Okuqukethwe
I-anti-Müllerian hormone: yini wonke amantombazane angama-nulliparous okufanele azi ngayo
Izinkomba zayo zibonisa ngokusobala kakhulu impilo yesistimu yokuzala. Uma uhlela ukubeletha kuphela ngemva kweminyaka engu-35, kumane kudingekile ukuba uhlolwe le hormone.
I-hormone ye-Anti-Müllerian iyinkomba ebaluleke kakhulu. Lena into evumela udokotela ukuba ahlole amandla okuzala wesifazane kanye nezinguquko ezingenzeka emsebenzini wama-ovari.
i-gynecologist-reproductologist ehamba phambili yenethiwekhi yezikhungo zokuzala kanye nezakhi zofuzo "Nova Clinic"
I-anti-Müllerian hormone - AMG - ikhona futhi emzimbeni wesilisa. Enkambweni yokuthuthukiswa kwe-intrauterine yokuqala, nguye onquma ukuthuthukiswa kombungu wesilisa. Ebudaleni, emzimbeni wesilisa, i-hormone ye-anti-Müllerian iyaqhubeka nokufihlwa ngamaseli athile emasendeni, futhi ukuhlolwa kwezinga laleli hormone kusiza ekutholeni izinhlobo ezinzima zokungazali kwabesilisa.
Emzimbeni wesifazane, i-hormone ye-anti-Müllerian ikhiqizwa amaseli atholakala kuma-ovarian follicles. Inombolo yama-follicles iyahlukahluka empilweni yonke futhi inqunyelwe. Kuyoba esiphezulu esiteji sokuthuthukiswa kwe-intrauterine.
Ngeshwa, uma inani le-follicle lincishisiwe, awukwazi ukuphoqa umzimba ukuba ukhiqize ezengeziwe. Lapho izimpahla ziphela, ukuya esikhathini kuzofika. Lena inqubo yemvelo yokuqedwa komsebenzi wokuzala, lapho ukusebenza okuvamile kwesitho kanye nesigqi sokujikeleza kokuya esikhathini kuba yinto engenakwenzeka.
Ekuqaleni komjikelezo ngamunye wokuya esikhathini, inani elithile lama-follicles lingena ekukhuleni okusebenzayo ku-ovary. Owesifazane omncane, iningi labo lingaba emjikelezweni owodwa: eminyakeni engu-20-25 kuya ku-20-30, ku-40 - 2-5 kuphela. Lezi follicle, eseziqalile ukukhula, zibonakala ngokucacile ku-ultrasound. Abukeka njengamabhamuza amancane angamamilimitha angama-3-6 ngosayizi.
Lezi follicles zikhethwa endaweni yokugcina amaqanda. I-reserve iyindawo yokugcina yonke i-follicles. Futhi inqubo yokukhetha ibizwa ngokuthi ukuqasha. Kulula ukucabanga lokhu njenge-akhawunti yemali ebhange elithembekile, lapho inani elithile lidonswa khona nyanga zonke. Uma uphansi inani lemali ku-akhawunti, liyancipha inani elizosetshenziswa kule nyanga. Kungakho, ngokuya ngeminyaka, ngokuncipha kwemvelo endaweni yokugcina ama-ovarian, inani lama-follicles angena ekukhuleni emjikelezweni onikeziwe liyancipha. Lokhu kubonakala ngokucacile ku-ultrasound.
Isiphetho salezi follicle ezikhethiwe sinqunywa kusengaphambili. Omunye wabo uzoba namandla, ngesikhathi se-ovulation, iqanda lizokhishwa kulo, ukuze, mhlawumbe, linikeze ukukhulelwa. Abanye bazoyeka ukukhula, bathole i-atresia (empeleni, intuthuko ehlehlayo, esikhundleni sezicubu ezixhumeneyo).
Kungani i-AMG ibizwa ngokuthi isivivinyo se-litmus sempilo yabesifazane
I-hormone ye-anti-Müllerian ikhiqizwa amaseli alawo ma-follicles agcinwe. Kungani ibalulekile? Njengoba kuyinzuzo enkulu yale nkomba ngaphezu kwamanye amahomoni nokubala inani lama-follicle ku-ultrasound scan.
Inani lama-follicles, njengezinkomba zamanye amahomoni, lingahluka kuye ngomjikelezo. Lokhu kungase kube ngenxa yezinto ezingavamile zobukhulu be-follicles, ubude bomjikelezo, ukwelashwa kwe-hormonal eyandulele. Kodwa i-hormone ye-anti-Müllerian izohlala izinzile futhi izimele. Izobonisa isimo sangempela kanye nenani lama-follicles hhayi kulo mjikelezo othile, kodwa endaweni yokugcina ama-ovarian iyonke. Lena inkomba elula futhi ebalulekile. Ukwehla kwe-ovarian reserve kuhlotshaniswa nokwehla kwamazinga e-anti-Müllerian hormone, futhi ukwehla kwalezi zinkomba okuvame ukusikhathaza kakhulu.
Isikhathi sokuhlola izinga le-AMH
ufuzo... Uma emgqeni wesifazane (umama, ugogo, udade) kwakukhona ukungahambi kahle kokuya esikhathini, ukungazali, ukuphuma esikhathini sokuqala, khona-ke lokhu kungase kube isignali esabekayo futhi kubonise ukuthambekela kofuzo ekuwohlokeni ngaphambi kwesikhathi kwe-ovarian reserve.
Ukusebenza ezithweni ze-pelvic, ikakhulukazi kuma-ovari. Izinga le-AMG lizosiza ukuqonda isimo sesiqiwi futhi ngezinye izikhathi lishintshe amaqhinga okusebenza. Ngemuva kwanoma yikuphi ukungenelela kuma-ovari, indawo yokugcina izokwehla. Izinga le-AMH lizosiza ekunqumeni ukubikezela kanye nezinhlelo zokuzala.
Ukungahambi kahle kokuya esikhathini… Umjikelezo wokuya esikhathini ongavamile noma, ngokuphambene nalokho, umjikelezo wokuya esikhathini ovamile, kodwa oqhubeka ufinyezwa futhi uyisizathu sokunikela ngegazi nge-AMG. Izimpawu zokuqala zokwehla okungabonakali endaweni yokulondoloza zibukeka njengokuncipha kwesikhathi somjikelezo (ngaphansi kwezinsuku ezingama-26).
Ukuba ngumama kwephuzile… Eqondiswa ukuphila komphakathi okusebenzayo, amantombazane esimanje ahlehlisa ukukhulelwa kuze kube mdala. Isistimu yokuzala yabesifazane iqala ukubhekana nobunzima bezinto eziphilayo ngokukhulelwa ngemva kweminyaka engama-35. Kulokhu, izinkinga eziningi zingagwenywa ngokwazi kusengaphambili isimo se-ovarian reserve. Ngezinye izikhathi kunengqondo ukuguqula ama-oocyte. Lena inqubo yezokwelapha evumela ukuthi ulondoloze amaqanda akho ngokudlula ukwehla kwemvelo endaweni yokugcina amaqanda engakwazi ukumiswa. Noma yiziphi izinkinga ngokukhulelwa noma ukuhlela ukukhulelwa ngemva kweminyaka engama-35 ziyizinkomba zokuhlola izinga le-AMH.
Ungalungiselela kanjani ukuhlolwa kwe-AMG
Ukuhlolwa kwegazi kwe-anti-Müllerian hormone kungenziwa nganoma yiluphi usuku lomjikelezo wokuya esikhathini. Njengomthetho, i-AMG inikezwa kanye namanye amahomoni wesifazane, okumele abukwe ekuqaleni komjikelezo (ngezinsuku ezingu-2-5).
Ngaphambi kokuthatha i-AMG, kunconywa ukuthi ugweme ukuvivinya umzimba ngokweqile nokubhema. Ngendlela, kunezifundo eziningi eziqinisekisa umphumela omubi kakhulu wokubhema esimweni se-ovarian reserve kanye nokwehla kwamazinga e-AMH.
Kukhona futhi okuthile okungaba nomthelela omuhle ekugxilweni kwe-anti-Müllerian hormone. Ngokweminye imibiko, isinxephezelo sokuntuleka kwevithamini D kuholela ekwandeni kwamazinga e-AMH. Kufanelekile ukusho ngokushesha iphuzu lokuthi akunakwenzeka ukwandisa isimo sangempela se-ovarian reserve, okungukuthi, inani lama-follicles. Ngeshwa, okwamanje ayikho indlela yokwenza lokhu, njengoba ukunikezwa kwamaqanda kuma-ovari kunqunyelwe.
Ukwehla nokwenyuka kwamazinga e-AMH kubonisani?
Isimo esijwayelekile ukugcinwa kwama-ovarian ngeminyaka ehlukene kubhekwa ngokwesilinganiso kusuka ku-2 kuye ku-4 ng / ml.
Ukuncipha kwe-ovarian reserve izinga le-AMH ngu-1,2 ng / ml. Ukubikezelwa kokuzala ngokuncipha kwe-AMH ngaphansi kuka-0,5 ng / ml kuba kubi kakhulu, futhi kwezinye izimo lokhu kungase kubonise isidingo se-IVF ngamaseli abanikeli. Lapha, ukufinyelela okufika ngesikhathi kudokotela nokuhlelela ukukhulelwa kubaluleke kakhulu.
Kunezimo lapho i-AMH inyuswa. Amazinga angaphezu kuka-6,8 ng / ml angase ahlotshaniswe ne-polycystic ovary syndrome (PCOS) noma i-multifollicular ovary syndrome. Ukwanda okuphawulekayo kwe-AMH ngaphezu kwe-13 ng / ml kudinga ukuhlolwa okwengeziwe nokukhishwa kwe-oncological pathology, kodwa ngokuvamile kutholakala ezinhlotsheni ezithile ze-PCOS.
Kungakhathaliseki ukuthi ingakanani izinga le-AMH, udokotela kuphela onganikeza ukuhlolwa okuphelele kwesimo. Uma inkomba yehliswa, okokuqala, kufanele ufune iseluleko sochwepheshe.