Iyini i-Metformin, Imiphumela Ekhona Yomphumela, nokuthi Kungani Isetshenziselwa Ukungafihli
I-Metformin iyisidakamizwa esishukela i-insulini esetshenziswa ngokuyinhloko ukuphatha isifo sikashukela, kodwa singasetshenziselwa ukuzala. Abesifazane abane-PCOS bangase bazuze ngokuthatha i-metformin yedwa, kanye ne-Clomid, noma ngisho nangesikhathi sokwelashwa kwe-IVF. Ngokuqondile indlela i-metformin ethuthukisa ngayo ukuzala ingacaci kahle.
Nakuba i-metformin ingasetshenziselwa ukwelashwa kokungazalwa , akusiyo imithi yokuzala.
Eqinisweni, ukuyisebenzisa ukuphatha ukungabi nalutho kubhekwa njengokusetshenziswa kwelebuli. (Ngamanye amazwi, impumelelo yokukhulelwa akuyona injongo eyakhelwe ekuqaleni yalesi sidakamizwa.)
Iyini le mithi? Futhi kungakusiza kanjani ukukhulelwa?
Yini i-Metformin?
Ukuqonda ukuthi i-metformin yenzani, kufanele uqale ukwazi ukuthi ukuphikiswa kwe-insulin kuyini. Abesifazane abaningi abane-PCOS banokumelana nesisulin. Ukuphikiswa kwe-insulini yilapho amangqamuzana omzimba ayeka ukuphendula emazingeni ajwayelekile e-insulin. Baba abacabangi kakhulu, noma abanamathele.
Ngenxa yalokho, umzimba ucabanga ukuthi akukho insulin eyanele ohlelweni. Lokhu kubangela ukukhiqizwa kwe-insulin engaphezu komzimba wakho okudingayo.
Kubonakala sengathi kukhona uxhumano phakathi kwe-insulin nama-hormone okuzala. Nakuba kungekho muntu oqiniseke kahle ukuthi lezi zixhumanisi zihlangene kanjani, amazinga e-insulini abonakala eholela emazingeni amaningi we-androgens.
Amadoda nabesifazane bane-androgens, kepha i-androgens ngokuvamile icatshangwa ngokuthi "amahomoni wesilisa." Amazinga aphezulu we-androgen aholela ezimpawu ze-PCOS nezinkinga ngokuvunguza.
I-Metformin kanye neminye imithi yokwehlisa i-insulini iyanciphisa amazinga angaphezu kwe-insulin emzimbeni. Ngaphandle kwe-metformin, i-rosiglitazone ne-pioglitazone yilezi ezinye izidakamizwa ezisetshenziselwa i-insulin ezingasetshenziswa ukuphatha i-PCOS.
Kungani i-Metformin isetshenziselwa ukuphatha i-PCOS?
Kunezizathu eziningi zokuthi udokotela wakho anganikeza i-metformin uma uphatha i-PCOS yakho, ezinye zazo ezihlobene nokuzala:
Ukuphikiswa kwe-insulin
Njengoba kushiwo ngenhla, ukuvimbela i-insulin kuvamile kubesifazane abane-PCOS.
I-Metformin ingahle ibekwe ukuba ilaphe ukumelana ne-insulin, engasiza ekulawuleni ama-hormone okuzala nokuqala kabusha ukuvuthwa.
Ukukhishwa kwe-Ovulation Induction
Olunye ucwaningo olwenziwe nge-metformin ne-PCOS lubonisa ukuthi imijikelezo yokuya esikhathini iba njalo futhi i-ovulation ibuya ngokuphathwa kwe-metformin. Lokhu kungenzeka ngaphandle kokudinga izidakamizwa zokuzala ezifana ne- Clomid .
Kodwa-ke, ezinye izifundo zocwaningo ezinkulu azizange zithole inzuzo yokuthatha i-metformin.
Ngenxa yalesi sizathu, odokotela abathile bayancoma ukuthi i-metformin isetshenziselwe kuphela ukuphatha abesifazane abano-insulin-resistant hhayi bonke abesifazane abane-PCOS kungakhathaliseki ukuthi bayakwazi ukumelana ne-insulin noma cha.
Ukuphikiswa kwe-Clomid
Ngenkathi i-Clomid izosiza abesifazane abaningi nge-PCOS ukuvuthisa, abanye besifazane bayamelana ne-Clomid . (Lena indlela enhle yokusho ukuthi ayisebenzi kubo.)
Ezinye izifundo zocwaningo zithole ukuthi ukuthatha i-metformin izinyanga ezingu-4 kuya kwezingu-6 ngaphambi kokuqala ukwelashwa kwe- Clomid kungaphumelela ukuphumelela kwabesifazane abanama-clomid.
Enye indlela yabesifazane abanokuphikiswa kwe-Clomid kungenzeka ibe yi- metformin ehlangene ne-letrozole .
Izidakamizwa Zokulimala Injectable
Uma i-Clomid ingakusizi ukuthi ukhulelwe, isinyathelo esilandelayo ngokuvamile i- gonadotropin noma imithi yokuzala injectable .
Ucwaningo luye lwathola ukuthi inhlanganisela ye-injection ene-metformin ingathuthukisa amanani akhulelwe aqhubekayo.
Ucwaningo oluthile oluthola ukuthi ukuhlanganisa i-metformin enezijocavo zithuthukisa izinga lokuzalwa elibukhoma uma kuqhathaniswa nokwelashwa ngezijova kuphela. Kulolu cwaningo, uma izinga lokuzalwa eliphilayo elinemijojwana yedwa engamaphesenti angu-27, ukwelashwa nge-metformin kanye nezinjectject kungaba ngcono izinga lokuzalwa eliphilayo kuze kube ngamaphesenti angama-32 kuya kwangu-60.
Ingozi Eyancipha Ye-Ovarian Hyperstimulation Syndrome
I-Ovarian hyperstimulation syndrome (OHSS) ingozi engenzeka lapho usebenzisa izidakamizwa zokuzala, ikakhulukazi ngesikhathi sokwelashwa kwe-IVF. Abesifazane abane-PCOS banengozi enkulu kakhulu yokuthuthukisa i-OHSS.
Ezinye izifundo zithole ukuthi i-metformin inganciphisa ingozi ye-OHSS ngesikhathi se-IVF. Kodwa-ke, akucaci ukuthi i-OHSS incishisiwe yini kwezinye izinqubo. Isibonelo, ucwaningo lwe-gonadotropins yedwa (ngaphandle kwe-IVF) alutholanga umehluko kuma-OHSS amanani uma enezela i-metformin kwiprothotho yokwelapha.
Ukuphindaphindiwe okuphindaphindiwe
Abesifazane abane-PCOS bangase babe nesifo sokukhulelwa kwesisu kunabantu abaningi. I-Metformin inganciphisa ingozi yokukhulelwa kwesisu kwabesifazane abane-PCOS, ngokwezinye izifundo.
Ucwaningo oluthile luye lwathola ukuthi ukwelashwa okuqhubekayo kwe-metformin ngesikhathi sokuqala kokukhulelwa kungasiza ekuvimbeleni ukukhulelwa kwesisu kwabesifazane abane-PCOS.
Kodwa-ke, ukuphepha kwe-metformin ngesikhathi sokukhulelwa akusikho kahle. Ukunquma ukuthatha i-metformin ngesikhathi ukhulelwe kuyingozi okufanele ixoxwe ngokucophelela nodokotela wakho.
Ukulahlekelwa Isisindo
I-PCOS ixhunyaniswe nokukhuluphala. Ukukhungatheka kwabesifazane abaningi, ukulahlekelwa isisindo nge-PCOS kungase kube nzima nakakhulu.
Ezinye izifundo zibonise ukuthi i-metformin ingasiza abesifazane nabakwa-PCOS ukuthi banciphise isisindo. Njengoba ukulahlekelwa isisindo kuye kwaboniswa ukusiza ukuqala kabusha i-ovulation futhi ufeze ukukhulelwa, udokotela wakho angase anikeze i-metformin, kanye nohlelo lokudla nokuzivocavoca, ukusiza ukuthuthukisa ukuzala kwakho.
Yiziphi Imiphumela Ezingezansi?
Umphumela ovame kakhulu we-Metformin isisu esithukuthele kakhulu, ngokuvamile uhudo, kodwa ngezinye izikhathi nokuhlanza nokucabangela. Ukuthatha i-metformin phakathi kokudla kungasiza ukunciphisa lo mphumela ohlangothini.
Imithelela emibi ehlobene nokugaya inganciphisa ngokuhamba kwesikhathi. Abanye besifazane bathola ukuthi ukudla okunjalo kubangela ukucasuka kwesisu kunabanye.
Imiphumela emibi kakhulu emayelana ne-metformin iyingozi yokungasebenzi kanye nesisindo esingavamile kodwa esibi kakhulu, i-lactic acidosis.
Ngenkathi uthatha i-metformin, udokotela wakho kufanele aqaphele imisebenzi yakho yezinso nesibindi. Abantu abanezinhliziyo, isibindi, izinso noma isifo sephaphu akufanele bathathe i-metformin. Qinisekisa ukunikeza udokotela wakho ngomlando wezokwelapha ngokuphelele.
Ukusetshenziswa kwe-metformin ukuphatha ukungabi nabantwana okuhlobene ne-PCOS kusacwaningwa, kanti odokotela abahlukahlukene banemibono ephikisanayo uma, nini, nokuthi kanjani ukusebenzisa i-metformin ukuphatha ukungasebenzi.
Ungesabi ukukhuluma okukhathazayo nemibuzo kumhlinzeki wakho wokunakekelwa, ukuze ndawonye, unqume ukuthi le mithi ikuphi.
Imithombo:
Creanga AA, Bradley HM, McCormick C, Witkop CT. "Ukusetshenziswa kwe-metformin ku-polycystic ovary syndrome: ukuhlaziywa kwe-meta." I-Obstetrics ne-Gynecology . 2008 Apr; 111 (4): 959-68.
UNazz FH, uJuici J. "Ukuqhubekela phambili kwe-metformin kunciphisa ukulahlekelwa kokukhulelwa kokuqala kwabesifazane basePakistani abakhulu kakhulu abane-polycystic ovarian syndrome." Ucwaningo lwe-Gynecologic and Obstetric . 2010; 69 (3): 184-9. Epub 2009 Dec 21.
Roy KK, Baruah J, Sharma A, Sharma JB, Kumar S, Kachava G, Karmakar D. "Isivivinyo esingahle senziwe ngokungahleliwe ngokuqhathanisa umphumela wezokwelapha kanye ne-endocrinological nge-rosiglitazone ne-laparoscopic ovarian drill in iziguli ezine-polycystic ovarian disease eziphikisana nokufakelwa kwe-ovulation nge-clomiphene citrate. " I-Archives ye-Gynecology ne-Obstetrics . 2010 Meyi; 281 (5): 939-44. Epub 2009 Dec 3.
> Tso LO1, Costello MF, Albuquerque LE, Andriolo RB, iMakedoniya CR. "Ukwelashwa kwe-Metformin ngaphambi nangesikhathi se-IVF noma i-ICSI kwabesifazane abane-polycystic ovary syndrome. "Cochrane Database Syst Rev. 2014 Nov 18; (11): CD006105. i-doi: 10.1002 / 14651858.CD006105.pub3.
> Yu Y1, Fang L1, Zhang R1, He J1, Xiong Y1, Guo X1, Du Q1, Huang Y1, Sun Y2. "Ukuphumelela kokuqhathanisa kwezifo zokwelashwa ezi-9 zokukhipha ama-ovulation ezigulini ezine-clomiphene syndiphene synds-syndrome syndrome-ovary syndrome: inethiwekhi-meta-analysis. "Sci Rep. 2017 Jun 19; 7 (1): 3812. i-doi: 10.1038 / s41598-017-03803-9.