Inqubo ikhulisa ukukhiqizwa kwamaqanda anamandla
I-Down-regulation iyinkulumo ososayensi abayisebenzisayo ukuchaza inqubo yokunciphisa noma yokucindezela impendulo yomzimba kumfutho othize.
Uma isetshenziselwa ngokufaka umanyolo we-in vitro (IVF) , phansi-isimiso somthetho ngokuyisisekelo "siphenduka" ama-ovari ukulawula kangcono ukuvuthwa kwamaqanda kanye nokuvuthwa kwamaqanda ngesikhathi sokwelashwa.
Kunezinhlobo ezimbili zezidakamizwa ezisetshenziswa kule njongo: GnRH agonists kanye GnRH abaphikisi.
I-agonist uhlobo lomuthi olushukumisa impendulo, kanti umphikisi uhlobo oluvimbela impendulo.
Nakuba izindlela zokwenza lezi zidakamizwa ezimbili zihluke, zombili zisebenza ngokucindezela ukukhiqizwa komzimba kwamahomoni ahlukahlukene aqala ukuthuthukiswa kwamaqanda nokuvuthwa kwamaqanda. Ngale ndlela, aphansi-alawula ukusebenza komzimba wama-ovari.
Kungani Ukulawulwa Ngaphansi Kokusetshenziswa Kusetshenziswa Ukwelapha kwe-IVF?
Ama-ovari akho anezinkulungwane ze- follicles . I-follicle ngayinye iqukethe amaqanda amancane noma i-oocyte.
Ekuqaleni komjikelezo wakho, i-hormone (LH) ne-follicle evuselela i-hormone (FSH) iqala ukusebenza kwenqubo yokuvuthwa eqenjini lamakhohlisi anomncintiswano. Njengoba i-follicles iqala ukukhula ngosayizi, izokhulula amanye ama-hormone ukulawula ukugeleza kwe-LH ne-FSH-ngezinye izikhathi phezulu, ngezinye izikhathi phansi-kuze kube sekugcineni ukuvuthwa kwenzeka.
Ukuvuthwa ngokuvamile kuhilela iqanda elilodwa kuphela. Ngemuva kokuba lelo qanda likhishwe, zonke ezinye izintambo ezikulo qembu ziyabuna futhi ziyafa.
Nge-IVF, udokotela wakho akafuni lokhu kwenzeke. Esikhundleni salokho, umgomo uzoba ukwehla-lawula leyo mpendulo ukuze:
- I-follicles eminingi iyakwazi ukukhiqiza iqanda elinamandla, elivuthiwe.
- Amaqanda ahlala ezinhlathini ukuze zivunwe kalula.
Izidakamizwa ezisetshenziselwa ukulawulwa phansi
Kunezinhlobo zezidakamizwa ezisetshenziselwa i-IVF ukuze zenzeke Zibekwe ngokubanzi ngokulandelayo:
- Ama-agonists ahlanganisa izidakamizwa ezifana neLupron (leuprolide) , i-Synarel (nafarelin), ne-Zoladex (i-goserelin). I-GnRH i-agonists ilingisa i-hormone eyenziwa ngokwemvelo eyaziwa njenge- gonadotropin-release hormone (GnRH) . Lena i-hormone edala ukukhiqizwa kwe-FSH ne-LH. Ngokukhukhumeza umzimba nge "GnRH" yokukhohlisa, ama-ovari akhula kakhulu futhi ekugcineni agweme ukukhiqizwa kwe-LH ne-FSH ngemuva kwamasonto amathathu.
- Abaphikisi be-GnRH bahlanganisa izidakamizwa i-Antagon (ganirelix) ne-Cetrotide (cetrorelix). Abaphikisi be-GnRH basebenze ngokubopha kwi-receptor ku-GnRH futhi bavimbela ikhono layo lokuthola izimpawu kwanoma yiluphi uhlobo. Ngokwenza njalo, ukukhiqizwa kwe-FSH ne-LH kuvaliwe masinyane.
Ngemuva kokuthatha izidakamizwa ze-GnRH izinsuku ezimbalwa noma amasonto amaningi, i-ultrasound ingasetshenziswa ukuqinisekisa ukuthi uhlaka lwe-uterine luncane futhi amaqanda alungele ukuvunwa. Imithi yokwelapha izobe isetshenziselwa ukukhuthaza ama-ovari, emva kwalokho amaqanda ayovuna ngaphansi kwe-anesthesia yendawo.
Izindlela Ezingezansi Zendlela Yokunciphisa Ngaphansi
Nakuba phansi-isimiso somthetho kuyindlela ephumelelayo yokususa ama-ovari ngesikhathi se-IVF, ayisebenzi kahle kubo bonke abesifazane.
Lokhu kuyiqiniso ikakhulukazi kwabesifazane abanezinqolobane eziphansi ze-ovarian (amaqanda aphansi kakhulu).
Ngenxa yokuthi kuzoba nezinkinga ezimbalwa zokusebenza, izidakamizwa ze-GnRH zingasebenza kahle. Esikhundleni sokusulaza ama-ovari, bangase baqede ukukhansela umjikelezo ngokuphelele.
Kulaba besifazane, kunezinkambiso ezihlukile zokutshala izitshalo ezizosebenzisa ukufeza phansi-umthethonqubo:
- Ukuqala amaphilisi okulawula ukubeletha inyanga ngaphambi kwe-IVF bese weqa ukulinganisa ukucasula inqubo yokuvuthwa nokuvuna
- Ukunikeza izidakamizwa ze-GnRH ngezinga eliphansi noma izinsuku ezimbalwa
- Ukuqala ukwelashwa kwe-GnRH okuningi ngokuhamba kwesikhathi kunokujwayelekile
- Ukuqala bese uqeda ukujola kwe-GnRH ngezigaba ezahlukene
- Ukwengeza ama-hormone engeziwe ekwelapheni
Phakathi nalesi sikhathi, udokotela uzosebenzisa ukuhlolwa kwegazi kanye ne-ultrasound ukuhlola nokulawula kangcono ukuthuthukiswa kwezintandokazi.
Imithombo:
> Badawy, A .; I-Wageah, A .; El Gharib, M. et al. "Amasu okuThuthukisa ukuThuthukisa ukuThuthukisa ukuThuthukiswa komphumela we-IVF / ICSI kwabampofu abaphendula ama-Ovarian." J Reprod Infertil. 2012; 13 (3): 124-30.
> Magon, N. "I-gonadotropin-ekhulula ama-agonist agonists: Ukwandisa i-vistas." I- Ind J Endocrinol Metab. 2011; 15 (4): 261-7; I-DOI: 10.4103 / 2230-8210.85575.