Kunzwisisa Zvavari, Zvavanoita, uye Mazhinji Aunofanira Kuva nawo
Muchivharo chemadzimai ekuberekwa , chironga chekuvhara mazai chikafu chinokonzera mvura chine mazai, kana oocyte . Iyi follicles inowanikwa mune mavha mavari. Munguva yekuputika , zera rakakura rinosunungurwa kubva mumapurisa. Kunyange zvazvo mapuropiki akawanda anotanga kukura imwe neimwe yekutenderera, kazhinji inongova imwe chete inopisa mazai. Mushure mokuputika, follicle inoshandiswa kuva corpus luteum .
Izvozvo zvisingasununguki mazai akakura akaparara, imwe nzira inozivikanwa seatresia iyo inogona kuitika pane imwe nhanho yehutukutu hunoitwa. Inenge 99 muzana yeovarian follicles ichaparara uye haizombovi yakakura zvakakwana kuti isunungure mazai.
Nyaya yekukura uye kubudirira inoratidzirwa panguva yekurapa kwechibereko . Pakukura kwekushandiswa (yakashandiswa panguva yekurapa kwaIVF ), chinangwa ndechokukurudzira maovari kuti awedzere huwandu hwehutano hunokurumidza panguva imwe chete. Kuongorora kwe ultrasound, inozivikanwawo se antral follicle count (AFC), inogona kuitwa sechikamu chekuedzwa kwekubereka . Uyu muedzo unoitwa kuti uongorore mazai ovarian.
Chii Chinonzi Antral Follicles uye Inofanotaura Sei Kuchera?
Nechepfungwa, kana iwe uchigona kuziva kuti ndeapi follicles iri mukati mako mavari, iwe unogona kuva nemafungiro emangani maawa mawakasiya. Hazvibviri kuverenga kuti vangani follicles vari mumavhizha mavo nekuti ivo vaduku zvikuru kuti vasaonekwa.
Zvisinei, kamwe kana follicle inosvika pane imwe nzvimbo, inogona kuonekwa kuburikidza ne ultrasound.
Mifananidzo inotanga kunyanya, yakawanda zvikuru. Zvose zvipembenene muhutari zvinotanga sezvipfeko zvepamusoro. A folmordial follicle ingo 25 mamita mamita-iyo 0.025 mamita. Hazvibviri kuona neziso rakashama, regai kuvhara pane ultrasound.
Zuva roga roga, zvipfeko zvinotyisa "zvinomutswa" nezviratidzo zvehomoni uye dzinotanga kukura. Chero bedzi ivo vachiramba vachirarama uye vapedza kudzidza kusvika pachikamu chinotevera, vanokura uye vakura.
Chimwe chezvikamu izvi chikamu chepamusoro. Munguva iyi, follicle inowana girasi rakazara-inodzwa inozivikanwa semusana. Nyeredzi dzine an antrum dzinonzi antral follicles. Vanoyera pakati pe2 ne 10 mm muhupamhi. Kune mamwe maonero, an antrum follicle ikozvino 5mm yakawanda mazana maviri pane yakange yakaita seyimbo inokosha ye follicle.
Antrum follicles ekupedzisira inoonekwa pane ultrasound. Kutsvakurudza kwakawana kuti nhamba yevashandi antrum follicles pane mavha mavari inobatanidza kusvika kuwandu hwemazai akasiiwa. Iwe haukwanise kuziva kuti ndeapi mapuro follicles akawanda aripo, asi kana mukadzi ane vashoma folral follicles iri kuitika pamashizha, iwe unofungidzira kuti ovarian reserve yakadzika.
Antral follicles inobereka mazinga akawanda ehomoni inonzi anti-mullerian hormone (AMH). Iyi hormone inotenderera muropa rako. Kuyera AMH maitiro kuburikidza nebasa reropa ndiyo imwe nzira yekuongororwa mazai ovarian.
Chii Chinonzi Antral Follicle Count (AFC) Test?
An antral follicle count is test test. Yakaitwa ne transvaginal ultrasound, dzimwe nguva pakati pekushanduka kwezuva 2 ne5.
Iko ultrasound tech inotarisa pavharo imwe neimwe uye inotora nhamba ye follicles iri pakati pe2 ne 10 mm.
Chiremba wako anogona kuraira izvi kuedza
- Batsira kuongorora chirwere chinonzi polycystic ovarian syndrome
- Kukupa pfungwa yekuti kubereka kwako kunomirirei maererano nezera rako (une zvakawanda here, zvishoma, kana chiyero chema follicles uchienzaniswa nevamwe vezera rako)
Chiyero chinogona kuitwa sechikamu chekubereka kubereka. Kana kuti, inogona kurongerwa kusati kwatanga kuronga kurapa.
Ndezvipi Zvakawanda Zvakawanda zveAlexral Zvakajairika?
Yeuka kuti zvakajairika kuti nzvimbo dzako dzekuvhara mazamu dziende pasi sezvaunenge uchikwegura.
Saka, zvinowanzoitirwa munhu ane makore makumi maviri nemashanu hazvirevi zvekuti munhu ane makore makumi matatu nemasere. Nezvo zvakataurwa, an antral follicle nhamba ye 3 kusvika ku6 inonzi yakaderera.
Chimwe chechikoro chekudzidza chakaita antral follicle kuverengwa kune vakadzi vane ruzivo rwakavimbiswa (zvidzidzo zvakawanda zve AFC zvakaitwa kuvakadzi vasingabereki). Kuti zvibatanidzwe muchidzidzo ichi, vakadzi vaifanira
- Iva nenguva yekuenda kumwedzi, kuenzana kubva pamazuva makumi maviri nemashanu kusvika makumi matatu
- Iva nenyuchi , inopupurirwa nokuva nekupisa kunomuka pane chetatu yepasi yechando yechati
- Wakave nemimba kune mwana mumwe chete munguva yakapfuura, mukati megore rimwe chete
- Usave nehunozivikanwa hwehomoni kana chirwere chekupedzisira
- Akadzivisa kuberekwa nekuberekwa kwemwedzi miviri isati yasvika
Pano paiva nevana vavo vanoverengera antral follicle counts (AFC), pamwe nehuwandu hwakaonekwa (kubva pasi kusvika kune yakakwirira kupfuura AFC count).
| Age range | Avhareji AFC | Lowest AFC | Highest AFC |
| 25 kusvika ku 34 | 15 | 3 | 30 |
| 35 kusvika ku40 | 9 | 1 | 25 |
| 41 kusvika 46 | 4 | 1 | 17 |
Kuva nehutachiwana evhaan reserve hazvireve kuti iwe haugone kutora pamuviri. Asi zvinoreva kuti mazai ako haafaniri kupindura mishonga yekubereka pamwe chete nemukadzi ane mazai anopfuura ovarian. Unyanzvi hweunyanzvi hwe ultrasound uye inyanzvi ye ultrasound pachayo inogona kuchinja mhinduro. Kana imwe yepakati ichitsvaga chikonzero chakaipa, funga kuwana imwe pfungwa.
Vakadzi vane antal low follicle count vasati vava nemakore makumi mana makumi mana vanogona kuonekwa kuti vane hutachiwana hwekutanga hunoita, hunozivikanwa sekusakanganiswa kwemaawa masikati . Antral follicle inoratidzika seyakaderera semukadzi ane makore . Rimwe rinoshamisa risingareki follicle count rinogona kuratidza polycystic ovarian syndrome (PCOS) .
Basa Rinoita Zvipfeko Zvichitamba Mukudarika Kwemwedzi?
Kuenda kwako kumwedzi kunoparadzaniswa kuva zvikamu zviviri zvekutanga, follicular phase, uye luteal phase .
Munguva ye follicular stage, follicles mudunhu redzidzo yepamusoro yekuvandudzwa inotorwa uye inotanga chirongwa chichapedzisira chichiita kuti kuve nechirwere. Nepo huwandu hwemapurisa huchatanga muhutanga urwu, imwe chete (kana maviri) ichasvika pakukura zvakakwana uye kusunungura mazai. Kana uri kutora mishonga inobereka , micheche yakawanda inogona kusvika padanho rinopisa.
Iyo follicles pachayo inofanirwa ku:
- Kudya nekuchengetedza oocyte, sezvo inopinda kuburikidza ne oogenesis
- Kusunungura hutori hunokosha huri kubereka, kusanganisira estradiol uye inhibin B, iyo inoratidza pituitary uye hypothalamus gland kuwedzera kana kuderedza kusunungurwa kwaGnRH , FSH , uye LH
- Kuchinja ku corpus luteum mushure mekuvhara, izvo zvinobudisa mahomoni progesterone uye estrogen
Chii Chiri Kuitika Mukati yeChirangaridzo Chikamu cheMwedzi Wokutanga?
Icho chinonzi follicular chinyorwa chekutenderera kwako chinotanga pazuva rekutanga remakore ako. Kusvika mumwedzi ndiko kusunungurwa kwemuviri wepamusoro-soro kumagetsi ekupedzisira, ayo akavakwa mukufungidzira kuberekwa. Pakupera kwenguva yako, uterine liningine ichave yakaonda. Iyo michina ichakura uye ichava yakasviba zvakare mushure mokunge ovulation.
Asi izvi zvisati zvaitika, sezvaunenge uri panguva yako, mazai ako ari kugadzirira dhi rinotevera rekuvhura. Pakati pemashanu nematanhatu follicles inotanga kukura muvira rako. Iyo hormone FSH-follicle inoita hormone-inobudiswa uye yakasunungurwa nehutu hwepituitary. Ndiyo hormone inokonzera follicles kuti ikure.
Sezvo follicles inowedzera muhukuru, inosunungura uye yakawanda isrogen. Iyo yakakwirira masero eestrogen chiratidzo cheganda repituitary kunonoka kuderedza kubudiswa kweFSH. Kunyangwe iwe wakatanga nemishanu kana matanhatu, imwe chete (uye dzimwe nguva mbiri) ichaita kuti iwedzere. Nhamba dzezasi dzeFSH dzinokonzera kuti maduku maduku awedzere kukura kana kutorega kukura, nepo follicle yakakura ichiri kuramba ichikura.
Pakupedzisira, rimwe follicle rinova guru rinotyisa. Vamwe vanoramba vachikura vachifa. Apo follicle inosvika pedyo nekukura kwayo kukuru, inodonongodza kunyange isrogen. Izvo zvisati zvaitika, kuwedzera mazinga eesrogen kunotungamirirwa kumazinga ekuderera eFSH, apo maestrogen mazinga ari akakwirira zvikuru, pane shanduko umo chirwere chepituitary chinopindirana nehomoni.
Yakakwirira kwazvo maitiro eesrogen inotora gland repituitary kuti ribudise uye ribudise LH kana kuti luteinizing hormone. Izvi zvinokonzera follicle kuti ipedze matanho ekupedzisira ekufambisa, uye pakupedzisira, follicle ichaparuka uye inosunungura mazai. Iyi ndiyo nguva yekuvhunga.
Folliculogenesis: Matanho e Follicular Development
Iwe unogona kufunga kuti follicular kukura inotanga uye inoguma munguva ye follicular phase yekuenda kumwedzi, asi iwe unenge usina kururama pamusoro pazvo.
Zvose zvipenyu zvinotanga musikana asati aberekwa, apo mavha mavari anotanga kuumbwa. Panguva ino, mazai mavari ane zvinyorwa zvepollical chete. Nyaya dzinogona kuramba dziri mu "kurara" iyi kwemakore makumi mashanu asati "amuka" uye achipfuura mumatanho ekufambira mberi. Zvinotora chero kupi zvako kubva pamwedzi mitanhatu kusvikira kune rimwe gore kuenda kune chimwe chinhu chinonyanya kukosha kusvika kune chikwata chakakura chekuvhunga-yakagadzirira follicle.
Pazvikamu zvose zvehutano hunobudirira, zvakawanda zve follicles zvicharega kusimbiswa nekufa. Hasi dzose dzakakosha dzemapurisa dzichapfuura nheyo imwe neimwe. Funga nezvazvo semakwikwidziro kusvika kune maOlympic yeOvulation. Dzimwe follicles dzichadonha, uye dzimwe dzichaenderera mberi. Pasi pane imwechete yezana yakambosvibisa oocyte.
Zvikamu zve folliculogenesis ndezvi:
- Primordial follicle (iyo nzvimbo yose follicles iri mukati memapapiro emwana mucheche mwana)
- Primary follicles (kurohwa kwemashoma mashoma follicles mu-primary follicle stage inoitika zuva rimwe nerimwe, kutanga pakuberekwa nekuenderera mberi kusvika pakuenda kumwedzi)
- Secondary follicles (iyo inosanganisira kuwedzera kwe theca cells, iyo inogona kuvhara mahomoni)
- Zvidzidzo zvepamusoro, zvinowanzonzi antral follicles (izvo zvinonzi follicles zvine chinyamuti chakazara mumvura chinonzi antrum, follicles panguva ino inoonekwa ne transvaginal ultrasound)
- Graafian follicle (a follicle yakawanda zvakakwana kuti ifukidze, imwechete chete kana maviri yepamusoro-soro follicles mumutambo mumwe nomumwe inokura kusvika pakuvhunga)
- Corpus luteum (kwete technically follicle zvakare, corpus luteum inotanga kubva pamapururu akavhurika akazarura yai.)
Ndezvipi Zvakawanda Zvinofanira Kufanirwa Nemapenzi?
Kana uri kuenda kuburikidza nekurapa kwekubereka, chiremba wako anogona kutarisa kukura kweupenzi kuburikidza ne ultrasound. Munguva idzi idzi dzinowedzera, nhamba yekuvandudza follicles ichaverengwa. Izvo zvichaenzaniswa.
Nyeredzi dzinoyera mumamilimita (mm). Kazhinji, chiremba wako achange achida kuronga kutora kwako-kana hCG / LH kuvhara-apo follicles yako yava kuda kusvika pakukura zvakakwana. Izvi zvakapoteredza 18 mm.
Mhando yakakura yakagadzirira kuvhara ichayera chero ipi zvayo pakati pe18 ne25 mm.
Ndezvipi Zvinyorwa Zvizhinji Ndinofanira Kuwana Panguva yeMagetsi?
Zvakanaka, iwe unongoda imwe chete kana mbiri dzakakura follicles munguva yeComidy cycle . Unogona kunzwa wakanetseka paunowana imwe chete kana maviri follicles yakakura zvakakwana kuti ifukidze. Zvisinei, yeuka kuti zvimwe hazvirevi chinhu chakanaka. Chimwe chese chinokonzera kukura chikafu chinogona kusunungura mazai, ezvo iyoi inogona kuwedzerwa.
Kana uine mapiritsi maviri, unogona kutora mapatya . Kana, iwe unogona kunge usingafungi zvachose. Kana, iwe unogona kutora mumwe mwana. Ovulation haina chivimbo chekubata pamuviri.
Ndezvipi Zvinyorwa Zvizhinji Zvisingagoneki kweIUI kana Gonadotropins Cycle?
Kufanana neClomid, zvakanaka, iwe unongoda imwe kana maviri follicles kukura kusvika pakukura. Mishonga inokonzera kubereka (gonadotropin) inouya nehuwandu hwekuita pamuviri. Zvinokwanisika kukudziridza zvitatu, zvina, kana kunyange zvakanyanya kukura follicles.
Kana iwe ukawana mana kana kupfuura follicles, chiremba wako anogona kubvisa kupora kwako. Izvi zvinogona kureva kuvhara chirongwa cheIUI chakarongwa, kubvisa chinotyisa kupfura, uye / kana kukuudza kuti urege kuita zvepabonde.
Kana chiremba wako achikuudza kuti usaita zvepabonde, zvakakosha iwe unoteerera. Mungozi yekuita mitezo kana katatu yakakwirira uye yakawanda yakawanda yakakura follicles. Kubata pamuviri kwakawanda kuchaisa iwe nevana vako muhutano. Zviri nani kumirira nekuedzazve pane imwe nzira.
Ndezvipi Zvinyorwa Zvikuru Ndinofanira Kuva nazvo Panguva Yechiratidzo cheVIV?
Munguva yekurapa kwaVIV , chiremba wako anoda kukurudzira maovari kuti uwedzere mapurogramu akawanda. Chero pakati pemakore 8 ne15 follicles inonzi inogamuchirwa.
Munguva yekuwana mazai, chiremba wako achatsvaga follicles ane seni inotungamirirwa ne ultrasound. Zvose mapurisa hazvirevi kuti ane mazai epamhando. Saka, usashamisika kana nhamba ye mazai inotorwa isingapfuuri nhamba yehutano hukuru follicles wawakanzi iwe waive nawo.
Shoko Rinobva Kunyanya
Nyaya yemapurisa nekukura kunogona kuva chinokonzera kushungurudzika. Panguva yekuedzwa, kudzidza kuti yako antral follicle count haisi yakakwirira sezvinotarisira inogona kukonzera kushushikana. Kuonekwa kwepasi ovarian reserve kunogona kunyanya kuoma kurarama nayo. Chiremba wako anogona kukurudzira IVF neiyo mupi weii , nzira iyo yose isati yakaroorana kana inoda kutora.
Nyaya inowanikwa uye zviyero panguva yekurapa kwekubereka kunogona kukutumira iwe pachinotinhira-chema chekunzwa. Ko mazai ako anobudisawo mashoma here? Zvakawandisa? Zvose zvinorevei?
Kunyange zvazvo follicle kuverenga inoratidza chiratidzo chekubereka-uye panguva dzokurapwa, follicle zviyero zvinogona kuziva kana chirwere chinopfuurira kana chibviswa-yeuka kuti nhamba imwe haina kukutsanangurira, kana kunyange kunyatsofanotaura nguva yako yekubereka.
Vakadzi vane pasi-antral follicle vanogona kutora pamuviri, dzimwe nguva vane mazai avo. Imwe ultrasound munguva yekurapa ingasaunza mashoko akanaka, asi kugadziriswa kwemishonga yako yekuberekwa kunogona kuita kuti inotevera sarudzo inobatsira zvikuru.
Kana usina chokwadi kuti follicle yako inorevei zvinoreva, taura nachiremba wako. Usatya kutsvaga pfungwa yechipiri pamusoro pekuedza kubereka uye kuongorora zvirwere. Uye iva nechokwadi chekushandira rubatsiro . Kuedza kubereka uye kurapwa kunonetsa . Iwe haufaniri kuita izvi chete.
> Sources:
> Antral Follicle Count. USC Fertility. http://uscfertility.org/fertility-treatments/antral-follicle-count/.
> Jayaprakasan K, Campbell B, Hopkisson J, Johnson I, Raine-Fenning N. "Anotarisira, kuenzanisa tsanangudzo ye anti-Müllerian hormone, inhibin-B, uye nhatu-dimensional ultrasound zvinokonzerwa neanvarian reserve muhuwandu hwehurombo husingapinduri rinodzora kuraira kwemaawa. "Fertil Steril. 2010 Feb; 93 (3): 855-64. doi: 10.1016 / j.fertnstert.2008.10.042.
> Scheffer GJ, Broekmans FJ, Looman CW, Blankenstein M, Fauser BC, teJong FH, teVelde ER. "Nhamba yevarral follicles muvakadzi vakakurumbira vane kubereka kwakaratidza ndiyo yakanakisisa kuratidza nguva yekuberekwa." Hum Kudzorerwa. 2003 Apr; 18 (4): 700-6. doi: 10.1093 / humrep / deg135