Gani GnRH Agonists na IVF, Endometriosis, da Fibroids
Lupron, GnRH agonist, daya daga cikin mafi sananne kuma mafi ƙi na IVF maganin maganin maganin gargajiya . Wannan shi ne mahimmanci saboda mawuyacin sakamako masu illa: sauye-sauyen yanayi, ciwon kai, da walƙiya.
GnRH agonists kamar lupron ana amfani da su sosai don maganin endometriosis da fibroids. Mafi mahimmanci, mai amfani da GnRH za a iya amfani dashi don tayar da kwayoyin halitta maimakon sababbin hCG da aka harba a yayin yunkurin YUI .
Yin amfani da kullun don jiyya na haihuwa kamar IVF ana dauke da "lakabin-kashe." Wannan ya ce, Lupron ya kasance wani ɓangare na jiyya na shekaru da yawa. Yanayin "lambar alamar" bai kamata damu da ku ba.
A cikin dogon lokaci, sakamakon illa na lupron na iya zama mai tsanani. Lupron magani na tsawon lokaci yana faruwa da endometriosis ko maganin fibroid.
Idan aka yi amfani da shi don magani, sai lupron ya yi amfani da miyagun ƙwayoyi.
Wadanne Magunguna ne Gidan Hakanan GnRH?
Lupron abu ne kawai na GnRH agnoists.
Leetrolide acetate, wanda aka sayar a karkashin sunan Lupron Depot, ana daukar shi ta hanyar injections, yawanci farawa a cikin zagayowar kafin IVF farawa.
Idan aka yi amfani da IVF, ana iya bada Lupron a matsayin allurar ko inganci kullum.
Nawaylin acetate, wanda aka sayar a ƙarƙashin sunan suna Synarel, da kuma buserelin, wanda aka sayar a ƙarƙashin sunan suna Suprecur, sune GnRH agonists da aka dauka ta hanyar yaduwa na yau da kullum.
Ana kuma farawa da su kafin watanni IVF.
Goserelin, wanda aka sayar a ƙarƙashin sunan mai suna Zoladex, yawanci na GnRH da aka tsĩrar da shi ta hanyar karami, mai kwakwalwa, wanda aka yiwa shi kawai a karkashin fata.
Ɗaya daga ciki shine wata daya.
Yanayin Lupron
Lupron da gaske ya sanya jiki a cikin wata mawuyacin hali, matsakaicin lokaci na mazaopausal. Yawancin abubuwan da suka shafi illa sune kama da abin da mata ke fuskanta a lokacin menopause.
Labari mai dadi shine cewa da zarar an fara jiyya daga gonadotropin , za a rage yawancin abubuwan da za a samu. (Duk da haka, zaku yi la'akari da halayen gonadotropin da haɗari .)
Lura: Yaya yawancin illa da ka fuskanta zai dogara da dalilin da yasa kuma har tsawon lokacin da kake ɗaukar GnRH agonists. Saboda Lupron shine mafi yawancin amfani da GnRH agonist a lokacin magani na haihuwa, sakamakon binciken da aka yi a cikin ƙasa ya nuna zuwa binciken da aka yi a kan Lupron lokacin da aka karɓa don da yawa makonni. Duk da yake kashi-kashi na iya bambanta tsakanin nau'i-nau'i daban-daban na GnRH agonists, jigon jerin abubuwan da zasu iya haifar da ita shine kama.
Abubuwan da ke cikin layi na Lupron sun hada da:
- Hotunan haske (70 - 80 bisa dari)
- Ciwon kai (25 - 32 bisa dari)
- Saurin yanayi da kuma ciwo (10 - 22 bisa dari)
- Rashin ruwa mai laushi da walwala (11 - 28 bisa dari)
- Acne (kashi 10)
- Janar na jiki (8 - 19 bisa dari)
- Nausea (8 - 13 bisa dari)
- Haɗin gwiwa (7 - 8 bisa dari)
- Edema (5 - 7 bisa dari)
- Nervousness (4 - 6 bisa dari)
- Janar ciwon ciki (3 - 7 bisa dari)
- Adadin nauyi (3 - 13 bisa dari)
- Rage libido (2 - 11 bisa dari)
- Dizziness (2 - 11 bisa dari)
- Tingling ("fil da needles") a cikin makamai da ƙafafu (1 - 7 bisa dari)
- Tashin tausayi (2 - 6 bisa dari)
Lokacin da aka dauki lokaci mai tsawo, kamar yadda suke a lokacin zalunta endometriosis ko fibroids, zaka iya dakatar da samun lokacinka.
Wannan ba fasaha ba ne a matsayin sakamako mai tasiri tun lokacin sakamako ne na magungunan miyagun ƙwayoyi (don rufe ƙananan hormones wanda ke haifar da haila).
Lokacin da ake karɓar agonists GnRH ta hanyar allurar, ciwo da redness a wurin ginin yana iya faruwa.
Lokacin da aka ɗauka a matsayin mai laushi na hanci, halayen zunubin zai iya faruwa.
Alamar mahimmanci! Ba'a iya lissafin duk wata tasiri da haɗari ba. Idan kuna fuskantar matsalolin haɗari mai tsanani, sababbin alamun bayyanar cututtuka, ko damuwa saboda kowane dalili, tuntuɓi likitan ku. Bayanai a cikin wannan labarin ba zai maye gurbin shawara tare da likita ba.
Mene ne GnRH Agonists? Yaya ake amfani dashi A lokacin IVF?
Wani irin miyagun ƙwayoyi, GnRH agonists ne hormones na wucin gadi wanda ke nuna jikin jikin jikin jikin jikin jikin mutum (hormone) gonadotropin-releasing hormone (GnRH).
GnRH agonist na farko zai haifar da ƙara yawan karuwa a cikin samar da kwayoyin hormones FSH da LH . Duk da haka, bayan wannan karamin karamin, glanden tsinkaya ya dakatar da haifar da hormones , hana kwayar halitta .
Wannan ƙarfafawa na farko a FSH da LH shine dalilin da yasa magunguna na GnRH zasu iya amfani dashi a wasu lokutan don haifar da samuwa.
Har ila yau, idan aka yi amfani da ita don magance endometriosis, alamar cututtuka na iya kara damuwa da farko. (Dubi ƙasa don ƙarin bayani akan wannan.)
A tsarin IVF , ana amfani da kwayoyi kamar lupron tare da gonadotropins . Masu maganin suna hana kwayar halitta .
Maimakon haka, likita na haihuwa zai shayar da kwayoyin halitta tare da wasu kwayoyi masu haihuwa, a cikin hanyar sarrafawa da ake kira superovulation .
Magungunan magunguna sun hana karfin LH na halitta. Hanya na LH na iya haifar da ƙwayoyin da ke yin amfani da su kafin a dawo da su daga ovaries.
(Idan an yi amfani da ƙwai kafin a dawo da su, suna "ɓacewa" a cikin kogin pelvic. Ba za a iya amfani dashi ba don maganin IVF idan wannan ya faru.)
Ta yaya masu amfani da GnRH suka yi amfani da Endometriosis da Fibroids?
Idan aka yi amfani da ita don magance endometriosis , ana daukar GnRH agonists har tsawon watanni uku zuwa shida. Yaya sau da yawa za a samu injections da / ko nassi na hanci ya dogara ne da amfani da miyagun ƙwayoyi.
Makasudin maganin endometriosis shine don dakatar da samar da estrogen, wanda ke ciyar da adadin endometrial. By "yunwa" wadannan ajiya, an rage ciwo.
A farkon makonni biyu zuwa makonni uku na magani, alamun lafiyarku na iya karawa. Wannan yana faruwa ne saboda ƙarfafawar farko a FSH da LH. Ya kamata ku yi magana da likitanku idan kun damu.
Bayan kimanin makonni hudu zuwa takwas, alamar cututtrissis ya kamata inganta.
Lokacin da ake amfani da fibroids, burin shine ya rage yawan fibroid kafin a tilastawa. By "yunwa" da fibroid na estrogen, da salla shrinks. Jiyya zai iya faruwa na tsawon watanni uku ko hudu kafin yin aikin tiyata.
Saboda wadannan kwayoyi suna haifar da matsayi na mazaopausal na wucin gadi, yana da muhimmanci a san cewa ba za ku iya yin ciki ba yayin shan GnRH agonists don endometriosis ko fibroids.
Ba su da magani na haihuwa don endometriosis ko fibroids, kuma ba zasu inganta yawan haihuwa ba.
Idan kana so ka yi ciki, zaka buƙaci ka dakatar da magani.
Dangane da maganin da kake shanwa, yana iya ɗauka a ko ina daga makonni huɗu zuwa shida (tare da ƙwararruɗa masu yaduwa) ko makonni shida zuwa goma (tare da injections) don haihuwa don dawowa.
Muhimmiyar mahimmanci : kada ku dogara ga GnRH agonists don kare jima-jita. Lokacin da aka ci gaba, idan ka yi ciki, GnRH agonists zai iya cutar da tayin tayi.
Saboda wannan dalili, ƙila ka buƙaci amfani da hanyar shayarwa na haihuwa (kamar kwaroron roba ko diaphragm) don tabbatar da baka yin ciki ba.
Kamar yadda kullum, magana da likitan ku.
Risks na GnRH Agonists
FDA ba ta yarda da Lupron da sauran masu maganin GnRH ba don amfani da jiyya. Amfani da shi a lokacin IVF an dauke shi "lakabi-lakabin". Saboda haka, ba a san ainihin abin da ke tattare da hadarin ba lokacin da ake amfani da shi don kulawa da haihuwa.
Da wannan ya ce, waɗannan su ne hadarin da aka sani yayin da ake amfani da su wajen maganin endometriosis, fibroids, ko ciwon daji. Hadarin da ake yi a IVF na iya zama kama.
Dama : Idan kana da tarihin bakin ciki , GnRH agonists zai iya haifar da mummunan ciki.
Kada ku ci gaba da wannan daga likitanku; gaya musu idan kun fuskanci damuwa da damuwa ko kuma damuwa game da abubuwan da ke tattare da yanayi.
Rage kashi mai yawa : A cikin matan da suka yi amfani da Lupron a tsawon watanni uku, kashi kashi ya karu da kashi 2.7. Watanni shida bayan yin magani, yawan kashi yana da mahimmanci, amma lokaci mai tsawo ba bayan da ya faru ba.
Har ila yau, ba a sani ba a wane lokaci ne karuwar kashi kashi ya zama irreversible. A saboda wannan dalili, ba a bada magani ga fiye da uku zuwa watanni shida.
Ba a bayar da shawarar ga Lupron ga mata masu fama da rage yawan kashi ba. Idan kana da tarihin iyali na osteoporosis, ambaci wannan ga likitan ka.
Pituitary apoplexy : Wannan shi ne lokacin da ciwon tumo (wanda ba a taɓa gano shi) ba. Wannan yana da mahimmanci, yawancin lokuta yana faruwa a cikin makonni biyu na jiyya, da kuma wani lokaci a cikin farkon sa'a.
Idan ka fuskanci ciwo mai tsanani mai tsanani, vomiting, canje-canje na gani, ciwo na tsokoki a ciki ko kusa da idanuwanka, yanayin halin canzawa, ko alamun zuciya na zuciya, samun magani a hankali.
Ƙananan ƙananan haɗari don tasowa ciwon sukari, ciwon zuciya, da kuma bugun jini : Wadannan halayen sun samo asali ne a cikin mazajen shan GnRH agonists don magance cutar ta prostate. Ko dai suna da haɗari ga mata yayin da IVF ke kulawa ba a sani ba.
Alternatives zuwa GnRH Agonists
Yana da muhimmanci a san cewa GnRH agonist s ba shine kawai zaɓi na IVF ba.
Sauran ya hada da masu adawa da GnRH, kamar Antagon (ganirelix acetate) da Cetrotide (cetrorelix).
Ba kamar GnRH agonists, GnRH antagonists ne FDA yarda don amfani a lokacin IVF magani. Kuna kuma dauke su don lokaci mafi tsawo. Wannan na iya rage adadin ko tsawon lokaci da kayi rinjayar sakamako.
Masu gwagwarmayar GnRH na iya zama mafi aminci, bisa ga wasu nazarin. Lokacin da ake amfani dashi a lokacin kula da haihuwa, mata suna da ƙananan haɗari na ciwon ɓarkewar ƙwayar mata na hyperstimulation idan aka kwatanta da GnRH agonists.
Dama yiwuwar cewa masu haɓaka GnRH sun fi tsada kuma ba dukkanin likitoci na haihuwa ba sun saba da amfani da su.
Sources:
Al-Inany HG, Youssef MA, Aboulghar M, Broekmans F, Sterrenburg M, Smit J, Abou-Setta AM. "GnRH Antagonists sun fi aminci fiye da Agonists: wani Ɗaukaka na Cochrane Review. "Hum Rerod Update. 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. "Binciken gwajin gwaji na maganin maganin hormone guda uku daban-daban a cikin shirin IVF: binciken da zai yiwu. " Eur J Obstet Gynecol Reprod Biol . 2002 Yuli 10; 103 (2): 140-5.
FDA Na'urar Sadarwa ta FDA: Ɗaukaka zuwa Binciken Tsaro na GnRH Agonists da Sanarwa ga Masu GnRH Agonists don Ƙara Sabon Bayanin Tsaro ga Labeling game da Ƙarin Rigar Ciwon sukari da Wasu Cututtuka na zuciya da jijiyoyin jini. FDA: Cibiyar Abinci da Drug.
Lupron Depot (leuprolide acetate for depot suspension) Injection, Foda, Lyophilized, Don dakatarwa . Abbott Laboratories.
Wood, Ros. GnRH.