa awake avula i-oocyte.
Izigaba ze-folliculogenis:
- I-follicle eyinhloko (isigaba zonke izinhlobo ze-follicles zingaphakathi kwama-ovari womntwana osanda kuzalwa)
- Izintandokazi eziyinhloko (ukuqashwa kwezintambo ezimbalwa eziyinhloko emlandweni oyinhloko oyilandelayo kwenzeka nsuku zonke, kusukela ekuthombeni nasekuqhubekeni kuze kube sekupheleni kokuya esikhathini)
- I-follicles yesibili (okubandakanya ukwengezwa kwamaseli we-theca, okuzokhipha ama-hormone)
- I-follicles ephakeme, eyaziwa nangokuthi i-antral follicles (okuyizintambo eziqukethe i-fluid-filled filled cavity ebizwa ngokuthi i-antrum, follicles kulesi sigaba ibonakala nge-ultrasound transvaginal)
- I-folale ye-Graafian (i-follicle enkulu ngokwanele ukuze ivule, i-follicle eyodwa noma amabili kuphela ephakeme emjikelezweni ngamunye iyovuthwa ibe yi-ovulation)
- I-Corpus luteum (engeyona i-follicle engasekho, i-corpus luteum ivela e-follicle evuliwe evulekile iqanda.)
Indlela Okufanele Yenziwe Ngayo Izintambo?
Uma uthola ukwelashwa kokuzala, udokotela wakho angase aqaphe ukuthuthukiswa kwezintambo nge-ultrasound. Phakathi nalezi zinkimbinkimbi, inani lezintambo ezinokukhula lizobalwa. Zizobalwa futhi.
Izintambo zilinganiswa ngamamitha (mm). Ngokuvamile, udokotela wakho uzofuna ukuhlela injini yakho yokudubula-noma i-hCG / LH-uma izintambo zakho zizofinyelela usayizi ogcwele ovuthiwe. Lokhu ku-18 mm.
I-follicle evuthiwe eseduze ukuvunguza iyokala cishe phakathi kuka-18 no-25 mm.
Zingaki Izintambo Okufanele Ngifinyelele Ngesikhathi Sokuhamba Kwe-Clomid?
Okuhle, ufuna kuphela eyodwa noma amabili follicles ubukhulu obuhle ngesikhathi umjikelezo Clomid . Ungase uzizwe udangele uma uthola ukuthi eyodwa kuphela noma amabili follicles zikhulu ngokwanele ukuvunguza. Nokho, khumbula ukuthi okuningi akuyona into enhle. Yonke inhlanhla evuthiwe ekhulile ingakhipha iqanda, futhi lelo qanda lingase likhule.
Uma unezintambo ezimbili, ungakhulelwa amawele . Noma, ungase ungacabangi nhlobo. Noma, ungase ucabange ingane eyodwa. Ukuvuthwa akuqinisekisi ukukhulelwa.
Zingaki Izintambo Ezijwayelekile Zomjikelezo We-IUI noma we-Gonadotropins?
Njengama-Clomid, ngokufanele, ufuna kuphela ukuthi i-follicle eyodwa noma ezimbili ikhule ukuze ikhule. Imithi yokwelapha engakhiwa (i-gonadotropins) iza nenengozi ephakeme yokukhulelwa okuningi. Kungenzeka ukuthuthukisa izintambo ezintathu, ezine, noma ngaphezulu ezivuthiwe.
Uma uthola izintambo ezine noma ngaphezulu, udokotela wakho angakwazi ukukhansela umjikelezo wakho wezokwelapha. Lokhu kungase kuhoxise ukukhansela inqubo ye-IUI ehleliwe, ukukhansela i-trigger shot, kanye / noma ukutshela ukuthi ubaleke ubulili.
Uma udokotela wakho ekutshela ukuthi ungalalali, kuyadingeka ukuthi ulalele. Ingozi yokukhulelwa ama-triplets noma ama-quadruplets aphezulu ngamaphutha amaningi avuthiwe. Ukukhulelwa okuningi kuzokubeka impilo yakho engozini kanye nezingane zakho. Kungcono ukulinda uphinde uzame komunye umjikelezo.
Zingaki Izintambo Okufanele Nginayo Ngesikhathi Sokuhamba Kwe-IVF?
Ngesikhathi ukwelashwa kwe-IVF , udokotela wakho ufuna ukukhuthaza ama-ovari akho ukuvuthwa ama-follicles amaningana. Noma kuphi phakathi kwezintambo ezingu-8 no-15 zibhekwa njengesiyingi esamukelekayo.
Ngesikhathi uthola amaqanda, udokotela wakho uzothatha izintambo ezinamapulisi ane-ultrasound eqondiswayo. Wonke ama-follicle ngeke abe neqanda lekhwalithi. Ngakho-ke, ungamangali uma inani lamaqanda elibuyiselwayo lingaphansi kwenani lezintambo ezinomsoco otshelwa ukuthi unayo.
Izwi elivela ku-Verywell
Usayizi we-follicle kanye nokubala kungaba umthombo wokucindezeleka. Ngesikhathi sokuhlola, ufunda ukuthi isibalo sakho se-antral follicle asikho phezulu njengoba sithemba singabangela ukukhathazeka. Ukuxilongwa kwezinqolobane eziphansi ze-ovarian kungaba nzima kakhulu ukubhekana nazo. Udokotela wakho angancoma i- IVF nge-egg donor , indlela okungezona yonke imibhangqwana ekwazi ukuyenza noma ethanda ukuthatha.
Ukubalwa kwe-follicle kanye nokulinganisa ngesikhathi sokwelashwa kokuzala kungakuthumela futhi emzimbeni wokuzwela. Ingabe ama-ovarie akho akhiqiza kakhulu? Okuningi kakhulu? Konke kusho ukuthini?
Ngenkathi ukubala kwe-follicle kuyinkomba ebalulekile yokuzala-futhi ngesikhathi sokwelashwa, izibalo ze-follicle zinganquma ukuthi umjikelezo uzoqhubeka yini noma ukhanseliwe-khumbula ukuthi inombolo eyodwa ayikuchazi, noma ngisho nokubikezela ngokuphelele ukuthi uzozala esikhathini esizayo.
Abesifazane abanezintambo eziphansi ze-antral follicle bangakhulelwa, ngezinye izikhathi ngamaqanda abo. Enye i-ultrasound ngenkathi umjikelezo wezokwelapha ingase ingenise izindaba ezinhle, kodwa ukulungiswa kwemithi yakho yokuzala kungenza imiphumela elandelayo ye-ultrasound ibe ngcono kakhulu.
Uma ungaqiniseki ukuthi kusho ukuthini u-follicle yakho, khuluma nodokotela wakho. Ungesabi ukufuna umbono wesibili mayelana nokuhlolwa kokuzala nokuthola imiphumela yokuxilongwa. Futhi qiniseka ukuthi uzama ukuthola usizo . Ukuhlolwa kokuzala kanye nokwelapha kuyabangela ukucindezeleka . Awudingi ukwenza lokhu wedwa.
> Imithombo:
> I-Antral Follicle Count. USC Fertility. http://uscfertility.org/fertility-treatments/antral-follicle-count/.
> I-Jayaprakasan K, i-Campbell B, i-Hopkisson J, uJohnson I, i-Raine-Fenning N. "Ukuhlaziywa kwe-anti-Müllerian hormone, i-inhibin-B, ne-three-dimensional ultrasound esinqunyweni se-ovarian reserve ekubikezelweni kokuphendula okubi ukuvuselelwa kwe-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. "Inamba yama-antlic follicles kubesifazane abavamile abanezithelo ezivunywayo yiyona ndlela engcono kakhulu yokuveza iminyaka yobudala." U-Hum Reprod. 2003, 18 (4): 700-6. i-doi: 10.1093 / i-humrep / deg135