Kuyini i-Ultrasound? Kungani futhi Kusetshenziselwa Kanjani Ukuphathwa Kwe-Infertility?
Izilinganiso ze-Ultrasound ziyingxenye ebalulekile yokuhlolwa kokungakhulelwa kanye nokwelashwa kokuzala . Uma uke waba nengane ngaphambili , ungajwayele uhlobo lwe-ultrasound eyenziwe phakathi nesikhathi sokukhulelwa kwesikhathi eside. Ngisho noma ungakaze ube nengane, kungenzeka ukuthi ubonile ukuhlolwa kokukhulelwa kwe-ultrasound kumabhayisikobho noma kuthelevishini. Noma, mhlawumbe, umngane noma ilungu lomndeni kungenzeka ukuthi wabelane ngesithombe se- ultrasound somntwana ongakazalwa nawe.
Ama-Ultrasounds akwenzile phakathi nesikhathi sokukhulelwa kwesikhathi sekuvame ukukhulelwa kwesisu. Ngamanye amazwi, i-transducer (idivaysi ephuma futhi ithola amagagasi omsindo we-ultrasound) ishukunyiswa nxazonke kwesisu.
Ukuze kuhlolwe ukubeletha nokwelashwa, iningi lama-ultrasound lenziwe ngokuphindaphindiwe-okungukuthi nge-vaginal-ne-wand encane ekhethekile.
Ama-ultrasound awabuhlungu, nakuba angase angakhululekile.
Ngesikhathi sokuhlolwa kwe-infertility, ama-ultrasound scans anganikeza ulwazi kuma-ovarie, i- endometrial lining , nesibindi. I-ultrasound ekhethekile ingasetshenziselwa ukuhlola izindawo zokugcina ama-ovarian , isimo se-uterine ngokuningiliziwe, nokuthi ngabe ama-tubes fallopian avulekile noma avinjelwe.
Ngesikhathi ukwelashwa kwe-fertility, i-ultrasound isetshenziselwa ukuqapha ukuthuthukiswa kwezintambo kuma-ovari kanye nobukhulu be-endometrial lining. I-Ultrasound isetshenziswa futhi phakathi ne-IVF ye-egg retrieval, ukuqondisa inaliti ngaphakathi kodonga lwangasese kuma-ovari.
Abanye odokotela basebenzisa i-ultrasound ngesikhathi sokudluliswa kombungu.
Uma ukhulelwa , i- endocrinologist yakho yokubeletha cishe izohlehlisa ama-ultrasounds ambalwa ngaphambi kokukubuyisela ku-OB / GYN yakho evamile.
Ama-Basics e-Infertility ye-Ultrasound Scan
Ama-ultrasound scans asebenza ngokusebenzisa amagagasi omsindo aphezulu ukudala isithombe sezitho zangaphakathi zakho.
Ngeke ukwazi ukuzwa amagagasi omsindo.
I-transducer iyisetshenziswa esetshenziswa ngesikhathi se-ultrasound ukuphuma nokuthola lawa mavaysi omsindo aphezulu. Ngesikhathi sokuhlolwa kokuzala nokuguqulwa, ochwepheshe kungenzeka basebenzise izinhlobo ezimbili ezihlukene zamadivayisi we-transducer: eyodwa esetshenziselwa i-ultrasound yesisu nesesibili esisetshenziselwa ukudluliselwa.
Ngesikhathi i-ultrasound yesisu, i-gel igxila phezu kwesisu sakho. Khona-ke, i-transducer ihanjiswe ngobumnene phezu kwesisu. I-gel yenza kube lula ukuthi i-transducer ilayishe isikhumba sakho.
Ngesikhathi i-ultrasound ye-transvaginal, i-transducer ihlotshaniswa ne-wand, ende ende. Ikhondomu ifakwa phezu kwendandatho futhi i-gel yokugcoba ivulekile ngokukhululekile phezu kwekhondomu.
Uchwepheshe uzokunika isibambo soguquko lwe-transducer, ngakho-ke ungabeka kahle i-transducer ngaphakathi kwegciwane lakho kuze kube yilapho lizohamba kahle. Uzobe ususa isibambiso kumuntu ochwepheshe, ozoqhuba ukuhlolwa.
Amagagasi omsindo akhishwa yi-transducer. Bakhala (noma bahlehlise emuva) lapho beshaya izitho zangaphakathi. Umshini we-ultrasound uhumusha lezi zibonakaliso bese ubaphendukela esithombeni sedijithali.
Ngaphambi kwe-ultrasound yesisu, udokotela wakho cishe uzokucela ukuthi uphuze izinkomishi eziningana zamanzi emahoreni ngaphambi kokuhlolwa kwakho, kodwa ucele ukuthi ungazikhululi uma uzizwa udinga ukuchama.
(Mhlawumbe uzozizwa unesifiso sokuhamba!)
Isikhwama esigcwele siphoqa amathumbu akho endleleni, ngakho izitho zakho zokuzala zilula ukubona. Uma i-ultrasound yesisu isiphelile, uzokwazi ukusebenzisa indlu yokugezela.
Nokho, ukuze ubone imininingwane edingekayo yokuhlolwa kokuzala nokuphathwa, i-transvaginal ultrasound inikeza isithombe esingcono nakakhulu.
Iphuzu le-Transvaginal transducer lifakwa ngaphansi kwesigungu somlomo , esiseduze nezitho zakho zokuzala.
Ngaphandle kwe-ultrasound yesisu nesisu, kunezinye izilinganiso ezikhethekile ze-ultrasound ezingaba udokotela wakho.
- I-Antral follicle count ultrasound : lokhu kwenziwa ngedivayisi evamile ye-ultrasound ye-transvaginal, kodwa kudinga ukuqeqeshwa okukhethekile kochwepheshe ukuze agcwalise ngokunembile.
I-Antral follicle count count ultrasounds ingasiza ekunqumeni izinqolobane zakho zama- ovari kanye nokusiza ukuxilongwa nge- polycystic ovarian syndrome (i-PCOS) . Ungase ube noma ungenakho ukuhlolwa kokubala kwe-folral follicle njengengxenye yesibalo sakho sokuqala sokuzala.
Lokhu kungase kuhlelwe ngokwehlukana noma ngasikhathi sinye njengokuskena kwe-ultrasound jikelele.
- I-3D ultrasound : Izithombe eziningi ze-ultrasound ziyi-two-dimensional. Ukuthuthukisa ubuchwepheshe manje nakho kungaveza izithombe ezintathu.
Lokhu kuvumela ukutholakala okungcono kwezinye izifo ezingavamile kanye nezinkinga ze-tube fallopian ezingabonakali kwi-scan ye-2D ye-ultrasound evamile. - I-Sonohysterogram : I-sonohysterogram iyinhlangano ekhethekile ye-ultrasound ehilela ukudlulisa isisombululo saline esibelethweni nge-catheter. Isixazululo saline sigcwalisa isisu sakho, okwenza kube lula ukubona ngeso lengqondo ukuma kanye nanoma yikuphi ukunamathela okungenzeka ngaphakathi.
I-sonohysterogram ingenziwa ngesikhathi sokusebenza okuyisisekelo, kodwa isetshenziselwa kakhulu izimo ezithile. - I-hysterosalpingo-contrast sonography (i-HyCoSy): Lokhu kufana ne-sonohysterography ngaphandle kwedayi noma isisombululo saline ehlanganiswe nama-bubbles emoyeni esetshenziselwa ukucacisa ukuthi ngabe ama-tublopian tubes avulekile noma avinjelwe.
Kuvame kakhulu odokotela ukuthi bahlole ukuthi ngabe ama-tubespial tubespian avulekile ne -HSG, okuyi-X-ray ekhethekile .
Izinzuzo zokuba ne-HyCoSy phezu kwe-HSG yilokho- i-HyCoSy ingabangela ukungakhululeki okungaphezu kwe-HSG
- I-HyCoSy ayidingi imisebe noma ukuvezwa kwe-iodine
- i-HyCoSy ingenziwa ngesikhathi esifanayo njengokuhlolwa kwe-ultrasound jikelele (okusho ukuqokwa okuncane)
Ukuhlolwa kokuzala: Okuthi uDokotela Wakho Uhlolisisa Nge-Ultrasound
Nansi udokotela wakho wokuzala ohlola nge-infertility ultrasound scan.
Isikhundla esijwayelekile kanye nokuba khona kwezitho zokuzala : Ingabe konke okumele kubekhona khona? Ingabe yonke indawo isendaweni efanele?
Kubonakala sengathi umbuzo oyisisekelo, kodwa abanye besifazane bazalwa ngaphandle kwama-ovari noma isisu sabo.
Ama-ovari : I-ultrasound tech izobuka ama-ovari akho. Uzoqaphela ubukhulu bawo nokuma kwawo.
Uzophinde abheke ubufakazi bobubili obujwayelekile futhi abajwayelekile ngama-ovari. Ama-cysts amancane amancane afana nomgexo weparele angabonisa i-polycystic ovarian syndrome. Ukuba khona kwe-cyst endririum enkulu kunakhombisa ukuthi kungenzeka yini i-endometriosis .
Ezimweni ezingavamile, inqwaba engeyona i-cyst ingatholakala kuma-ovari.
Inombolo ye-Antral follicle : Lokhu kungase kube yingxenye yeskena evamile ye-infertility ultrasound noma ingase ihlelwe ngokwehlukana. I-Antral follicles uhlobo oluthile lwe-follicle olutholakala kuma-ovari. Ziyingxenye yokuphila kweqanda / i-oocyte .
Inani eliphansi kakhulu le-antral follicle lingase libonise izindawo ezincane zokugcina ama-ovarian. Isibalo esingajwayelekile kakhulu se-antral follicle singabonisa i-PCOS.
Isibeletho : I-ultrasound tech izobona ubukhulu be-uterine, ukuma, nesimo.
Uma i-ultrasound i-3D, kungase kwenzeke nakanjani ukubona ngeso lengqondo izinto ezithile ezingavamile, njenge- bicornuate noma i- septate uterus .
Uchwepheshe uzophinde abheke noma yikuphi ukuboniswa kwezixuku ze-uterine, njenge- fibroids , polyps, noma i-adenomyosis.
Lezi azikwazi ukubonwa njalo nge-ultrasound evamile. Ukuhlolwa okungaphezulu kungadinga i-sonohysterogram noma i-hysteroscopy.
Ubuningi be-Endometrium : Ububanzi besisu, i-endometrium, bukhulu futhi buguquka njengoba umjikelezo wakho wokuya esikhathini uqhubeka.
Uchwepheshe uzobheka izinkomba ezinempilo ukuthi i-endometrium isesiteji kufanele ibe, ngokususelwa ngosuku lokuhlolwa kwakho.
I-ultrasound tech nayo izokala ubukhulu be-endometrium. Kumele kube mncane ngaphambi kokuvuthwa kwegazi nokukhudlwana emva kokuvuthwa.
Kungenzeka ukuthi izinkinga zamathambo ezintambo : I-ultrasound eyisisekelo ayinakukwazi ukuthatha amashubhu aphilile. Noma kunjalo, i-tube fallopian ingabonakala nge-2D ultrasound evamile uma ivuvukala noma igcwele uketshezi, okungenzeka nge-hydrosalpinx .
I-ultrasound eyisisekelo ayikwazi ukucacisa ukuthi ngabe amashubhu we-fallopian acacile futhi avulekile. Ukuze uhlole ukuthi amashubhu avulekile noma avaliwe, udokotela wakho cishe uzohlehlisa i-HSG.
Kodwa-ke, nge-ultrasound ekhethekile eyaziwa ngokuthi i-hysterosalpingo-contrast sonography (i-HyCoSy), udokotela wakho angakwazi ukubona ukuthi amashubhu avinjelwe noma cha.
Ubufakazi obunokwenzeka bokubambisana : Ngokucindezela ngobuningi izitho zokuzala ne-transducer transvaginal, lochwepheshe ungabona ukuthi izitho zihamba ngokukhululekile futhi njengoba kufanele, noma zibonakala zibambisana.
I-tech ingase isebenzise i-wand ye-ultrasound ukuze iphoqe kahle ngama-ovari, ukuze ubone ukuthi ihamba kanjani emgodini we-pelvic. Ama-ovariya abonakala abanjwe komunye nomunye ngezinye izikhathi abiza ngokuthi "ukumanga ama-ovari."
Ukunciphisa kungavimbela izitho zokuzala ukuba zihambe ngokukhululekile. Ukuxhaswa kungenziwa kusuka ekuthelelekeni kwangaphambili kwesisu noma kusuka ku-endometriosis.
Ukugeleza kwegazi kumalungu okubeletha : uma udokotela wakho esebenzisa umbala we-Doppler, lochwepheshe angakwazi ukuhlola ukugeleza kwegazi nxazonke nge-cyst noma ubuningi. Lokhu kungasiza ukuhlukanisa phakathi kwe-cyst enempilo, i-cyst endrialrial (endometrioma), noma i-tumor ovarian.
Yini Engenakukwazi Ukulinganisa Nge-Ultrasound?
I-Ultrasound ayikwazi ukuxilonga noma ukulawula okulandelayo
Izigubhu ezivinjiwe ezingavamile : Ngaphandle kwe-hysterosalpingo-contrast sonography (i-HyCoSy), i-ultrasound eyisisekelo ayikwazi ukuhlola amashubhu we-fallopian.
I-Endometriosis : Ukuhlinzwa kuphela kwe- laparoscopic kungaphazamisa i-endometriosis.
Yize kungenzeka ukuthi ngezikhathi ezithile ubone izimboni ze-endometriosis enzima kwi-ultrasound, amacala aphansi futhi aphansi kakhulu awavamile ukubonakala.
Ezinye izifo ezingavamile : i-ultrasound evamile ayinakwenzeka ukubamba noma ukuxilonga okungajwayelekile kwe-uterine.
Kungenzeka ukuthi i-sonohysterogram iyadingeka, noma i-hysteroscopy engavamile, ukuhlola ngokugcwele isibeletho.
Ama-ultrasound Scans Ngesikhathi Ukwelashwa Kwemvelo: Yini futhi Kungani?
Izilinganiso ze-Ultrasound ziyingxenye ebalulekile yokuqapha ukwelashwa kokuzala.
I-Ultrasound ayivame ukusetshenziswa ukuhlola imijikelezo ye-Clomid uma ubona i-OB / GYN evamile, kodwa ingasetshenziswa uma uya emtholampilo wokuzala .
I-ultrasound ivame ukusetshenziselwa ukuqapha imijikelezo ye-gonadotropin futhi isetshenziselwa njalo ngesikhathi sezinhlelo ze-IVF .
Nakhu okumele ukwenze.
Iskena se-ultrasound esisekelwe phansi : Udokotela wakho cishe uzokutshela ukuthi ushayele ihhovisi labo ngosuku lokuqala lwenkathi yakho, inyanga yomjikelezo wakho wokwelashwa ohleliwe. Bayofuna ukuhlela umsebenzi wegazi kanye ne-ultrasound ezinsukwini ezimbalwa ezilandelayo.
Lokhu kuyaziwa njenge-baseline ultrasound yakho. Inhloso ukuhlola ukuthi ayikho ama-cyst engavamile kuma-ovari ngaphambi kokuqala imithi yokuzala.
Ngezinye izikhathi, i- corpus luteum cysts enenkani inamathela ngisho nangemva kokuqala kwesikhathi sakho. Lokhu akuyingozi futhi ngokuvamile kuzohamba ngaphandle kokungenelela. Noma kunjalo, ukwelashwa kungase kubambezeleke okwamanje. Imithi yokwelapha ingadambisa i-cyst.
(Lokhu kungenwa yi-ultrasound yokuqala ye-transvaginal kuyokwenzeka uma uqala ukuya esikhathini.Nakuba lokhu kungaba nakho okungahambi kahle, akuyona into okumele uyihlaziye ngayo. Awunjalo owesifazane wokuqala ukuba abe sesikhathini sakhe ngesikhathi sokuhlolwa kwe-ultrasound. khathaza isazi se-ultrasound nhlobo.)
Ukukhula kwe-Follicle : Lokhu kuyinkomba yokuqapha kwenombolo ngesikhathi sokunakekelwa kokuzala. Lawa wonke ama-ultrasound transvaginal, futhi, kuye ngokuthi ukwelashwa, ungase ube emtholampilo njalo ngezinsuku ezimbalwa ngenxa yalezi zingqinamba.
Udokotela noma i-ultrasound tech izobe ibheke ukubona ukuthi zingaki izinhlobo ze-follicle ezikhulayo nokuthi zikhula ngokushesha kangakanani. Imithi yakho yokuzala ingahle ishintshwe noma ihle, kuye ngokuthi ukukhula kwe-follicle.
Uma i-follicles ifinyelela usayizi othize, "i-trigger shot" yakho (umjovo we-hCG) noma ukubuyiselwa kwamaqanda kuzohlelwa.
Kungenzeka futhi ukuthi izintambo ezimbalwa noma eziningi kakhulu zingase zithuthuke.
Uma uthola ukwelashwa kwe-IVF, futhi ezimbalwa ezingekho izintambo ezibonakalayo, umjikelezo wakho ungakhanselwa.
Uma une-IUI noma i-gonadotropin yokwelashwa, futhi izintambo eziningi kakhulu zikhula, umjikelezo wakho ungakhanselwa ukuze ugweme ingozi yokuba nokukhulelwa okuphezulu kokukhulelwa okuningi .
Ubuningi be-Endometrial : I-ultrasound tech cishe izolinganisa ubukhulu bakho be-endometrial. Ngokusekelwe kulolu lwazi, udokotela wakho angashintsha imithi yakho yokwelapha yokuzala.
Inqubo eqondiswa yi-Ultrasound : Akuyona ingxenye yokuqapha, i-ultrasound ingasetshenziswa ngesikhathi sokwelashwa uqobo.
Ngesikhathi ukwelashwa kwamaqanda, ukwelashwa kwe-IVF, inaliti eqondiswa i-ultrasound isetshenziselwa ukuthola amaqanda avela kuma-ovari. Abanye odokotela basebenzisa i-ultrasound ngesikhathi sokudluliswa kombungu.
I-Ultrasound Scan Ngaphambi Kokukhulelwa Kwangaphambi Kakhulu
Uma ukhulelwa ngenkathi ukwelashwa kwe-fertility, ngeke uthunyelwe ngokushesha ku-OB / GYN yakho evamile. Udokotela wakho wokuzala uzokuqala ukuqiniseka ukuthi ukukhulelwa kuyaqhubeka njengoba kulindeleke, okungenani emavikini okuqala.
I-ultrasound yokuqala izohlelwa cishe isonto eliyisithupha. Lena amasonto amabili edlule isikhathi esilindelekile noma usuku lokuhlola lokukhulelwa. Uchwepheshe uzobe esibheka isikhwama somzimba. Akungabazeki ukuthi ukushaya kwenhliziyo kuzotholakala kuleli phuzu, ngakho ungathukutheli uma ungaboni.
Udokotela wakho uzophinde afune ukubona ukuthi uthwala iziphindaphindwe. Kulesi sigaba, akunakwenzeka ngaso sonke isikhathi ukubona ngokuqinisekile uma uphatha okungaphezu kweyodwa.
Uma isikhwama sokugcoba sesibe sesibonisiwe, ukukhulelwa kuthathwa njengokukhulelwa komtholampilo . (Ukukhulelwa kwamakhemikhali kungukuthi umsebenzi wegazi uthola ukuthi i-hormone ikhulelwe , kodwa ayikho enye imibonakaliso yokukhulelwa ebonakalayo okwamanje.)
Ngemva kwamasonto ambalwa, cishe uzothola enye i-ultrasound. Lokhu kuzoba ukubheka isibalo se-fetal futhi sinethemba lokushaya kwenhliziyo. Bazophinde baphinde bazame ukuqinisekisa ukuthi uphethe i-singleton, amawele, noma ngaphezulu.
Uma kutholakala ukushaya kwenhliziyo, uzothunyelwa ku-OB / GYN yakho yokunakekelwa kokubeletha. Ngisho nangemva kokungasebenzi, i-OB / GYN engozini enkulu ayidingi ngokujwayelekile ekukhulelwe okuphephile .
> Imithombo:
> Grigore M1, Mare A. "Izicelo ze-3-D ultrasound ekungeneni kwesifazane . "U-Rev Med Chir Soc Med Nat Iasi . 2009 Okthoba-Dec; 113 (4): 1113-9.
> Groszmann YS1, Benacerraf BR2. "Ukuhlolwa okuphelele kwe-anatomy kanye ne-morphology yesiguli esingenasifo ekuhambeleni okukodwa; ukuhlolwa kwesimanje kwe-ultravic acid ukuhlolwa. " Fertil Steril . 2016 Jun; 105 (6): 1381-93. i-doi: 10.1016 / j.fertnstert.2016.03.026. Epub 2016 Apr 4.
> Hrehorcak M1, i-Nargund G1. "Ukuhlola okukodwa kwe-One-Stop" usebenzisa ubuchwepheshe obuphezulu be-ultrasound. "I- Facts Views Vis Obgyn . 2011; 3 (1): 8-12.