Khatarta iyo Saameynaha Dhibaatooyinka Mukhaadaraadka Cadaadiska ah
Ka hor inta aanad bilaabin daaweyn leh gonadotropins - mararka qaarkood loo yaqaano cirbad - dhakhtarkaagu waa inuu kuu sharxaa saameynta iyo daaweynta halista ah. Waxaad qaadan kartaa gonadotropins si wadajir ah Clomid , iyaga oo u gaar ah, iyada oo qayb ka ah wareegga IUI , ama qayb ka mid ah wareegga daaweynta IVF .
Gonadotropins ayaa sidoo kale loo isticmaalaa haweenka ku deeqaya ugxanta ugxanta iyo habka loo dhigo ukunta barafka .
Inta badan saamaynta daawada gonadotropin waa mid khafiif ah, laakiin xaalado dhif ah, qaar ayaa noqon kara kuwo halis ah iyo xitaa nafta halis galinaya.
Qoraal muhiim ah! Dhamaan waxyeelooyinka soo noqnoqda iyo halista waxaa ku qoran hoosta. Haddii aad la kulanto waxyeelo daran, calaamado aan caadi ahayn, ama aad ka welwelsan tahay sabab kasta, la xiriir dhakhtarkaaga. Macluumaadka ku jira qodobkan ma beddelayo la tashiga xirfadle caafimaad.
Waa Maxay Daawooyinka loo Qadariyo Gonadotropins?
Gonadotropins waa daawooyinka bacriminta oo ay ku jiraan FSH, LH , ama isku dhafka labada (oo loo yaqaan 'gonadotropins' menopausal, ama hMG). Waxay sidoo kale ka mid yihiin hCG hormoonka, taas oo ah mid si lamid ah u eg LH.
Hormoodyadan waxaa lagu qaadaa duritaanka.
Gonadotropins waxaa lagu soo saari karaa shaybaarka iyada oo la adeegsanayo tiknoolajiyada DNA-ga ee dib-u-kicinta , ama laga soo saaro oo laga nadiifiyo kaadida postmenopausal ama haweenka uurka leh.
Magacyada noocyada gonadotropins abuuray iyadoo la adeegsanayo tiknoolojiyada DNA-da ee dib-u-kicinta waxaa ka mid ah Gonal-F (rFSH), Follistim (rFSH), Puregon (rFSH), Luveris (RLH), iyo Ovidrel (rHCG).
Bravelle, Metrodin, iyo Fertinx waa magacyada calaamadaha loogu talagalay kaadida laga soo saaro FSH.
Novarel, Pregnyl, iyo Profasi waa kaadiso laga soo saaro hCG.
Magacyada noocyada kiniiniga laga soo saaro kaadimareenka gonadotropins ee bini'aadamka (isku-dar ah FSH iyo LH) waxaa ka mid ah Humegon, Menogon, Pergonal, Repronex, iyo Menopur.
Waxyeellooyinka soo-raaca ee Gonadotropins
Fiiro gaar ah: Boqolleyda hoos ku xusan waxay ka tarjumaysaa cilmi baaris la barbardhigay Gonal-F - oo ah rFSH, oo lagu sameeyay shaybaar la isticmaalayo tiknoolajiyada DNA-ga dib u-uruurinta - iyo urofollitropin, ama uFSH, taas oo lagu nadiifiyey FSH laga soocay kaadida haweenka postmenopausal. Siciradu wax yar bay u kala duwan yihiin daroogada illaa daroogada, laakiin dhibaatooyinka daaweynta gonadotropin guud ahaan waa isku mid.
Waxyeellooyinka soo raaca ee gonadotropins waxaa ka mid ah:
- Madax xanuun (rFSH: 22%, uFSH: 20.2%)
- Lalabbada (rFSH: 13.6%, uFSH: 3.5%)
- Infekshinka neefta sare ee maskaxda (rFSH: 11.9%, uFSH: 7.9%)
- Dareemada caloosha (rFSH: 9.3%, uFSH: 12.3%)
- Gaaska (rFSH: 6.8%, UFSH: 8.8%)
- Cudurka Sinus (RFSH: 5.1%, UFSH: 5.3%)
- Xanuunada guud (rFSH: 5.9%, uFSH: 6.1%)
- Nuujintii Nafaqada (RFSH: 5.1%, UFSH: 2.6%)
- Finanka (rFSH: 4.2%, UFSH: 2.6%)
- Niyadjabka naaska (rFSH: 4.2%, UFSH: 6.1%)
- Faa'iidada culeyska (rFSH: 3.6%, UFSH: 0.0%)
- Neefsashada Neefsashada (RFSH: 2.5%, UFSH: 6.1%)
- Dhiig aan caadi ahayn ama qaniinyo (rFSH: 2.5%, UFSH: 0.9%)
- Matag (RFSH: 2.5%, UFSH: 2.6%)
- Ka qaadista xanuun xanuun, casaan (rFSH: 2.5%, uFSH: 0.9%)
- Dawakhaad (rFSH: 2.5%, UFSH: 0.0%)
Khataraha Gonadotropins
Ovarian Hypermimulation Syndrome (OHSS) : OHSS waxay dhacdaa marka ugxan-yari iyo caloosu ay ku bararaan dheecaan. Ilaa 10 ilaa 20% haweenku waxay horumarin doonaan qaabab fudud oo ka mid ah OHSS, oo badanaaba xallin doona iyaga. Waa muhiim inaad u sheegto xitaa calaamado khafiif ah dhakhtarkaaga, si ay si taxadar leh kuula socoto.
Haddii aad leedahay PCOS , waxaad ku jirtaa khatar aad u sareeya oo lagu sameeyo OHSS.
OHSS aad u xun ayaa ku dhaca wax ka yar 1% bukaannada. Isla markiiba la xiriir dhakhtarkaaga haddii aad isku aragto matag, xanuun caloosha ah ama miskaha, miisaanka oo aad u kacsan, ama aad u daran.
Xaamilada uurka leh : Iyadoo ku xiran daraasadda aad eegto, xaddiga dheefyada daaweynta gonadotropin waa meel kasta oo ka jirta 2% ilaa 30%, iyada oo la gaarsiiyo 5% ama saddex meelood oo uur ah.
Daraasadaha caafimaadku waxay ogaadeen in uurooyinka intooda badan ay dhaceen 12 ilaa 14% waqtiga isticmaalka rFSH ama uFSH. Kormeerka taxadar leh iyo isticmaalka qiyaasta ugu hooseysa ee yar waxay yareyn kartaa halista.
Markaad isticmaasho gonadotropins inta lagu jiro IUI ama keligaa, way adagtahay in la xakameeyo khatarta dhufan badan marka loo isticmaalo xilliga IVF. Inta lagu jiro IVF, dhakhtarkaagu wuxuu u gudbin karaa hal embriyaha.
Haddii aad ka walaacsan tahay halista dhuftsyada, oo aad isticmaalaysid cudurrada sida qayb ka mid ah wareega IUI, waxaad u baahan kartaa inaad weydiiso dhakhtarkaaga wax yar-IVF .
Noocyada Ovarians : Cystic ovarian badiyaa waxay ku dhacdaa gonadotropins. Iyadoo rFSH, waxay ku dhacaan qiyaastii 15% waqtiga, iyo uFSH waxay dhacaan ilaa 29% waqtiga.
Caadi ahaan, waxay ku xaliyaan naftooda. Xaalado dhif ah, waxaa laga yaabaa inay u baahdaan waxqabadyo qalliin.
Xanuunka infekshinka goobta : Casaan iyo dareen-celin caadi ah waa caadi, laakiin marar dhif ah, goobta cirbadda ayaa laga yaabaa inay qaadsiiso. La xiriir dhakhtarkaaga haddii aad ku aragto goobta cirridka kordheysa ee casaanka, diirimaad joogto ah, barar, qashin, ur, ama xanuun daran. Sidoo kale, haddii aad qandho ka hesho 101, la xiriir dhakhtarkaaga.
Rugta Adnexal (ama burush) : Dhacdooyin dhif ah (ka yar 2% wakhtiga), ugxan-sidaha ayaa laga yaabaa inuu boogo, dillaaco, ama dhiig baxo, oo u baahan wax-qabad qalliin. Tani waxay dhacdaa sababtoo ah ugxan-daradu waxay noqotaa mid culus waxayna ka weyntahay kicinta.
Uurka Ectopic : Khatarta uureysiga ectopic wuu yaraa marka la qaato gonadotropins. Uurka uurjiifku wuxuu noqon karaa mid halis galiya nolosha ama wuxuu ubaahnaan karaa faragelin qalliin.
Dhiigxinjirta dhiigga : Xaalad aad u dhif ah (4.2 halkii 1,000) laakiin waxay noqon kartaa khatar nafeed.
Halista xinjirta dhiigga ee kor u kaca ma ahan kaliya inta lagu jiro daaweynta, laakiin, haddii aad uur yeelato, waxay sii wadi doontaa in ay ka sarreyso muddada uurka.
Haddii aad isku aragto calaamadaha dhiig-xinjirowga dhiigga - barar ama xanuun hal lug, diirimaad goobaha ay dhibaatadu saameysey, isbedel ku yimaada midabka maqaarka (casaan, muraayad, ama cirro) - isla markiiba la xiriir dhakhtarkaaga.
Haddii aad isku aragto astaamaha xasaasiyadda sambabada - si lama filaan ah u neefsatid neefsashada, xanuunka laabta oo ka sii daraya markaad isku daydo inaad qaado neef qoto dheer ama markaad qufacdo, dareemid madax-wareer ama suuxdin, garaaca wadnaha, dhidid, dhiig qufac, dareen Cadaalad daro - si degdeg ah u raadso caawimo caafimaad.
> Isha
Gonal-f (follitropin alfa ee cirbadeynta). Xaashida macluumaadka daroogada. http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/20378scf015_gonal_lbl.pdf
Henriksson P, Westerlund E, Wallén H, Brandt L, Hovatta O, Ekbom A. "Dhibaatada tromboembolism ee sambabada iyo dhiig-baxa ee uur-ku-jirka kadib markii la bacrimiyo faytowlaha: daraasad isweydaaris ah." BMJ. 2013 Jan 15; 346: e8632. doi: 10.1136 / bmj.e8632. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546085/
Saameynnada Calaamadaha Gonadotropins: Xaashida Xaqiiqda Bukaanka. Bulshada Maraykanka ee Daaweynta taranka.