Isigaba Esifushane Luteal: Izimbangela, Izimpawu, kanye Nokwelapha

-Delile

• Ukubuka konke
• Yini ebangela isigaba esifushane se-luteal?
• Izimpawu zesigaba esifushane se-luteal
• Ukuhlonza isigaba esifushane se-luteal
• Ukwelashwa kwesigaba esifushane se-luteal
• Izingxabano mayelana nesici se-luteal phase
• Akukho ukuvumelana mayelana nokuthi ungahlonza kanjani i-LPD
• Abukho ubufakazi obucacile bokuthi i-LPD ibangela ukungabi nenzalo
• Kunobufakazi obunqunyelwe ekusebenzeni kahle kwemithi yokwelashwa kwe-LPD
• Izinyathelo ezilandelayo
• Q:
• A:

Ukubuka konke

Umjikelezo we-ovulation uvela ngezigaba ezimbili.

Usuku lokuqala lwesikhathi sakho sokugcina luqala isigaba sokulandelana, lapho i-follicle kwesinye sama-ovari yakho ilungiselela ukukhipha iqanda. Ukuvuthwa kulapho iqanda likhishwa esibelethweni lingene kushubhu le-Fallopian.

Ingxenye yokugcina yomjikelezo wakho ibizwa ngokuthi isigaba se-luteal, esenzeka ngemuva kwe-ovulation. Isigaba se-luteal sihlala kusuka ku-. Ngalesi sikhathi, umzimba wakho ulungiselela ukuthi kungenzeka ukhulelwe.

Ifollicle esibelethweni sakho ebiqukethe iqanda ngaphambi kokushintshwa kwe-ovulation kwi-corpus luteum. Umsebenzi oyinhloko we-corpus luteum ukukhipha i-hormone progesterone.

Iprogesterone ivuselela ukukhula noma ukuqina kohlaka lwesibeletho sakho. Lokhu kulungisa isibeletho ukufakwa kweqanda elikhulelwe noma umbungu.

Isigaba se-luteal sibalulekile emjikelezweni wokuzala. Abanye besifazane bangaba nesigaba esifushane se-luteal, esaziwa nangokuthi i-luteal phase defect (LPD). Ngenxa yalokho, kuba nzima ukukhulelwa.

Yini ebangela isigaba esifushane se-luteal?

Isigaba esifushane se-luteal ngesinye esihlala izinsuku eziyi-8 noma ngaphansi. I-hormone progesterone ibalulekile ekufakweni nasekukhulelweni okuyimpumelelo. Ngenxa yalokhu, isigaba esifushane se-luteal singafaka isandla ekungazali.

Lapho kwenzeka isigaba esifushane se-luteal, umzimba awukhiphi i-progesterone eyanele, ngakho ulwelwesi lwesibeletho aluthuthuki kahle. Lokhu kwenza kube nzima ukuthi iqanda elikhulelwe lifakwe esibelethweni.

Uma ukhulelwa ngemuva kokuvuthwa, isigaba esifushane se-luteal singaholela ekukhulelweni kwesisu kuqala. Ukugcina ukukhulelwa okunempilo, ulwelwesi lwesibeletho kufanele lube lukhulu ngokwanele ukuze umbungu uzinamathele futhi ukhule ube ingane.

Isigaba esifushane se-luteal futhi singaba ngenxa yokwehluleka kwe-corpus luteum.

Uma i-corpus luteum ingakhiphi iprogesterone eyanele, ulwelwesi lwakho lwesibeletho lungachitheka ngaphambi kokufakwa kwamaqanda avundisiwe. Lokhu kungadala umjikelezo wokuqala wokuya esikhathini.

I-LPD nayo ingabangelwa izimo ezithile, njenge:

• i-endometriosis, isimo lapho izicubu ezivame ukutholakala ngaphakathi kwesibeletho ziqala ukukhula ngaphandle kwesibeletho
• i-polycystic ovarian syndrome (i-PCOS), ukuphazamiseka okubangela ama-ovari akhulisiwe ngama-cysts amancane
• ukuphazamiseka kwe-thyroid, njenge-thyroid engasebenzi ngokweqile noma engasebenzi kahle, i-Hashimoto's thyroiditis, nokuntuleka kwe-iodine
• ukukhuluphala ngokweqile
• i-anorexia
• ukuzivocavoca ngokweqile
• ukuguga
• ukucindezeleka

Izimpawu zesigaba esifushane se-luteal

Uma unesigaba esifushane se-luteal, ungahle ungaboni ukuthi kunenkinga. Eqinisweni, ungahle ungasoli izingqinamba zokuzala uze ungakwazi ukukhulelwa.

Uma unenkinga yokukhulelwa, udokotela wakho angaphenya ngokuqhubekayo ukuze abone ukuthi unayo yini i-LPD. Izimpawu zingafaka:

• ngaphambi kwemijikelezo ejwayelekile yokuya esikhathini
• ukubona phakathi kwezikhathi
• ukungakwazi ukukhulelwa
• ukukhulelwa kwesisu

Ukuhlonza isigaba esifushane se-luteal

Uma ungakwazi ukukhulelwa, ukuthola imbangela eyisisekelo kuyisinyathelo sokuqala sokwenza ngcono izingqinamba zakho zokukhulelwa. Khuluma nodokotela wakho mayelana nokuzala.

Bangakwazi ukwenza izivivinyo ezahlukahlukene ukuthola ukuthi ukungabi nenzalo kubangelwa isigaba esifushane se-luteal noma esinye isimo. Kungenzeka uhlolwe igazi ukuhlola amazinga akho ama-hormone alandelayo:

• i-follicle-stimulating hormone (FSH), i-hormone ekhishwe yi-pituitary gland elawula ukusebenza kwe-ovary
• i-luteinizing hormone, i-hormone ebangela i-ovulation
• iprogesterone, i-hormone egqugquzela ukukhula kolwelwesi lwesibeletho

Ngaphezu kwalokho, udokotela wakho angancoma i-endometrial biopsy.

Ngesikhathi se-biopsy, kuqoqwa isampula encane yolwelwesi lwakho lwesibeletho futhi ihlolwe ngaphansi kwesibonakhulu. Udokotela wakho angabheka ubukhulu bendwangu.

Bangaphinde ba-ode i-ultrasound ye-pelvic ukuthi ihlole ubukhulu besikhumba sakho sesibeletho. I-pelvic ultrasound isivivinyo sokuthatha izithombe esisebenzisa amagagasi omsindo ukukhiqiza izithombe zezitho endaweni yakho ye-pelvic, kufaka phakathi eyakho:

• amaqanda
• isibeletho
• umlomo wesibeletho
• amashubhu we-fallopian

Ukwelashwa kwesigaba esifushane se-luteal

Lapho nje udokotela wakho ekhomba imbangela eyimbangela ye-LPD yakho, ukukhulelwa kungenzeka. Ezimweni eziningi, ukuphatha imbangela kuyisihluthulelo sokwenza ngcono ukuzala.

Isibonelo, uma isigaba esifushane se-luteal sivela ekuzivocavoca ngokweqile noma ekucindezelekeni, ukunciphisa izinga lomsebenzi wakho nokulawulwa kwengcindezi kungadala ukubuya kwesigaba esijwayelekile se-luteal.

Amasu wokuthuthukisa amazinga okucindezeleka afaka:

• ukunciphisa izibopho zomuntu siqu
• izivivinyo zokuphefumula okujulile
• ukuzindla
• ukuzivocavoca umzimba ngokulingene

Udokotela wakho futhi angancoma ukwengeza i-chorionic gonadotropin (hCG), eyi-hormone yokukhulelwa. Ukuthatha lesi sithasiselo kungasiza umzimba wakho ukuthi ubambe izinga eliphakeme le-hormone progesterone.

Udokotela wakho futhi angancoma ukuthatha izengezo ezengeziwe ze-progesterone ngemuva kwe-ovulation. Lokhu kusiza ulwelwesi lwakho lwesibeletho lukhule luze lube sezingeni lapho lungasekela ukufakelwa kweqanda elikhulelwe.

Ezinye izindlela zokwandisa amathuba akho okukhulelwa zibandakanya imishanguzo, njenge-clomiphene citrate, evuselela ama-ovari akho ukuthi akhiqize ama-follicles amaningi futhi akhulule amaqanda amaningi.

Akuzona zonke izindlela zokwelapha ezisebenza kuwo wonke umuntu wesifazane, ngakho-ke kuzofanele usebenze eduze nodokotela wakho ukuthola umuthi osebenza kahle noma isengezo.

Izingxabano mayelana nesici se-luteal phase

Kunezimpikiswano ezithile maqondana ne-LPD, lapho abanye ochwepheshe bebuza iqhaza layo ekungazali nokuthi ngabe ikhona ngempela yini.

Ake sibheke lokhu ngokuqhubekayo.

Akukho ukuvumelana mayelana nokuthi ungahlonza kanjani i-LPD

I-endometrial biopsy sekuyisikhathi eside isetshenziswa njengethuluzi lokuxilonga le-LPD. Kodwa-ke, izifundo ezedlule zikhombisile ukuthi imiphumela ye-biopsy ayihambisani kahle nokuzala.

Amanye amathuluzi wokuxilongwa kwe-LPD afaka phakathi ukukala amazinga we-progesterone kanye nokuqapha izinga lokushisa lomzimba we-basal (BBT).

Kodwa-ke, azikho kulezi zindlela ezifakazelwe ukuthi zithembekile ngenxa yokwehluka kwenqubo nokwehluka phakathi kwabantu.

Abukho ubufakazi obucacile bokuthi i-LPD ibangela ukungabi nenzalo

Ngo-2012, i-American Society of Reproductive Medicine yakhipha isitatimende mayelana ne-LPD nokungabi nenzalo. Kulesi sitatimende, bathe njengamanje abukho ubufakazi obanele bocwaningo ukusekela ukuthi i-LPD iyodwa idala ukungabi nenzalo.

Ucwaningo olulodwa lwango-2017 lwathola ukuthi umjikelezo ohlukanisiwe onesigaba esifushane se-luteal wayevamile, kuyilapho imijikelezo ephindaphindekayo enesigaba esifushane se-luteal yayingavamile. Kuphethe ngokuthi isigaba esifushane se-luteal singathinta ukuzala kwesikhashana, kepha hhayi isikhathi eside.

Ucwaningo lwango-2018 kwabesifazane abenza in vitro fertilization (IVF) lubheke ubude besigaba se-luteal nezinga lokuzalwa. Bathola ukuthi akukho mehluko ezingeni lokuzalwa kwabesifazane abanezigaba ezimfishane, ezijwayelekile, noma ezide.

Kunobufakazi obunqunyelwe ekusebenzeni kahle kwemithi yokwelashwa kwe-LPD

I-American Society of Reproductive Medicine yaxoxa ngezindlela ezahlukahlukene zokwelashwa kwe-LPD ngonyaka ka-2012. Bathe okwamanje akukho ukwelashwa okuye kwaboniswa ngokungaguquki ukwenza ngcono imiphumela yokukhulelwa kwabesifazane abanemijikelezo yemvelo.

Ukubuyekezwa kukaCochrane ko-2015 kuhlolwe ukwengezwa nge-hCG noma i-progesterone ekukhiqizeni okusizwayo.

Kutholakale ukuthi yize lezi zindlela zokwelashwa zingaholela ekuzalweni okuningi kune-placebo noma ukwelashwa okungatholakali, ubufakazi obuphelele bokusebenza kwabo bebungaphelele.

I-Clomiphene citrate kwesinye isikhathi isetshenziselwa ukwelapha i-LPD. Noma kunjalo, okwamanje kusebenza ngokusebenza kwayo.

Izinyathelo ezilandelayo

Ukungakwazi ukukhulelwa noma ukuphuphunyelwa yisisu kungakhungathekisa futhi kudumaze, kepha usizo luyatholakala.

Kubalulekile ukuthi ungazinaki izinsolo zokuzala.

Ngokushesha lapho ufuna usizo kudokotela ukuthola ukuthi yini imbangela, ngokushesha ungathola ukwelashwa futhi usize ekwandiseni ithuba lakho lokukhulelwa okunempilo.

Q:

Ungabona kanjani ukuthi uhlangabezana nesigaba esifushane se-luteal futhi udinga ukufuna ukwelashwa?

- Isiguli esingaziwa

A:

Kunzima ukwazi ukuthi ngabe uhlangabezana nesigaba esifushane se-luteal njengoba ungahle ungabi nazimpawu noma izimpawu. Uma uzama ukukhulelwa futhi unenkinga, noma uhlangabezana nokuphuphuma kwezisu, kufanele ukhulume nodokotela wakho ukuze ubone ukuthi kufanele yini ukuhlolwa ngezimbangela zokuzala. Lokhu kungafaka ukuhlolwa kwesici sesigaba se-luteal.

- UKatie Mena, MD

Izimpendulo zimelela imibono yochwepheshe bethu bezokwelapha. Konke okuqukethwe kunolwazi oluqinile futhi akufanele kuthathwe njengezeluleko zezokwelapha.