Kunzwisisa GnRH Agonist for IVF, Endometriosis, uye Fibroids
Lupron, anonzi GnRH agonist, ndeimwe yezvinozivikanwa uye yakavengwa zvikuru yeVIV inorapwa injectable kubereka zvinodhaka . Izvi zvinonyanya kuitika nekuda kwezvakaipa zvisingaiti migumisiro: mafungiro ekuchinja, misoro, uye kupisa.
GnRH agonist semapironi inonyanya kushandiswa mukurapa endometriosis uye fibroids. Zvishoma nezvishoma, GnRH agonist inogona kushandiswa kukurudzira kuvharidzira pane nzvimbo yagara ichiita hCG kutema kupfura munguva yeIUI .
Kushandisa lupron kurapa kwakadai seVIV kunonzi "off-label". Izvozvo zvakati, lupron yave iri chikamu chekurapa kwekubereka kwemakore mazhinji. I "off-label" zita rakakodzera harifaniri kukunetsa.
Mune nguva refu, lupron madhara zvinogona kunge zvakakomba. Kurapa kwenguva refu kwemapironi kunoitika ne endometriosis kana fibroid kurapwa.
Kana yakashandiswa kurapwa, lupron inoshandiswa kwenguva pfupi kushandisa zvinodhaka.
Ndeapi Mishonga Inonzi GnRH Agonist?
Lupron ibhii rimwe chete reGnRH agnoists.
Leuprolide acetate, inotengeswa pasi pezita rezita rinonzi Lupron Depot, inotorwa nemajojo, kazhinji inotanga muhutano husati hwavapo IVF chirwere chinotanga.
Kana yakashandiswa nokuda kweVIVF, Lupron inogona kupiwa sejandi rimwe kana kujowa kwezuva nezuva.
Nafarelin acetate, inotengeswa pasi pezita rechiratidzo Synarel, uye buserelin, inotengeswa pasi pezita rinonzi Suprecur, ndeye GnRH agonist anotorwa nenzira yezuva nezuva.
Zvinowanzotanga mwedzi musati waita IVF.
Goserelin, inotengeswa pasi pezita rainzi Zoladex, inonzi GnRH agonist inotumirwa kuburikidza neduku duku, kuiswa kwebiodegradable, injowa pasi peganda.
Rimwe rinogadzirisa rinotora mwedzi umwe.
Migumisiro Yechechi yeLupron
Lupron inonyanya kuisa muviri mumuviri wakadzokeredzwa, kwenguva pfupi inonzi menopausal. Zvizhinji zvemigumisiro yakafanana zvakafanana nevakadzi vanoona panguva yekuenda kumwedzi.
Mashoko akanaka ndeokuti kare kana gonadotropin mishonga inotanga, dzakawanda zvemigumisiro yacho dzichaderedzwa. (Zvisinei, iwe pachako uchange uchitarisana negonadotropin migumisiro uye njodzi .)
Cherechedza: Zvikanganiso zvipi zvaunosangana nazvo zvinotarisa kuti nei uye kwenguva yakareba sei uri kutora GnRH agonists. Nokuti Lupron ndiyo inoshandiswa kakawanda GnRH agonist munguva yekurapa kwekubereka, rutivi rwemigumisiro yezvikamu pasi apa rinoreva kuongororwa kwakaitwa zvakananga paLupron kana kutorwa kwemavhiki mashoma. Kunyange zvazvo zvikamu zvingave zvakasiyana pakati pemhando dzakasiyana-siyana dzeGnRH agonists, ruzhinji rwemigumisiro inogona kuitika yakafanana.
Zvinowanzovhiringidza zveLupron zvinosanganisira:
- Kupisa kunopisa (70 - 80 muzana)
- Musoro (25 - 32 muzana)
- Maitiro anofamba uye kuora mwoyo (10 - 22 muzana)
- Vaginal kuoma uye kutsamwa (11 - 28 muzana)
- Acne (10 muzana)
- Zvose muviri aches (8 - 19 muzana)
- Nausea (8 - 13 muzana)
- Utano huri pamwe chete (7 - 8 muzana)
- Edema (5 - 7 muzana)
- Kutya (4 - 6 muzana)
- Zvose zvinotambudza mudumbu (3 - 7 muzana)
- Kuwedzera kwehuwandu (3 - 13 muzana)
- Yakaderera libido (2 - 11 muzana)
- Chizivi (2 - 11 muzana)
- Tingling ("pini nemasero") mumakumbo nemakumbo (1 - 7 muzana)
- Chirwere chepabonde (2 - 6 muzana)
Paunotora nguva yakareba, sezvavari apo mukurapa endometriosis kana fibroids, unogona kurega kuwana nguva yako.
Ichi hachisi chechipiri chinokonzerwa nemagumisiro sezvo ichigadziriswa chiitiko chemishonga (kubvisa mahomoni anokonzera kumwedzi).
Apo GnRH agonist inotorwa nejisi, kusuruvara uye kubwinya panzvimbo yejojo inogona kuitika.
Kana inotorwa sechirwere chinoputika, kutsamwa kwezvivi zvinogona kuitika.
Nyaya inokosha! Hazviiti zvose zvinokonzerwa nemigumisiro uye njodzi dzakanyorwa. Kana uri kutarisana nemigumisiro yakakomba, zviratidzo zvisingawanzoitiki, kana unonetseka nechikonzero chero chipi zvacho, taura nechiremba wako. Mashoko aya ari munyaya ino haaiti nzvimbo yekubvunzurudza nevhidhiyo.
Chii Chinonzi GnRH Agonist? Inoshandiswa Sei MuHIV?
Mhando yemishonga inobereka, GnRH agonist ndiyo mahomoni anonyanya kufanana nemuviri wemarimone gonadotropin-releasing hormone (GnRH).
A GnRH agonist inotanga kutungamirira kukurumidza kukurumidza mukugadzirwa kwehomoni FSH neLH . Zvisinei, mushure mekuwedzera kwenguva pfupi, chirwere chepituitary chinorega kubudisa mahomoni , kudzivirira kuvhara .
Iko kukura kwekutanga mu FSH uye LH ndechikonzero nei GnRH agonist dzimwe nguva ingashandiswa kuita kuti kuve nekuvhara.
Icho chikonzero nei, kana uchishandiswa kurapa endometriosis, zviratidzo zvinogona kukuvadza pakutanga. (Ona pasi apa kuti uwane mamwe mashoko pamusoro peizvi.)
Mukurapa kwaVIV , zvinodhaka zvakadai semapironi zvinoshandiswa pamwe chete ne gonadotropin . Vagonist vanodzivirira hutachiona hwemhuka.
Pane kudaro, chiremba wekubereka achaita kuti hunyoro huve nemamwe mishonga inobereka, nenzira inodzora inozivikanwa sekukura .
Mishonga iyi inodzivirirawo kuputika kweHM. Kushanduka kwemazuva eHS kunogona kutungamirira mazai anouraya vasati vangawanazve kubva mavha mavari.
(Kana mazai akavharwa vasati vadzorerwa, vanowana "kurasikirwa" mukati memharavha yepilvic.Haizogone kushandiswa kurapwa kweVF kana izvi zvichiitika.)
Ko GnRH Agonist Inoshandiswa Sei Kubata Endometriosis uye Fibroids?
Kana yakashandiswa kurapa endometriosis , GnRH agonist inotorwa nguva dzose pamusoro pemwedzi mitatu kusvika kumitanhatu. Iwe unowanzogamuchira sei majikisi uye / kana chirwere chinopisa chinodaro pamushonga unoshandiswa.
Chinangwa chekupedzera chirongwa chemigumo ndeyekumisa kushandiswa kweesrogen, iyo inopa zvokudya zvekupedzisira. Noku "nzara" idzi idzi, kurwadziwa kunoderedzwa.
Mumavhiki maviri kusvika matatu ekurapa, zviratidzo zvako zvinogona kuwedzera. Izvi zvinoitika nekuda kwekuwedzera kwekutanga muFSH neLH. Iwe unofanirwa kutaura nechiremba wako kana iwe unonetseka.
Mushure memavhiki mana kusvika masere, zviratidzo zvako zve endometriosis zvinofanira kuvandudza.
Kana yakashandiswa kurapa fibroids, chinangwa kazhinji kacho kuderedza ukuru hwe fibroid vasati vavhiyiwa. Ne "kushaya nzara" iyo fibroid ye estrogen, kuwanda kunopera. Mishonga inogona kuitika kwemwedzi mitatu kana mina isati yaitwa chirongwa.
Nemhaka yokuti mishonga iyi inokonzera chirwere chemazuva mashoma, zvakakosha kuziva kuti haugone kutora pamuviri paunotora GnRH agonist ye endometriosis kana fibroids.
Haisi mushonga wekubereka kwe endometriosis kana fibroids, uye haazogadziri kubereka kwako.
Kana iwe uchida kutora pamuviri, iwe unoda kurega kurapwa.
Zvichienderana nemishonga yaunotora, inogona kutora chero ipi zvayo kubva kumavhiki mana kusvika matanhatu (ine pine spray agonists) kana masvondo matanhatu kusvika gumi (nemakisi) kuitira kubereka kwako kudzoka.
Nyaya inokosha : haufaniri kuvimba neGnRH agonists kuti zvachose kudzivirira ovulation. Kana uchitorwa uchienderera mberi, kana iwe uchinge wava nepamuviri, GnRH agonist inogona kukuvadza mwana anokura mwana.
Nokuda kwechikonzero ichi, iwe unogona kushandisa nzira inopesana yekudzivirira kuberekwa (semakondomu kana chirafu) kuti uone kuti haubereki.
Sezvo nguva dzose, taura nachiremba wako.
Ngozi dzeGnRH Agonists
Iyo FDA haina kubvumidza zvakakwana Lupron nemamwe magonist GnRH kushandiswa mukurapa kwekubereka. Kushandiswa kwaro panguva yeVIV kunonzi "off-label". Saka, hazvizivikanwi kuti njodzi dzose ndeipi kana dzinoshandiswa mukurapa.
Nezvo zvakataurwa, izvi ndezvizivo zvinowanzozivikanwa kana zvichishandiswa kurapa endometriosis, fibroids, kana kenza yeprotate. Zvimwe zvinokonzerwa nekurapwa kweVIV zvinogona kufanana.
Kushungurudzika : Kana iwe une nhoroondo yekuora mwoyo , GnRH agonist inogona kutungamirira kukuora mwoyo kwakanyanya.
Usaisa izvi kubva kuchiremba wako; vaudze kana iwe unowedzera kuora mwoyo kana kuti unonetseka nemafungiro ane chokuita nemafungiro.
Kupera kwemafupa emapfupa : Madzimai avo vakashandisa Lupron kwenguva yakareba kwemwedzi mitatu, kuwedzera kwepfupa kwakaderera 2.7 muzana. Mwedzi mitanhatu inotora kurapwa, hutachiona hwemapfupa hwakaita sehunovandudza, asi kwenguva yakareba mushure mezviitiko hazvizivikanwi chaizvo.
Izvo hazvizivikanwi panguva ipi iyo kuderera kwepfupa kwemafupa kusingabvumirwi. Nokuda kwechikonzero ichi, kurapwa kwemwedzi inopfuura mitatu kusvika kumatanhatu hakukurudzirwi.
Lupron haigamuchirwi nevadzimai vari pangozi yekuderedza masimba emapfupa. Kana iwe uine mhuri yehutano hwehutachiona, taura izvi kune chiremba wako.
Pituitary apoplexy : Izvi ndizvo zvinoitika apo chirwere chepituitary (kazhinji chisati chaongororwa) chinopa ropa. Izvi hazviwanzoitiki, zvinowanzoitika mukati mavhiki maviri okutanga ekurapwa, uye dzimwe nguva mukati maawa ekutanga.
Kana uchinge uchinge uchinge uchinge uine musoro wakanyanya, kushambidzika, kuonekwa kunoonekwa, kuora muviri kwemuviri wako mukati kana kumativi ako, maonero emagariro, kana zviratidzo zvekurwadziwa kwepfungwa, kurapwa nokukurumidza.
Dambudziko duku rakawedzerwa rekukura kwechirwere cheshuga, kurwisa kwemwoyo, uye kurohwa : Zviitiko izvi zvakanyanya kunyanya kuwanikwa nevarume vachitora GnRH agonists kurapa kenza yeprotate. Kunyangwe vari mungozi kuvakadzi panguva yehutano hweVIV hazvizivikanwe.
Zvimwewo zveGnRH Agonists
Zvakakosha kuziva kuti GnRH agonist s haisi yega yega yeVIVF.
Imwe nzira inosanganisira vanopikisa GnRH, saAntagon (ganirelix acetate) uye Cetrotide (cetrorelix).
Kusiyana neGnRH agonists, GnRH vanopikisa ndeye FDA inobvumidzwa kushandiswa munguva yehutano hweVIV. Iwe unotorawo ivo kwenguva shomanana. Izvi zvinogona kuderedza chiyero kana urefu hwenguva unosangana nemigumisiro.
Vadzivisi veGnRH vangave vakachengeteka, maererano nezvimwe zvidzidzo. Apo yakashandiswa panguva yekurapa kwekubereka, vakadzi vaiva nehuwandu hwekuwedzera hutachiona hwekuvhara maziso kana kuenzaniswa neGnRH agonist.
Izvo zvinogona kuitika ndezvokuti vanopikisa GnRH vanodhura zvikuru uye havasi vese vadzidzisi vekubereka vanojaira kuishandisa.
Sources:
Al-Inany HG, Youssef MA, Aboulghar M, Broekmans F, Sterrenburg M, Smit J, Abou-Setta AM. "GnRH Antagonists Akachengeteka Kupfuura Vagonist: Chirongwa cheChrisrane Review. "Hum Kudzosera. 2011 Jul-Aug; 17 (4): 435. doi: 10.1093 / humupd / dmr004.
El-Nemr A, Bhide M, Khalifa Y, Al-Mizyen E, Gillott C, Lower AM, Al-Shawaf T, Grudzinskas JG. "Clinical kugadziriswa kwetatu zvakasiyana-siyana gonadotrophin-kurega hormone yakafanana mune chirongwa cheVIV: aunotarisira kudzidza. " Eur J Obstet Gynecol Anozvidza Nyoro . 2002 Jul 10; 103 (2): 140-5.
FDA Mishonga Yekuchengetedzwa Kwemishonga Kukurukurirana: Kuvandudza Kuenderera Kunochengetedzwa Kwekuchengetedzwa kweGnRH Agonist uye Notification kune Vagadziri veGnRH Agonists kuwedzera Idzva Rokuchengetedza Ruzivo Mukunyora Nezvekuwedzera Kwengozi yeShuga uye Zvimwe Zvirwere Zvoutachiona. FDA: US Food uye Drug Administration.
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