Umhlahlandlela wemihla ngemihla kuComid Treatment for Problems Ovulation
Uyithatha kanjani i-Clomid yokungasebenzi ? Uma udokotela wakho enqume lesi sidakamizwa esithandwayo sokuzala, cishe uyazi ukuthi yini ongayilindela. Yiqiniso, ukwelashwa kuzohluka kusuka komuntu kuya komuntu, kuye ngezici ezithile.
Isibonelo, ukwelashwa kwe-Clomid ne-gynecologist ngokuvamile kubonakala kuhlukile ukwelashwa ngumchwepheshe wokhula. Ngezinye izikhathi i-Clomid ihlanganiswe nokwelashwa kwe- IUI (intrauterine insemination) . Ngokuvamile, kunqunyelwe ukuthi kulungiswe isikhathi sokulala ekhaya. Le mhlahlandlela yosuku yokwelapha izokunikeza umqondo jikelele walokho umjikelezo wakho ungase ubukeke.
Inothi elibalulekile : Njengalokhu njalo, landela imiyalelo kadokotela wakho lapho uthatha i-Clomid, futhi ungabi namahloni ngokubuza imibuzo ngaphambi, ngesikhathi, noma ngemuva kokwelashwa.
I-Clomid Cycle Day Day 1: Isikhathi Sakho Siqala
Udokotela wakho cishe uzokutshela ukuthi uxhumane nehhovisi lakhe ngosuku lokuqala lwenkathi yakho. Uma unenkathi engavamile , udokotela wakho angase anikeze imithi iPravera, uhlobo lwe-progesterone, ukuze enze isikhashana kuqala.
Usuku lokuqala lwenkathi yakho yosuku ophethe ukugeleza kokuya esikhathini hhayi nje ukubonakala okulula kakhulu. Uma ungaqiniseki uma inkathi yakho iqalile ngempela, noma uma ukuphuma kwegazi ukukhanya okungavamile, cela udokotela wakho. Kungenzeka ukuthi uthathe ukuhlolwa kokukhulelwa kwe-beta (nge-blood work) ukuqinisekisa ukuthi awukhulelwe.
Usuku olulodwa lomjikelezo wakho usuku lokuqala lwenkathi yakho. Kodwa-ke, ukuze nje udideke kakhulu, udokotela wakho angakutshela ukuthi usuku lwakho olusemthethweni olulodwa usuku olulandelayo ngemuva kokuqala kwesikhathi sakho. Kuxhomeke ukuthi yisiphi isikhathi sosuku ukugeleza kwakho kuqale. Lesi yisinye sezizathu ongase udinge ukubiza udokotela wakho ngaphambi kokuqala ukwelashwa.
Bhala lolu suku phansi, njengoba uzodinga ukuthatha i-Clomid ngezinsuku ezithile zomjikelezo wakho. Ungadinga futhi ukuthi uvivinyo oluthile lwenziwe ezinsukwini ezithile. Ukwenza umjikelezo ube lula ukulandelela, ungabhala ekhalendeni lakho izinsuku zomjikelezo wakho eceleni kwezinsuku zekhalenda. Isibonelo, uma ngo-Ephreli 3 uthola isikhathi sakho, ubhala u-1 embuthanweni ngo-Ephreli 3, u-2 embuthanweni ngo-Ephreli 4, njalonjalo.
I-Clomid Cycle Day 2-3: I-Baseline Ultrasound Check
Uma ubiza udokotela wakho ngosuku lokuqala lomjikelezo wakho, ungase ucelwe ukuthi uhlele isheke eliyisisekelo se-ultrasound. Lokhu kungenzeka ukuthi yenziwe ngumchwepheshe wokhula. Ukuqashwa kwe-ultrasound kuyashesha futhi kuzokwenziwa nge-transvaginally. I- ultrasound yangaphandle iyenziwa nge-probe ye-ultrasound nge-vaginal yakho.
Udokotela wakho ufuna ama-cysts kuma-ovari, ukuze angadideki nama-cysts amancane umuntu angabona ngama-ovaries we-polycystic . Kulokhu, udokotela ufuna i-cyst enkulu. Ngokuvamile, i-ultrasound ayitholi lutho. Uma konke kubukeka kuhle, umjikelezo wakho ungaqhubeka njengoba uhleliwe.
Uma i-ultrasound ithola i-cyst noma i-cysts, udokotela wakho cishe uzosula lo mjikelezo. Kungadingeka ulinde kuze inyanga ezayo uzame futhi. Uma bethola i-cyst, ungakhathazeki. Lezi zinhlayiya azivamile ukulimaza futhi zizophela zodwa. Ukugxeka okuyinhloko kuyodingeka ulinde enye inyanga ukuqala ukwelashwa.
Njengoba njalo, cela udokotela wakho uma ukhathazekile.
Usuku lwe-Clomid Cycle 3-5: I-Clomid Treatment iqala
Uma ususuliwe udokotela wakho ukuze uqale umjikelezo, uzothatha isilinganiso sakho sokuqala se-Clomid ngosuku udokotela wakho ayala ngayo. Uzothatha umthamo owodwa nsuku zonke izinsuku ezinhlanu, kodwa ngeke uthathe noma iyiphi i-Clomid ngosuku lokuqala lomjikelezo wakho.
Udokotela wakho angakutshela ukuthatha amaphilisi e-Clomid kwenye yezinhlelo ezilandelayo:
- Ezinsukwini zomjikelezo 3, 4, 5, 6, no-7
- Ezinsukwini zomjikelezo 5, 6, 7, 8, no-9
Abanye odokotela bazobe uqale ukwelashwa ngosuku lomjikelezo wesibili noma usuku lomjikelezo 4, nakuba lokhu kungavamile. Akukho kubonakala sengathi kukhona umehluko ekuphumeleleni kokukhulelwa phakathi kokuqala kweComomid ngosuku lwesithathu noma ngosuku 5. Odokotela abahlukene bakhetha ukusebenzisa izinqubo ezihlukene.
Kwezinye izimo, udokotela wakho angakucela ukuthi ushintshe usuku lokuqala ekuqaleni komjikelezo wakho, ukuze ubone ukuthi uzokwenza umehluko kuwe. Ngokufanelekile, thatha i-Clomid ngesikhathi esifanayo nsuku zonke. Abanye bathi ukuthatha iphilisi ngaphambi kombhede kungakusiza ukuba ulale ngenye yemiphumela emibi . Abanye benza kangcono uma bethatha iphilisi ekuseni.
Uma unomjikelezo owodwa we-Clomid, ungazama ukukuthatha ngesikhathi esithile sosuku, kodwa ungashintshi isikhathi sosuku uma uqala umjikelezo ngaphandle kokuthi ukhulume nodokotela wakho.
Izinsuku ze-Clomid Cycle 3-9: I-Clomid iqala ukusebenza
Ngeke uchithe ezinsukwini ezinhlanu uthatha amaphilisi e-Clomid. Kodwa-ke, ngesilinganiso sakho sokuqala, i-Clomid iqala ukusabela kwamakhansela okuzogcina ekuholele ekuvuthweni.
Ngamafuphi, i- hormone i-FSH (i-follicle stimulating hormone) ibonisa ama-ovari ukuba akhule namaqanda avuthiwe (okugxilwe emilenzeni yamanzi) ukuze akhululwe nge-ovulation. Njengoba i-follicles kuma-ovari ikhula, ikhulula i-estrogen. Ukwanda kwe-estrogen kubonisa ukuthi ubuchopho buyanciphisa ukukhiqizwa kwe-FSH. Lokhu, futhi, kunciphise ukugqugquzelwa kwama-ovari.
I-Clomid isebenza ngokukhohlisa ubuchopho ekucabangeni amazinga akho e-estrogen aphansi ngokungajwayelekile. Lokhu kwenza lokhu ngokuvimbela i-estrogen ekubophezelweni kwe-receptor yayo. I-Estrogen iyajikeleza ekusakazweni kwegazi lakho, kodwa ama-receptors akakwazi ukukuthola. Ucabanga ukuthi akukho follicles ekhulayo kusukela i-estrogen ibonakala iphansi, umzimba wakho uphendula ngokukhulula i-hormone ekhululekile ye-gonadotropin, noma i-GnRH.
I-GnRH isho umgogodla wakho we-pituitary ukukhiqiza ngaphezulu i-FSH ne-LH. Amazinga aphezulu e-FSH ashukumisa ama-ovari, futhi amazinga aphezulu e-LH ekugcineni enza ukuvuthwa kwe-ovulation. Ngisho noma uthatha i-Clomid izinsuku eziyisihlanu kuphela, ukusabela kwamaketanga okuqala ngephilisi yakho yokuqala kuqhubeka nenyanga. Lesi yisinye sezizathu zokuthi ungaqhubeka uhlangabezana nemiphumela emibi izinsuku ngemuva kokuba uthathe isilinganiso sakho sokugcina.
Izinsuku ze-Clomid Cycle 10 kuya ku-21: Ukuqapha izintambo
Ngaphandle kokusikisela ukuthi usebenzisa i- kit ovulation predictor kit ukuze ukwazi ukuchitha isikhathi socansi lwezinsuku zakho ezivundile kakhulu, izifo eziningi zezinkinga zokubeletha aziqapheli ngokucophelela imijikelezo ye-Clomid yokwelapha.
Lokho kusho ukuthi iningi lokugcina izakhi ze-endocrinologists lenza. Odokotela abanomsoco baqapha imijikelezo kaComomid ngezizathu ezimbili eziyinhloko:
- Ukuze unake ukuthi zingaki izinhlobo ze-follicle ezikhulayo , ngakho-ke zingakwazi ukukhansela umjikelezo uma kuvela ngaphezulu kokubili (noma okungaphezulu kweyodwa)
- Ngokuhamba kwesikhathi i-trigger idutshulwa (ichazwe esiteji esilandelayo) noma i- IUI (intrauterine insemination)
Ukuqapha umjikelezo ngokuvamile uqala ezinsukwini ezimbalwa ngemuva kokuthi iphilisi yakho yokugcina ithathwe futhi ingabandakanya ama-ultrasound kanye negazi ukusebenza njalo ezinsukwini ezimbalwa uze uvula. Uchwepheshe we-ultrasound uzolinganisa izintambo ezikhulayo, kanti udokotela wakho uzothatha isinqumo-ngokusekelwe ekukhuleni kwabo-lapho isikhathi siqala ukudubula (uma unayo eyodwa), i-IUI, noma ubulili bomjikelezo.
Uma izintambo ezimbili zikhula zibe ngosayizi ovuthiwe, udokotela wakho angahle noma angakuneluleka ukuba usuke umjikelezo. I-follicle emibili emikhulu iphakamisa izimo zakho zokukhulelwa amawele , kodwa akuqinisekisiwe. Tshela udokotela wakho uma kubalulekile kuwe ukuba ugweme ukukhulelwa amawele, ngakho-ke angakunikeza kangcono ukuthi yini okufanele ukwenze.
Uma izintambo ezintathu noma ngaphezulu zivuthiwe, udokotela wakho cishe uzokhansela lo mjikelezo, okusho ukuthi uzocelwa ukuba ungalalali (ukugwema ukukhulelwa). Futhi uma i-IUI noma i-trigger shot ihlelwe, ngeke futhi kunikezwe ukugwema ukukhulelwa okukhudlwana okuningi, okufaka izingozi ezinkulu kuwe nabantwana bakho esizayo.
Uma umjikelezo wakho ukhanseliwe, njengokukhungathekisa njengoba lokhu kungaba (futhi njengokungathi kunzima njengokungayinaki i-doc yakho futhi ubulale ocansini noma kunjalo), kufanele uthathe izixwayiso zodokotela wakho ngokungathí sina. Kungaba isibonakaliso esihle sokuthi umzimba wakho uphendukela ku-Clomid kangaka. Ngethemba, emjikelezweni olandelayo, udokotela wakho angalungisa ukwelashwa kwakho ukuze angashukumisi amaqanda amaningi. Kungcono ukulinda kuze kube yisikhathi esilandelayo kunokuqeda ukukhulelwa okuphezulu.
Ama-Cycle Cycle Days 15 kuya ku-25: I-Trigger Shot (Mhlawumbe)
Uma ubona ochwepheshe bezala, angase abeke umjovo we-hormone gonadotropin (hCG) ye-hormone yomuntu ngaphezu kwe-Clomid-eyaziwa nangokuthi "i-trigger shot." Ibizwa ngokuthi i-trigger shot ngoba ibangela ukuvuthwa ukuthi kwenzeke emahoreni angu-24 kuya kwangu-36. Udokotela wakho angahle acele ukudubula ukudubula ukuze asize isikhathi esingcono sokuba i-IUI noma ubulili noma ukunikeza ama-ovari akho amandla engeziwe.
Kungenzeka ukuthi uzwile nge-hCG uma ufunda mayelana nokuhlolwa kokukhulelwa, ngoba i-hCG yi-hormone yokukhulelwa. Emzimbeni, i-hCG yenza okuningi njenge-HH (i-hormone yokuqondisa i-hormone), okuyinto i-hormone ephakamisa ngaphambi nje kokuvuthwa futhi isayine i-follicles ukuze ihlukane futhi ikhulule iqanda.
I-trigger edutshulwa ivame ukunikezwa izinsuku ezingu-7 kuya kwezingu-9 ngemuva kwephilisi yakho yokugcina ye-Clomid, kodwa inganikezwa ngemuva kwalokhu uma ukuqapha kwe-ultrasound kuthola ukuthi izintambo zakho zifuna isikhathi esengeziwe sokuvuthwa ngaphambi kokukhishwa emibhedeni yazo epholile.
Inothi elibalulekile : uma unikezwa i-trigger shot, qaphela ukuthi ukuhlolwa kokukhulelwa kuthathwe phakathi nesonto ngemuva kwalokho kungabhalisa njengokuhle, ngisho noma ungakhulelwe. Uhlolo luzobe luqoqa ama-hormone anikezwe nge-injection.
Izinsuku ze-Clomid Cycle 10 kuya ku-17: I-Clomid Sexy Time, Mhlawumbe IUI
Ukuvuthwa ngokuvamile kwenzeka ezinsukwini ezingu-5 kuya kwezingu-10 emva kokuthatha iphilisi ye-Clomid yokugcina.
Ngakho uma uthatha i-Clomid ngezinsuku ezintathu kuya kwezingu-7 emjikelezweni wakho, cishe uzovota phakathi kwezinsuku ezingu-10 no-16. Uma uthatha i-Clomid ezinsukwini ezingu-5 kuya ku-9, ukuvota kungenzeka phakathi kwezinsuku ezingu-12 no-17 zomjikelezo wakho .
Ukuvuthwa kungakwenzeka ngisho nangemva kwezinsuku eziyi-10 emva kwephilisi yakho yokugcina ye-Clomid, ngakho-ke into okumele uyikhumbule. Uma unikezwe i-trigger shot, khona-ke ukuvuthwa kuzokwenzeka amahora angu-24 kuya kwangu-36 ngemva komjovo.
Ngaphandle kokuba udokotela wakho akutshele ngenye indlela, kufanele uqale ukulala ocansini nsuku zonke , noma nsuku zonke, uqale izinsuku ezintathu emva kokuthatha iphilisi yakho yokugcina ye-Clomid. Kufanele uqhubeke ucansi kuze kube yilapho usuqinisekise ukuthi ukuvuthwa kwenzeka. Ungathola isiqinisekiso esivela eshadini lomzimba oshisa lokushisa noma ukuhlola kwegazi le-progesterone (elinikezwe ngosuku lwe-21 lomjikelezo).
Ingabe wenza umjikelezo we- IUI ? Ngokusekelwe kuma-ultrasounds akho kanye nesikhathi sokudutshulwa kwakho, udokotela wakho uzokutshela ukuthi ungenele i-IUI. Ezimweni eziningi, ungaba nobulili ezinsukwini zakho ezivundile ekhaya ngaphezu kwe-IUI yakho. (Cabanga njengesikweletu esengeziwe!)
Usuku lwe-Clomid Cycle 19 noma 21: Ukuhlolwa kwegazi le-Progesterone
Bobabili ochwepheshe bezinkinga zokubeletha kanye nochwepheshe bokuzala bavame ukuhlola ukuhlolwa kwegazi le-progesterone ngesikhathi esisodwa phakathi kwezinsuku ezingu-19 no-21, nakuba kunganikwa ngokuhamba kwesikhathi uma udokotela wakho eyazi ukuthi uke wavotela kamuva kunosuku 21 lomjikelezo wakho.
I-progesterone iyi-hormone ephakama emva kokuvuthwa, futhi ukuhlolwa kwayo kungase kuqinisekiswe ukuthi noma ngabe yini i-Clomid eyabangela ukuvuthwa. Esinye isizathu sokuhlola amazinga we-progesterone ukuqinisekisa ukuthi amazinga aphansi kakhulu. Uma kunjalo, udokotela wakho angalawula isidakamizwa se-progesterone wesifazane njengesisongezo.
Izinsuku ze-Clomid Cycle 21 kuya ku-35: Iviki Ezimbili Lizilindele
Lezi zinsuku ezimbili zilinda emva kokuvuthwa bese uphela noma ukuhlolwa kokukhulelwa okuhle noma isikhathi sakho . Lokhu cishe yingxenye eyinkimbinkimbi yomjikelezo ukukhuthazela. Konke ongakwenza ukulinda ubone ukuthi umjikelezo usebenze yini.
Phakathi neviki ezimbili ulinde , ungase ubone izimpawu ezincane ze- ovarian hyperstimulation syndrome . Uphawu oluvame kakhulu lwe-OHSS luvimbela. Icala elibi lingavamile uma uthatha i-Clomid, kodwa kungenzeka. Qinisekisa ukuxhumana nodokotela wakho uma izimpawu zakho zinzima noma uma ukhathazekile.
Qaphela : Abanye besifazane badideka ukuvimbela ama-ovaries ashukumisekile ama-Clomid njengendlela yokukhulelwa kokuqala , uma eqinisweni akusilo. Khumbula ukuthi eminye yemiphumela emibi ye-Clomid ingalingisa "izimpawu zokukhulelwa," bese uzama ukukhumbula ukuthi ukukhulelwa akusho ukuthi ukhulelwe .
I-Clomid Cycle Days 28 no-35: Usuku Lokuhlola Lokukhulelwa!
Ekugcineni, usuku olulindele kuyo yonke inyanga: usuku lokuhlola lokukhulelwa !
Udokotela wakho angalawula ukuhlolwa kokukhulelwa kwe-beta noma ukuhlolwa kwegazi okulinganisa ubuningi be- hCG , phakathi kweviki lakho ezimbili ulinde futhi ekupheleni, noma angase ahlele ukusebenza kwegazi kuphela ekupheleni. Kungenzeka futhi ukuthi uzokucela ukuba uthathe ukuhlolwa kokukhulelwa ekhaya ngesikhathi esithile phakathi kwezinsuku ezingu-28 no-35 zomjikelezo wakho, futhi akufundise ukuba ushayele uma uthola imiphumela emihle.
Uma ukuhlolwa kulungile , siyakuhalalisela! Udokotela wakho cishe uzoqapha ukukhulelwa amasonto ambalwa ukuqinisekisa ukuthi konke kuhamba kahle, futhi ukuhlola ukuthi ngabe ukhulelwe amawele (noma ngaphezulu). Uma uzwa ukwesaba okukhulu kunokuba ujabule, qiniseka ukuthi kuvamile. Ukukhulelwa emva kokubeletha akulula ngaso sonke isikhathi, ikakhulukazi ngokomzwelo .
Uma ukuhlolwa kungalungile , udokotela wakho angalinda futhi abuyisele futhi. Kungenzeka ukuthi amazinga e-hormone awaphezulu ngokwanele okwamanje. Kodwa uma uthola isikhathi sakho, cishe umjikelezo awuzange usebenze.
Ukuba nomjikelezo ongaphumeleli kungadabukisa, futhi kuvamile ukuzizwa unqotshwe futhi ulahlekelwe ithemba elithile. Khumbula ukuthi ungazama futhi ngezinye izikhathi ukwelashwa kudinga ukulungiswa ngaphambi kokuthi ufinyelele impumelelo.
> Imithombo:
> I-American Society for Medicine Reproductive, Imithi Yokukhipha Ukuvuthwa.
Coughlan C, Fitzgerald J, Milne P, Wingfield M. "Ingabe kuphephile ukubeka i-clomiphene citrate ngaphandle kwezindawo zokuqapha i-ultrasound?" J Obstet Gynaecol . 2010 Meyi; 30 (4): 393-6. i-doi: 10.3109 / 01443611003646280.