Ukwelashwa nge-Gonadotropins (Gonal-F, Follistim, Ovidrel, nabanye)

by URachel Gurevich; Kubukezwe ngu-Anita Sadaty, MD

Izindleko zokuphumelela, okumele zilindelwe, izindleko, kanye nezingozi zokusetshenziswa kwezidakamizwa ezikhulayo

I-Gonadotropini yizidakamizwa zokuzala eziqukethe i- follicle stimulation hormone (FSH) , i-hormone i-luteini (LH) noma inhlanganisela yale mibini. Lezi zidakamizwa zisetshenziselwa ukugqugquzela i-ovulation. Amagama weBrama angase awajwayele afaka i-Gonal-F, i-Follistim, i-Ovidrel, i-Menopur, ne-Luveris. (Amanye amagama ngezansi.)

I-Gonadotropins yaziwa ngokungahlelekile njengezinjectjectables.

Zinikezwa umjovo kuphela.

(Lokhu kuhluke emithini yezidakamizwa ezifana ne-Clomid ne- letrozole , okuyinto amaphilisi owathatha ngomlomo.)

Amahomoni akhona ngokwemvelo emzimbeni we-FSH no-LH ayaziwa nangokuthi i-gonadotropin. Badlala indima ebalulekile ekuvuthweni kwe-ovulation .

Zisebenza Kanjani?

Ukuze uqonde kangcono ukuthi i-gonadotropins isebenza kanjani, kufanele uqale uqonde ukuthi isistimu yokuzala yesifazane isebenza kanjani.

Funda okulula ukuqonda, isinyathelo ngezinyathelo incazelo yomjikelezo wesifazane wokuzala lapha.

Uma ungenayo isikhathi salokho, nangu ukuphinda okusheshayo okusheshayo!

Ngokuvamile, i-pituitary gland yakho iveza i-FSH ne-LH ekuqaleni komjikelezo wakho wokuya esikhathini. I-FSH ithunyelwa emzimbeni. I-LH igcinwe emgodini we-pituitary kuze nje ngaphambi nje kwe-ovulation.

I-FSH isitshela ama- follicles kuma-ovari akho ukuba avuke futhi akhule.

I-FSH imelela "i-follicle evuselela i-hormone." Ukwenza umqondo ophelele, okunikezwayo kuvuselela i - follicles !

Imithi ye-Gonadotropin yokuzala, okuyi-FSH noma i-FSH kanye ne-LH, yenza ngokufanayo.

Batshela ama-follicles kuma-ovari akho ukukhula nokuthuthukisa.

I-LH ivame ukuphakama nje ngaphambi kokuvuthwa phakathi nomjikelezo wemvelo futhi kusize noma yiliphi iqanda elivuthiwe ukuze liqhubeke nokukhula okukodwa nokukhululwa . Ngamanye amazwi, vula!

Ngesikhathi ukwelashwa nge-gonadotropins, unganikwa noma umjovo we-RLH noma, ngokuvamile, i- hCG . Lokhu kwenza njenge-spike ye-LH yemvelo futhi kuzosusa i-ovulation.

Okufanele Ukulindele

I-Gonadotropins ingasetshenziswa yedwa. Zingase zisetshenziswe njengengxenye yophiko lwe- IUI noma umjikelezo wezokwelapha we- IVF .

Ngezansi incazelo yokuthi zingasetshenziswa kanjani zodwa.

Uma uthola isikhathi sakho esilandelayo, uzobiza udokotela wakho.

Uzobe nomsebenzi wegazi kanye ne-ultrasound. Lokhu kuzokuqinisekisa ukuthi azikho izinkinga noma izizathu ongeke uphathwe kulo mjikelezo. (Ngokwesibonelo, ukuqinisekisa ukuthi awukhulelwe futhi awunayo i-cyst ovarian benary.)

Udokotela wakho cishe uzokuqala nge-75 kuya ku-150 IU yemithi ye-gonadotropin.

Kuye ngokuthi yi-gonadotropin enqunyelwe yini, kuzodingeka uzinike izijovo ngaphansi kwesikhumba (ngezansi) noma zibe muscle (intramuscularly).

Buza udokotela wakho noma umhlengikazi ukuthi abonise indlela yokuphepha ngokuphepha. Bazokwenza lokhu ngaphandle kokubuza.

Indlela Yokuzinikela Ngokwemvelo Engaphansi Kwangaphakathi
Indlela Yokuzinikela Ngokwe-IM Injection

Ezinsukwini ezimbalwa ezilandelayo, ama-hormone akho, ama-estradiol ngokukhethekile, kanye nama-follicles kuma-ovari akho azobe esweni ngokucophelela.

Lokhu kuqapha kwenzeka nge-blood work kanye ne-ultrasound njalo ezinsukwini ezimbalwa.

Kangakanani? Lokho kuzoxhomekeka ku-protocol yakho yodokotela, ukuthi uphendula kanjani izidakamizwa, nokuthi usondelene kanjani nokuvota.

Imithi yakho ingahle ihlelwe noma ihlelwe ngokuya ngemiphumela ye-ultrasound ne-hormone.

Umgomo ukugqugquzela ama-ovarie okwanele ukukhiqiza iqanda elilodwa elihle, kodwa hhayi ukuwaqhathanisa. Okunye ukuvuselela kungakwandisa izingozi zakho zokukhulelwa okuningi noma i- ovarian hyperstimulation syndrome (OHSS).

Lapho amazinga akho e-hormone nobukhulu be-follicle abonisa ukuthi ukuvunguza kuphelile, udokotela wakho angalawula umjovo we-hCG.

Lokhu kwaziwa nangokuthi "i- trigger shot ." Idala ukuvuthwa ukuba kwenzeke cishe amahora angu-36 kamuva.

Udokotela wakho kufanele akutshele ukuthi yiziphi izinsuku zokulala, ngakho-ke ungakwazi "ukubamba" iqanda bese ukhulelwa!

Indlela Yokubhekana Nezocansi Zomzimba Odokotela Ngesikhathi Sokwelashwa

Uma ukuvuthwa kwenzeka, ungase uqale ukuthatha i-progesterone. Akuwona wonke umuntu oyoyidinga lokhu, noma kunjalo.

Amazinga akho e-hormone azoqhubeka nokuqapha, nakuba kungavamile kakhulu.

Uzothatha ukuhlolwa kokukhulelwa ekupheleni komjikelezo ukuthola ukuthi ukwelashwa kuphumelele yini.

Ngezinye izikhathi, ukwelashwa kungahle kukhanseke phakathi. Lokhu kungase kwenzeke ngaphambi kokuthi i-trigger idutshe noma ngisho nangaphambilini.

Isizathu esivame kakhulu sokukhansela ukujikeleza ngukuthi udokotela wakho osolwa ukuthi ama-ovari akhishwe.

Ukuyeka imithi kungagwema icala elibi le-OHSS kanye ne-multiple order order.

Udokotela wakho angase akutshele ukuthi ubaleke ubulili.

Njengoba kunzima ukuzwa lokhu, kubaluleke kakhulu ukuthi ulandele imiyalelo kadokotela wakho.

Ukukhulelwa kungandisa amathuba okukhulelwa okuphezulu, okubeka wena nabantwana bakho engozini.

Futhi, uma uthuthukisa i-OHSS, ukukhulelwa kungenza kube nzima ukutakula.

Izinhlobo ezahlukene

Kunezinhlobo ezimbili eziyisisekelo ze-gonadotropins: i-gonadotropins ephindaphindiwe kanye ne-gonadotropin ekhishwe ngamanzi.

I-gonadotropin engapheliyo idalwa ebhokisatri besebenzisa ubuchwepheshe be-DNA obumnyama.

I-gonadotropin ye-FSH ephindaphindiwe emakethe ihlanganisa i-Gonal-F ne-Follistim.

Njengamanje, i-Luveris yiyona kuphela i-gonadotropin ye-LH ephindayo kuphela etholakalayo.

Ama-gonadotropin akhishwe e-Urinary akhishwa futhi ahlanzwa emcinini wabesifazane be-postmenopausal. (Umchamo wabo ukhululekile ngokwemvelo ku-FSH.) Zihlanganisa i-gonadotropins yabantu i-menopausal (hMG), i-FSH ehlanzekile ne-FSH ehlanzekile kakhulu.

I-gonadotropin ye-FSH ehlanjululwa umchamo ihlanganisa i-Bravelle ne-Fertinex.

I-gonadotropin yamadoda yokwelashwa (i-hMG) ye-menopausal iqukethe i-FSH ne-LH. Kuhlanganisa imithi efana ne-Humegon, i-Menogon, i-Pergonal ne-Repronex.

I-Menopur yi- hMG ehlanzekile kakhulu.

Isidakamizwa esihlobene, i-chorionic gonadotropin (hCG) yomuntu ngokuvamile iyingxenye yokunakekelwa kokuzala ne-gonadotropin injection .

Ungase ukwazi i- hCG njenge-hormone yokukhulelwa , kodwa futhi kwenzeka ukuthi i-molecularly efana ne-LH.

Emjikelezweni wemvelo, i-LH idala ukuvuthwa .

Njengengxenye yokwelashwa kwenzalo , umjovo weHCG ungasetshenziswa ukuqala ukuvuthwa.

I-Ovidrel, i-Novarel, i-Pregnyl no-Profasi yigama lamagama we-injection ye-hCG.

Izingozi ezihlangene

I-Ovarian hyperstimulation syndrome (OHSS) iyinkimbinkimbi enzima yokwelashwa kwe-gonadotropin.

I-OHSS enhle ivela ku-10% kuya kwezingu-20% kwabesifazane abathatha i-gonadotropin. I-OHSS engathí sina ivela ku-1% yesikhathi.

I-OHSS engathí sina ingaba yingozi uma inganakiwe noma ingelashwa kahle. Kubalulekile ukuthi wazi kahle izimpawu.

I-OHSS Izimpawu Nezokwelapha

Enye ingozi engaba yingozi ye-gonadotropin therapy yikhulelwe ngokuphindaphindiwe.

Ucwaningo oluthile luye lwabona ukuthi ukukhulelwa okungu-30% okukhulelwe ngamagonadotropini kuyizinwele noma ngaphezulu. (Lokhu kuqhathaniswa no-1% kuya ku-2% kuphela wokukhulelwa okukhulelwe.)

Ukukhulelwa okuningi nge-gonadotropin kuyizinwele. Kuze ku-5% yizintathu noma ngaphezulu.

Ukukhulelwa okuningi , kufaka phakathi ukukhulelwa okubili , kuyingozi kumama kanye nezingane.

Vala ukuqapha umjikelezo wezokwelapha kungasiza ekuvimbeleni ukukhulelwa okuningi.

Odokotela abaningi bazokhansela uma izinhlobo ezingaphezu kwezingu-3 zikhula noma uma amazinga e-estradiol ephakeme kakhulu.

Ezinye izifundo zikwazi ukuthola izinga lokukhulelwa kweziphindaphindaphinda libe ngu-5%. Bakwenzile lokhu ngokuqala ngomthamo ophansi, besebenzisa ukwanda okusheshayo kuphela uma kunesidingo nokuqapha okukhulu.

Izingozi Zokukhulelwa Zesibili
Kufanele Ngizikhulelwe Amawele Ngenhloso?
Imibuzo: Ingabe Izinkinga Zakho Zokuthola Amawele Amakhulu Kunokuningi?

Ingozi yokukhulelwa kwe-ectopic nokukhulelwa kwesisu iphakeme ngokukhulelwa kwe-gonadotropin.

Ngaphansi kwe-1% yabesifazane abathatha i-gonadotropin bayothola i-adnexal torsion, noma i-ovarian twisting.

Yilapho i-ovary iphikisana nayo ngokwayo futhi inqamula ukunikezelwa kwayo kwegazi. Ukwelashwa kuyadingeka ukuze ungabikho noma ususe i-ovary ethintekile.

Ingozi yakho yokucindezeleka kokukhulelwa - njengokukhulelwa kwengcindezi ephakeme yegazi nokuphazamiseka kwamapayipi - kungakhula kancane uma kuqhathaniswa nokukhulelwa ngokwemvelo.

Kungakhathaliseki ukuthi lokhu kubangelwa i-gonadotropins noma ukungabi namuntu akucacile.

Ngenxa yokuthi ama-gonadotropin ayinemithi ejoqayo, ungase uzwe ubuhlungu eduze nezindawo zokujova.

Uma usola ukutheleleka, qiniseka ukuxwayisa udokotela wakho ngokushesha.

Imiphumela emibi kanye nezinengozi ze-Gonadotropins

Yiziphi Izinzuzo Zempumelelo?

Ikhono lakho lokuphumelela kokukhulelwa nge-gonadotropin lizoxhomeka ezinhlobonhlobo zezici, kufaka phakathi iminyaka yakho kanye nesibangela sokungabikho.

Ucwaningo olwenziwa ngo-2011 yi-The Jones Institute for Medicine Reproductive lugxile emigqeni yokwelapha ye-gonadotropin engu-1,400. Izinga lokukhulelwa lilonke lalingu-12%, kanti izinga lokuzalwa eliphilayo lilinganiselwa ku-7.7%. Iziguli ezincane zinezinga eliphezulu lokuzalwa okuphilayo.

Kulolu cwaningo, ngokukhansela umjikelezo uma ama-follicles amathathu noma ngaphezulu aphakanyisiwe noma ama-estradiol ayephakeme kunama-1500 pg / ml, akwazi ukugcina izinga lokukhulelwa eliphansi libe ngu-2.6% ophansi.

Ucwaningo oludala luye lwathola amanani okukhulelwa aphezulu ne-gonadotropin kunalena.

Kodwa-ke, kungenzeka ukuthi izinga eliphezulu lokuphumelela lafika ekukhokhiseni ingozi ephezulu ye-OHSS nokukhulelwa okuningi.

Izindleko zokwelapha

Ukwelashwa kwe-Gonadotropin okungewona umjikelezo we-IUI noma we- IVF kungadala noma yikuphi phakathi kwe $ 500 kuya ku-$ 5,000.

Intengo ephakeme ibheka ukusebenza kwegazi nokuqapha kwe-ultrasound. Futhi, intengo iyahluka ngoba abesifazane abahlukene bayodinga inani elihlukile lemithi.

Inkampani yakho yomshuwalense ingakhokha enye ingxenye yokwelapha. Noma, bangakhokhela konke ... noma akekho kuwo.

Kungadingeka ukhokhe umtholampilo wakho wokuzala ngokugcwele. Khona-ke, kungase kudingeke ufeze ukubuyiselwa imali kusuka kumshuwalense wakho ngokwakho, noma umtholampilo ungasingatha izimangalo zomshuwalense kuwe.

Qinisekisa ukucacisa konke lokhu ngomtholampilo wakho wokuzala ngaphambi kokuqala ukwelashwa.

Awufuni ukumangala ngesikweletu esikhulu ekugcineni.

_Imithombo:

_{UGrene, uRobert A. noTarken, uLaurie.} _(2008). _{Ukulinganisela kwamaHhomomu aphelele Ukuzala.} _{I-United States of America: I-Press Rivers Three.}

_{R Homburg, CM Howles.} _{"Ukwelashwa kwe-FSH ephansi-kwesifo sofuba esihambisana nesifo sofuba se-polycystic: isisindo, imiphumela, ukucubungula ukucubungula."} _{Ukuvuselela Ukukhiqizwa Komuntu.} _{Ukuvuselelwa (1999) 5 (5): 493-499.} _{i-doi: 10.1093 / i-humupd / 5.5.493.}

_{I-Sarhan A, i-Beydoun H, i-Jones HW Jr, i-Bocca S, i-Oehninger S, i-Stadtmauer L. "I-Gonadotrophin yokuvuthwa kwe-induction nokuthuthukisa imiphumela: ukuhlaziywa kwemigqa engaphezulu kuka-1400."} _{Ukukhiqizwa kwe-biomedicine ku-intanethi.} _{2011 Aug; 23 (2): 220-6.} _{I-Epub 2011 Meyi 15.}

_{Imiphumela emibi ye-Gonadotropin: Iphepha Lokugcina Lokubekezela.} _{UmNyango we-American for Medicine Reproductive.} _{Kufinyelelwe ku-intanethi ngomhla ka-14 Agasti 2011.}

_{van Wely M, Kwan I, Burt AL, Thomas J, Vail A, Van der Veen F, Al-Inany HG.} _{"I-gonadotrophin engavumelani ne-urinary ye-ovarian stimulation in imijikelezo yokukhiqiza ubuchwepheshe bokuzala."} _{I-Cochrane Database Izibuyekezo Ezihleliwe.} _{2011 Feb 16; (2): CD005354.}

Zisebenza Kanjani?

Okufanele Ukulindele

Izinhlobo ezahlukene

Izingozi ezihlangene

Yiziphi Izinzuzo Zempumelelo?

Izindleko zokwelapha

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