Kazhinji Inoratidzwa Zvirwere Zvinodhaka + Mimwe Mishonga yekurapa
Munguva yekurapa kwekubereka , mishonga inogona kutora kuwira mune imwe yezvikamu zvina zvakasiyana:
- Mishonga yakagadzirirwa kukurudzira ovulation (kubereka zvinodhaka)
- Mishonga yakagadzirirwa kubvisa kana kudzora kumwedzi (yakashandiswa panguva yeVIV )
- Mishonga yakagadzirirwa kubata mamwe maitiro ekubereka
- Mishonga yakagadzirirwa kubata chirwere chepachirwere chinokonzera kubereka kwako
Mishonga chete inogona kushandiswa, kana inogona kushandiswa pamwe ne intrauterine insemination (IUI) , kurapa kwaVIV, kana kupindira kwokuvhiya.
Kunyange zvazvo kusununguka kunoita kuti varume nevakadzi vawane zvakaenzana, vakadzi vachiri kunyanya kutora mishonga yekurapa kunobatsira kupfuura varume. Izvi ndezvokuti zvinetso zvevarume vakawanda zvisingabereki hazvigoni kurapwa nemishonga. Zvisinei, mune dzimwe mamiriro ezvinhu, varume vanogonawo kutora mahomoni kana mamwe madhiragi sechikamu chekuita kurapa.
Iyo Inowanzobatwa Mishonga Inoberekera Mushonga: Clomid
Iwe wakangodaro wakanzwa nezve Clomid kare. Clomid, kana clomiphene citrate , inowanzotanga kushandiswa kwemishonga kana ichirapa chirwere chisina kumira . Inogonawo kukurudzirwa mumatanho ekutanga ekurapa kune vakaroorana vane chirwere chisina kutsanangurwa.
Clomid ipiritsi inotorwa nemuromo. Kazhinji kacho, Clomid inorayirwa yoga. Asi zvinogonawo kuunganidza Clomid nemimwe mishonga, zvinodhaka, kana kuti IUI kurapwa .
Zvikamu zvinowanzovhiringidza zvinokonzerwa nemusoro, kupisa kunopisa, uye mafungiro akachinja . Dzimwe njodzi dzechirwere cheCommid dzinosanganisira kubata mapatya kana kuti kukwirira-kutengesa kazhinji kamuviri , ovarian hyperstimulation syndrome , nekuvhiringidzika kwemaonero.
Zvimwe zvinokonzera uye njodzi dzakanyanyisa kufananiswa nemishonga inowedzera injodzi yekubereka.
Kunyange zvazvo isingazivikanwi, mamwe mamiriro ekusafa kwevarume angabatwa neComidid.
Femara (Letrozole): An Alternative kusvika Clomid
Femara, kana letrozole, yakanga isingatarisirwi kuva mishonga inobereka. Chaizvoizvo, iyo chirwere chekenza yemvere.
Zvisinei, ikozvino inoshandiswa kakawanda pamusana-mazita ekurapa matambudziko ovulation .
Kufanana neComomid, Femara inotorwa nemuromo. Inogona kushandiswa yoga, pamwe chete nemimwe mishonga kana kuti zvinodhaka, kana sechikamu chekurapa kweIUI.
Maererano nedzimwe tsvakurudzo, Femara inogona kuva yakashanda kupfuura Clomid kuvakadzi vane PCOS uye vakadzi avo vangave vasiri Clomid vakasagadzikana . (Clomid kusagadzikana kunoreva kuti Clomid haina kukurudzira ovulation sezvinodiwa.)
Zvimwe zvikanganiso uye njodzi dzinofanana zvikuru neClomid.
Femara haasi yakachengeteka kushandisa panguva yekuzvitakura. Izvozvo zvakati, nokuti Femara inotorwa nguva isati yasvika pakuenda kumwedzi-kusati kwatanga kubata--chiremba vanachiremba vanoona kuti yakachengeteka iyo inoshandiswa pakubereka.
Gonadotropins: Ovulation Kushushikana neInjectable Drugs
Gonadotropins ndiyo mishonga yakasimba-inokurudzira zvinodhaka. Izvo zvine biologically yakafanana follicle stimulation hormone (FSH) , luteinizing hormone (LH) kana kusanganiswa kwemaviri. Mumadzimai ekuberekwa, aya ndiwo mahomoni anokonzera mavhai ekukura uye kusunungura mazai.
Iyi mishonga inotorwa nejisi, kazhinji iri mumafuta ane mafuta (anozivikanwawo se subcutaneous injections.) Kliniki yako yekubereka inokurayiridza maitiro ekuzvipa majekiseni aya kumba.
Gonadotropins inogona kushandiswa yoga kana pamwe chete nemimwe mishonga ine kurara kwepabonde panguva yakatarwa kumba. Iyo inowanzoshandiswa panguva yeIUI kana IVF mishonga .
Zvipembenene zvakanyanya zvinowanikwa zvegonadotropin zvinosanganisira misoro, kusuruvara, kubvongodza, kunyorova, kufungidzira, uye kutsamwirwa panzvimbo yejojo.
Mungozi yako yekuita mapatya, katatu, kana yakakwirira mawanda yakawanda kwazvo ne gonadotropin kupfuura nemishonga yemuromo seClomid.
Ngozi yako yekudzidzira ovarian hyperstimulation syndrome inowedzerawo.
Kunyange zvazvo gonadotropin inoshandiswa zvikurukuru kuvakadzi, varume vane hypogonadotrophic hypogonadism vangave vakagadzirwa mishonga inoberekwa inobatsira yekuvandudza mazinga e testosterone nekuvandudza mararamiro emarara.
Gonadotropins chiremba wako anogona kupa zvinosanganisira ...
Zvinyorwa (follitropin beta) uye Gonal-F (follitropin alpha): mishonga iyi inofanana neHS hormone mumuviri wako. Izvo zvakasikwa mubasa raishandisa rejinist DNA teknolojia, iyo inoita kuti ive yakafanana nemahomoni enyu chaiwo.
Bravelle, Fertinex : Izvi zvinodhaka zvinokonzerwa nehutoni zvinosanganisira FSH, kunze kwekunge zvigadzirwa zvakagadzirwa mubazi, hormone inobviswa uye inonatswa kubva mumuchirwe wevakadzi vanotevera-menopausal.
Aya mishonga inoonekwa seasina simba kudarika FSH yakashandiswa kuburikidza nekugadzirisa DNA teknolojia, asi inodhura.
Ovidrel (choriogonadotropin alpha), Novarel, Pregnyl, APL: Mishonga iyi inoumbwa neHCG, kutemwa kwehomoni . Hemoni hCG yakafanana neHH mumuviri.
Iwe unogona kuyeuka LH ndiyo hormone inokonzera ovulation .
Novarel, Pregnyl, uye APL vanonatswa kubva mumuchirwe wevakadzi vane pamuviri, asi Ovidrel ibasa rakashandiswa kushandisa recombinant DNA teknolojia.
Luveris (lutropin alpha) : Iri iHH hormone, yakagadzirwa mubazi kuburikidza neRNA recombinant teknolojia.
Repronex, Menopur, Pergonal, Humegon : Iyi mishonga inobereka inosanganiswa IH uye FSH, inozivikanwawo sevanhu menopausal gonadotropins (hMG). Haisi kushandiswa kakawanda asi inogona kushandiswa mune zvimwe zviitiko zvakakosha.
Zvinodhaka Zvinoshandiswa Kudzora kana Kuderedza Kushushikana Muropa reVIV
Mimwe mishonga inoshandiswa munguva yekurapa kubvisa ovulation.
Sei? Zvikonzero zviviri zvinokosha:
- Munguva yekurapa kweVIV, kudzivirira ovulation mazai asati adzorerwa chirwere. Kana kamwe mazai akaiswa mumuviri, haagoni kuwanikwa kana kushandiswa kweVIV.
- Kuti urongedze mitsara pamwe neanokwanisa kuisa mazai kana kuti mutsara.
Kuberekwa kwepiritsi : Izvi zvinogona kutarisirwa kumwedzi musati wapera chirwere cheVIV.
Kudzora kuberekwa kunogonawo kushandiswa kurapwa.
Semuenzaniso, vakadzi vane PCOS vasingateereri kuComidid vanogona kuva nemhinduro yakanaka kune mishonga kana vakabata mapiritsi ekuberekwa kwemwedzi miviri vasati vapora.
Antagon, Ganirelix, Cetrotide, Orgalutran ( ganirelix acetate uye cetrorelix acetate): Izvi zvinodhaka zvinokonzerwa nevarwi veGnRH. Izvi zvinoreva kuti zvinoshanda zvinopesana nemahomoni LH neFSH mumuviri, kubvisa hutachiona. Dzinotorwa kuburikidza nekujaira.
Zvipembenene zvakanyanya zvinowanzobatanidza kusuruvara kwepamuviri, kuora musoro, uye kujowa kwemajeri.
Lupron, Synarel, Suprecur, Zoladex (leuprolide acetate, nafarelin acetate, buserelin, goserelin): Mishonga iyi inonzi GnRH agonists kana gonadotropin-inobudisa hormone agonists.
Lupron inotorwa nemajisi. Synare uye Suprecur ndiyo mapiritsi emvura. Zoladex inonunurwa kuburikidza nediki duku.
Zvinokonzera kubuda kwekutanga muFSH neLH kubhizha asi zvino kuita kuti muviri usiye kubudisa FSH neLH. Izvi zvinodzivirira kuvhara uye kunogadzirisa chikamu chestrogen.
Iyi mishonga inowanzoshandiswa panguva yekurapa kwaIVF, ichibvumira chiremba kuti aite chirwere chegunidotropin. Inogonawo kushandiswa kurapa endometriosis kana fibroids.
Zvipembenene zvinowanzoitika zvinopisa zvinopisa, misoro, manzwiro ezvinyamusi, uye kuomeswa kwemadzimai.
Mishonga Yokubata Mamwe Matambudziko Anobereka
Kurapa zvinodhaka mishonga inoshandiswa kukurudzira mazai. Zvisinei, izvi handizvo chete mishonga inogona kupiwa nachiremba panguva yekurapa kwekubereka.
Aspirin kana heparin : Kana wakambosangana nemararamiro anowanzoitika, kana iwe unorwara ane ropa thrombophilia chirwere (mamiriro apo maduku maduku eropa anogona kutungamirira pakuzvitakudza kuberekwa), chiremba wako anogona kupa zuva rega rega mwana aspirin kana majekiseni eropa- kuponda mishonga heparin.
Progesterone : Chiremba wako anogona kupa chirongwa cheprogesterone supplementation, zvichienderana nevakadzikadzi suppository kana majekiseni.
Vaginal progesterone suppositories inogona kurongedzerwa kana uri kutarisana nekusununguka kwepabonde kana kuti unofungidzirwa luteal phase defect . Inonzi progesterone inosvibiswa inowanzoshandiswa munguva yekurapa kwaVIV .
Estrogen : Chiremba wako anogona kupa chirwere chestrostine vaginal suppositories kana kupera kwako kwemakemikari kwakanyanya kuderera , kana iwe uchinge uchinge uchinge uchinge uoma kana kuti kurwadziwa munguva yepabonde , kana kuti kuvandudza hutano hwemuviri wako wemukati .
Izvozvo zvinogona kuitika pamusana pekushandisa kweClomid ndeyomukati mhondi yekervical , iyo inogona kukanganisa kubata. Kuwedzerwa kweComidhini kushandiswa kunogonawo kutungamirira kune imwe nhengo yakapetesa yemagetsi ekupedzisira. Estrogen inogona kubatsira nemibvunzo iyi.
Mishonga Inobata Mamiriro Ezvokurapa Maitiro
Dzimwe nguva, chirwere chepachirwere chinoderedza kukura kwako. Muzviitiko izvi, nyaya iyo inofanira kutarisirwa kutanga.
Kurapa chinokonzera kukanganisa kunogona kukwana kuvandudza kubereka kwako. Mushure mokurapa, unogona kukwanisa kuzvitora iwe pachako.
Zvisinei, pane dzimwe nguva, kusanganiswa kwemasarudzo kunodiwa. Iwe unogona kuve nekurapa kwekurapa kwechiremba nekuwedzera kumishonga yekuberekwa kana kupindira kwokuvhiya.
Glucophage (metformin): Metformin chirwere cheshuga, chinotarisirwa kurapa avo vane insulini yekudzivirira. Vakadzi vane PCOS vanowanzoongororwa kuti vane insulini yekudzivirira.
Imwe tsvakurudzo yakaratidza kuti kurapwa kwemasformin kunogona kubatsira kubvumira zvakare kana kutonga kuvhara kwevakadzi mune PCOS. Zvimwe zvidzidzo zvakawana kuti zvinogona kuderedza kusarudzwa kwepamuviri uye kubatsira Clomid kuita basa kuvakadzi vasina kukwanisa kuvhara Clomid chete.
Mishonga inorwisa mabhakitiriya : Kubatwa kwehutano hwekubereka kunogona kuderedza kubereka mune varume nevakadzi. Mune zvimwe zviitiko, utachiona hunogona kutungamirira kukura. Uku kuvhara kunogona kudzivirira mazai nehunhu kubva musangano.
Chero bedzi pasina kuora, mishonga inorwisa mabhakitiriya inongova yakakwana yekuvandudza kubereka. Zvisinei, kana mawere ane mazai akavharwa kana azere nemvura , chirwere kana chirongwa cheVF chinogonawo kudiwa.
Parlodel uye Dostinex (bromocriptine uye cabergoline): Mishonga iyi inonzi dopamine agonists. Ingave inorayirwa mu hyperprolactinemia.
Hyperprolactinemia ndiyo mamiriro apo mahomoni eprolactin akakura kwazvo. Prolactin ndiyo hormone inokonzerwa nekukura kwebonde uye lactation. High prolactin mazinga anogona kukonzera kusina kuwanikwa kana kusipo kwechirwere mumadzimai uye kunokonzera kuderera kwema sperm muvarume.
Parlodel uye Dostinex inogona kuderedza mapuroteni emuprolactin. Mimwe miviri inogona kuitika inosanganisira misoro, kushaya masimba, kuora musoro, uye chirwere. Hapana mungozi yakawedzerwa yekubata mapatya ane mishonga iyi kunze kwekuti kubereka mishonga yakadai seClomid inoshandiswa pamwe chete nekurapa.
Dzimwe nguva, izvi zvinogona kudzosera kuvhara mazai kana kuti chirwere chinowanzoita mbeu. Mune zvimwe zviitiko, kuvhiyiwa kana kuwedzera mishonga inobereka inodiwa.
Utachiona huri kurapa mishonga ye hypothyroidism kana hyperthyroidism : Anotsika kana kupfuura kupora utachiona kunogona kukonzera zvinetso zvekuberekwa varume nevakadzi.
Vakadzi vanogona kunge vasina maitiro, asi varume vanogona kunge vane hutachiwana hwepamuviri. Kurasikirwa kwechirwere kunogona kukonzera kuneta uye kuwedzera kukura. Kuwedzera muviri kunogona kuwedzera kukura kwekubereka.
Sources:
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Greene, Robert A. naTarken, Laurie. (2008). Perfect Hormone Balance For Fertility. United States of America: Three Rivers Press.
Mishonga yekukuvadza kuvhara: Chirevo chevarwere. American Society of Reproductive Medicine.
Ovarian Hyperstimulation Syndrome. Medical Encyclopedia, MedlinePlus.
Pratibha Singh, Manish Singh, 1 Goutham Cugati, 2 naAjai Kumar Singh. "Hyperprolactinemia: Anowanzosakonzerwa Nemhosva yeHuman Infertility." J Hum Reprod Sci . 2011 May-Aug; 4 (2): 102-103. doi: 10.4103 / 0974-1208.86094 PMCID: PMC3205532