Izingozi nemiphumela emibi yezidakamizwa zokuzala ezijoqayo
Ngaphambi kokuqala ukwelashwa nge- gonadotropins - ngezinye izikhathi kuthiwa yi-injection - udokotela wakho kufanele akuchazele imiphumela emibi engaba khona kanye nezingozi zokwelashwa. Ungase uthathe i-gonadotropin kanye no- Clomid , ngokwabo, njengengxenye yomjikelezo we- IUI , noma njengengxenye yomjikelezo wezokwelapha we- IVF .
I-Gonadotropins nayo isetshenziselwa abesifazane abanikela amaqanda abo kanye nezinqubo zokuqanda amaqanda .
Iningi lemiphumela emibi ye-gonadotropin ilula, kodwa ezimweni ezingavamile, ezinye zingase zibe yingozi futhi zisongela ukuphila.
Inothi elibalulekile! Akuzona zonke imiphumela emibi kanye nezingozi ezibalwe ngezansi. Uma unemiphumela emibi kakhulu, izimpawu ezingavamile, noma ukhathazekile nganoma yisiphi isizathu, xhumana nodokotela wakho. Ulwazi olukulesi sihloko aluhambisani nokubonisana nodokotela wezokwelapha.
Imiphi Imithi Ebhekwa NjengamaGonadotropin?
I-Gonadotropin yizidakamizwa zokuzala eziqukethe i-FSH, i- LH , noma inhlanganisela yamabili (okuthiwa i-gonadotropin yamadoda yenyama noma i-hMG). Zihlanganisa i- hmG ye-hormone, eyimvelo efana ne-LH.
Lawa mahomoni athathwa ngomjovo.
I-Gonadotropins ingenziwa kukhibhodi isebenzisa ubuchwepheshe be-DNA ephindaphindiwe , noma ingasuswa bese ihlanzwa emcinini wabesifazane besimo se-postmenopausal noma abakhulelwe.
Amagama omdanso we-gonadotropini adalwe ngokusebenzisa ubuchwepheshe be-DNA obuhlanganisa i-Gonal-F (rFSH), i-Follistim (rFSH), iPuregon (rFSH), i-Luveris (rLH), ne-Ovidrel (i-HRHG).
I-Bravelle, i-Metrodin, ne-Fertinex yigama lamagama we-FSH ekhishiwe e-urinary.
I-Novarel, i-Pregnyl, no-Profasi yi-hCG ekhishwe ngamanzi.
Amagama omdanso we-gonadotropin yabantu abanjwe ngamakhomba (inhlanganisela ye-FSH ne-LH) afaka i-Humegon, i-Menogon, i-Pergonal, i-Repronex ne-Menopur.
Imiphumela emibi ye-Gonadotropins
Qaphela: Amaphesenti angezansi abhekisela ocwaningweni ngokuqhathanisa i-Gonal-F - okuyi-rFSH, edalwe ebhodini esebenzisa ubuchwepheshe be-DNA obubuyiselwayo - ne-urofollitropin, noma iFFSH, ehlanjululwayo i-FSH ekhishwe emcinini wabesifazane be-postmenopausal. Amanani angahluka kancane kusuka ezidakamizweni kuya ezidakamizweni, kodwa imiphumela yezokwelapha ze-gonadotropin ngokuvamile iyafana.
Imiphumela emibi engase ibe khona ye-gonadotropin ihlanganisa:
- Amakhanda (rFSH: 22%, uFSH: 20.2%)
- I-nausea (rFSH: 13.6%, uFSH: 3.5%)
- Ukutheleleka okuphezulu kokuphefumula (rFSH: 11.9%, uFSH: 7.9%)
- Ukwethembeka kwesisu (rFSH: 9.3%, uFSH: 12.3%)
- Igesi (rFSH: 6.8%, uFSH: 8.8%)
- Ukuhlanganiswa kwesinus (i-rFSH: 5.1%, uFSH: 5.3%)
- Ukuvuthwa okujwayelekile (rFSH: 5.9%, uFSH: 6.1%)
- Ukushintsha kwe-mood (rFSH: 5.1%, uFSH: 2.6%)
- I-acne (rFSH: 4.2%, uFSH: 2.6%)
- Ububele besisu (rFSH: 4.2%, uFSH: 6.1%)
- Ukuzuza kwesisindo (rFSH: 3.6%, uFSH: 0.0%)
- Ukungahambi kahle kwamaphilisi (rFSH: 2.5%, uFSH: 6.1%)
- Ukusuka okungavamile noma ukuphawula (rFSH: 2.5%, uFSH: 0.9%)
- Ukuncintisana (i-rFSH: 2.5%, uFSH: 2.6%)
- Ukuphulukiswa kwesakhiwo sensimu, ubomvu (rFSH: 2.5%, uFSH: 0.9%)
- Usizi (rFSH: 2.5%, uFSH: 0.0%)
Izingozi zeGonadotropin
I-Ovarian Hyperstimulation Syndrome (OHSS) : I-OHSS ivela lapho ama-ovari nesisu sezivuvukala ngogesi . Kuze kube ngu-10 kuya kwezingu-20% kwabesifazane abazokwakha uhlobo oluthile lwe-OHSS, okuyinto evame ukuzixazulula yedwa. Kubalulekile ukubika nodokotela wakho izimpawu ezincane, ngakho-ke angakuqapha ngokucophelela.
Uma une- PCOS , usengozini enkulu yokuthuthukisa i-OHSS.
I-OHSS enamandla ikhona ezingaphansi kwezingu-1% zeziguli. Xhumana nodokotela wakho masinyane uma ubona ukuhlanza, ubuhlungu obukhulu besisu noma isisu, ukutholakala kwesisindo ngokushesha, noma ukuvinjelwa okukhulu.
Ukukhulelwa okuningi : Kuye ngokuthi ubheka isiphi isifundo, izinga lokuphindaphindiwe nge-gonadotropin ukwelashwa kunoma yikuphi kusuka ku-2% ukuya ku-30%, okungafika ku-5% triplet noma ukukhulelwa kwe-oda eliphezulu.
Izivivinyo zemitholampilo zithole ukuthi ukukhulelwa okuphindwe kabili kwenzeka esikhathini esiyi-12 kuya ku-14% ngesikhathi lapho usebenzisa i-rFSH noma i-uFSH ngokulandelanayo. Ukuqapha ngokucophelela nokusebenzisa umthamo ophansi kakhulu kunciphisa ingozi.
Uma usebenzisa i-gonadotropin phakathi ne-IUI noma yedwa, kunzima kakhulu ukulawula ingozi yeziphindaphindeka kunokuba isetshenziswe ngesikhathi se-IVF. Phakathi ne-IVF, udokotela wakho angadlulisa umbungu owodwa.
Uma ukhathazekile ngengozi yokuphindaphinda, futhi usebenzisa izinjectject njengengxenye yomjikelezo we-IUI, ungase ufune ukubuza udokotela wakho mayelana ne- mini-IVF .
Ama-cysts e-Ovarian : Ama-cysts ama-ovari ayenzeka ngokuvamile nge-gonadotropin. Nge-rFSH, zenzeka cishe ngo-15% wesikhathi, futhi nge-uFSH zenzeka cishe ngo-29% wesikhathi.
Ngokuvamile, zixazulula zodwa. Ezimweni ezingavamile, kungadinga ukungenelela kokuhlinzwa.
Ukutheleleka kwesayithi : Ukunye ukubomvu kanye nesisa kuyinto evamile, kodwa ezimweni ezingavamile, indawo yokujola ingathathwa igciwane. Thintana nodokotela wakho uma ubona ukuthi isisindo somjovo sisanda kubomvu, ukufudumala okuqhubekayo, ukuvuvukala, i-puss, iphunga, noma ubuhlungu obukhulu. Futhi, uma uthola imfiva ngaphezu kuka-101, xhumana nodokotela wakho.
I-Adnexal torsion (noma i-ovarian twisting) : Ezimweni ezingavamile (ezingaphansi kwezingu-2% zesikhathi), i-ovary ingase ishintshe, iphuke, noma ichithe, idinga ukungenelela kokuhlinzwa. Lokhu kwenzeka ngoba i-ovary iba yindlala futhi ikhulisiwe kusukela ekukhuthazeni.
Ukukhulelwa kwe-Ectopic : Ingozi ye- ectopic pregnancy yanda kancane uma ithatha i-gonadotropin. Ukukhulelwa kwe-Ectopic kungasongela ukuphila noma kungadinga ukungenelela okuhlinzekwayo.
Amaqabunga egazi : Okungajwayelekile (4.2 kuya ku-1,000) kodwa kungaba impilo engozini.
Ukwanda kwengozi ye-blood clot akuyona nje ngesikhathi sokwelashwa, kepha uma ukhulelwa, uyaqhubeka ephakeme ngesikhathi sokukhulelwa.
Uma ubona izimpawu zegazi elilodwa-ukuvuvukala noma ubuhlungu umlenze owodwa, ukufudumala ezindaweni ezithintekile, ukuguquka kombala wesikhumba (ubomvu, bluish, noma obala) - xhumana nodokotela wakho ngokushesha.
Uma uhlakulela izimpawu ze-embolism ye-pulmonary - ukuphefumula okusheshayo okungazelelwe, ubuhlungu besifuba bubuhlungu uma uzama ukuthatha umoya ojulile noma uma ukhwehlela, uzizwa unamakhanda noma uphazamisekile, uphawule ngokushesha, ukujuluka, ukukhwehlela igazi, umuzwa ukulimala okuzayo - uthole usizo lwezokwelapha ngokushesha.
> Imithombo
I-Gonal-f (i-follitropin alfa yomjovo). Ishidi lokwaziswa kwezidakamizwa. http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/20378scf015_gonal_lbl.pdf
UHenriksson P, Westerlund E, Wallén H, Brandt L, Hovatta O, Ekbom A. "Isimo se-thromboembolism ye-pulmonary ne-venous in pregnancy ngemuva kokukhulelwa kwe-in vitro: ukutadisha okuhlangene." BMJ. 2013 Jan 15; 346: e8632. i-doi: 10.1136 / bmj.e8632. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546085/
Imiphumela emibi ye-Gonadotropin: Iphepha Lokugcina Lokubekezela. UmNyango we-American for Medicine Reproductive.