Isidakamizwa sokuzala singanikeza izinzuzo ezibalulekile ngaphezu kwe-Clomid
I-Femara (i-letrozole) imithi yomlomo esetshenziselwa ukugqugquzela i-ovulation kwabesifazane abane- polycystic ovary syndrome (i-PCOS) nokungazalwa okungaqondakali. Ngenkathi i-Femara ivunywe yi-US Food and Drug Administration ukuze isetshenziswe njengesidakamizwa somdlavuza webele, isetshenzisiwe ngaphandle-ilebula ngabadokotela bokuzala kusukela ngonyaka ka-2001 ngoba inezimbangela ezimbalwa i- Clomid (clomiphene) kanye nengozi ephansi yeziningi ukukhulelwa.
I-Clomid iyinhlangano yokuqala yamanje yokukhetha ukwelashwa kwabesifazane abane-PCOS. Ucwaningo lwamuva, kodwa, luye lwasikisela ukuthi i-Femara inganikeza amazinga aphakeme kakhulu okukhulelwa ngaphakathi kwalaba besifazane
I-Femara iphinda isetshenziswe kakhulu ezimweni zokumelana ne-Clomid ngenkathi i-Clomid ingakwazi ukugqugquzela ukuvuthwa okungenani imijikelezo emithathu yokwelapha futhi naphezu kwemizamo ekhulayo.
Indlela yokusebenzisa i-Femara
I-Femara inikezwa ngo-2.5-milligram yellow, ithebhulethi enekhamera. Ngokusekelwe lapho isikhathi sakho siqala, udokotela wakho uzokutshela ukuthi uzoqala nini ukwelashwa. Ukwelashwa kuzothathwa ngezinsuku ezinhlanu ezilandelanayo.
Abanye ochwepheshe bezochumisa batusa ukuthatha amaphilisi ezinsukwini ezintathu, 4, 5, 6 no-7 zomjikelezo wakho. Abanye bavumela izinsuku ezingu-5, 6, 7, 8, no-9. Nakuba kuqhubeka ingxabano ukuthi iyiphi inkambo engcono ngempela, ucwaningo lwamanje lubonisa ukuthi amazinga okuphumelela aphezulu-noma-angaphansi okufanayo.
Ngokusekelwe lapho ukwelashwa kuqala, ungalindela lapho kuzodingeka uqale ukulala naye:
- Uma uqale ukwelashwa ngosuku lwesithathu , cishe uvula isikhathi esithile phakathi kosuku lwe-14 nosuku 17 lomjikelezo wakho. Ukukhulelwa, ungathanda ukuqala ukuya ocansini ngaphambi kokuba uguqe. Kulesi simo, uzoqala ukulala ocansini nsuku zonke (noma zonke izinsuku) kusukela ngosuku lwe-11 nokuphela ngosuku lwe-18.
- Uma uqale ukwelashwa ngosuku lwesishiyagalolunye, cishe uzovota phakathi kwezinsuku ezingu-16 no-19. Kulesi simo, uzoqala ukuya ocansini phakathi kwezinsuku ezingu-13 no-21.
Ukuze uqonde kangcono isikhathi sokuvuthwa, ungasebenzisa i- ovulation predictor kit . Uzoqala ukuhlola uma usuqedile ukwelashwa nokuvivinywa nsuku zonke uze uthole umphumela omuhle (obonisa ukuthi usondelene ne-ovulation). Lesi yisignali sokuqala ukuya ocansini.
I-Femara ingasetshenziselwa ukwelashwa kwe- intrauterine insemination (IUI) . I-Clomid ngezinye izikhathi ibhalwe eceleni kwe-Femara futhi ithathwe ndawonye ngezinsuku ezifanayo.
Okuqhamuka uma udla imishanguzo
I-Letrozole isebenza ngokunciphisa amazinga e-estrogen ukuze kukhuthazwe ukuvuthwa kwe-ovulation. Amazinga e-estrogen aphansi kwanoma yiluphi uhlobo angabangela owesifazane ukuba abe nezimpawu. Labo okuvame ukubonwa nge-Femara ukusetshenziswa kuhlanganisa:
- Ukukhathala
- Isizungu
- Izinwele
- Ukuvimbela
- Ukushisa okushisayo
- Izikhwama zobusuku
- Umbono ophundlekile
- Isisu esibuhlungu
- Ubuhlungu besisu
- Kunzima ukulala
- Ukukhipha noma ukungajwayelekile kokuphuma esikhathini
Uma uhlangabezana nombono ophukile noma izimpawu ezibonakala zilukhuni, xhumana nodokotela wakho ngokushesha.
Nakuba kungavamile, abesifazane abamba i-Femara bangase bahlakulele isimo esaziwa ngokuthi i- ovarian hyperstimulation syndrome (OHSS) esingabonakalisa ngezimpawu ezivela ekubhubheni nasehudo ukuya ekuphefumuleni okuncane nokuphefumula.
Ukuphumelela kwe-Femara
Kukhona ubufakazi obandayo bokuthi u-Femara angase afaneleke kakhulu kwabesifazane abane-PCOS ababhekene nenkinga yokuvota.
Ngokwesifundo se-2014 eshicilelwe eNew England Journal of Medicine , amaphesenti angu-27.5 abesifazane nabakwa-PCOS abathatha u-Femara bazalwa ngokuphumelelayo kuqhathaniswa namaphesenti angu-19.5 abathatha uComomid. Ucwaningo olufanayo lubonise izinzuzo kwezinye izindawo eziningana:
- Izinga lokuvota liphakeme kakhulu ne-Femara (amaphesenti angu-61.7) kuqhathaniswa neComomid (amaphesenti angu-48.3).
- Kwakukhona izinga lokuzalwa eliphakeme phakathi kwabesifazane abakhuluphele abane-PCOS abasebenzisa i-Femara.
- Kwakukhona ukukhulelwa okumbalwa kwabesifazane abasebenzisa i-Femara (amaphesenti angu-3.2) uma kuqhathaniswa nalabo abasebenzisa i-Clomid (amaphesenti angu-7.4).
Ingozi yokulahlekelwa kokubeletha, okwamanje, yayingaphezulu-noma-engafani nalokhu kwezidakamizwa zombili (Femara 31.8% ngokuhambisana nama-Clomid 28.2 amaphesenti).
Ngokufanayo, isifundo se-2015 eshicilelwe ku- PLoS One siphetha ukuthi kwakungekho umehluko omkhulu kulo lonke izinga lokukhubazeka kokuzalwa phakathi kwalabo abazelwe omama ababelethwe ngokwemvelo noma labo abasebenzisa i-Femara noma i-Clomid.
> Imithombo:
> Franik, S .; UKremer, J ;, Nelen, W .; futhi i-Farquhar, C. "I-Aromatase inhibitors yabesifazane abahlukumezekile abane-polycystic ovariary syndrome." I- Cochrane Database Syst Rev. 2014; 2: DOI 10.1002 / 14651858.CD010287.
> Kar S. "Ubufakazi bamanje obusekela i-letrozole yokukhipha i-ovulation induction." J Hum Reprod Sci. 2013; 6 (2): 93-8.
> Legro, R .; I-Brzyski, i-R .; I-Diamond, M. et al. "I-Letrozole ne-clomiphene ye-infertility kwi-polycystic ovary syndrome." N Engl J Med. 2014; 371 (2): 119-29.
> Sharma, S; Ghosh, S .; Singh, S. et al. "Ukuhlukumezeka KwamaKhansela Phakathi Kwabantwana Abazalwa Ngokulandela i-Letrozole noma i-Clomiphene ye-Infertility Treatment." PLoS ONE. 2015; 9 (10): e108219.