Isigaba sokugcina somjikelezo wokuya esikhathini, isigaba seluteal sidlala indima ebalulekile ekuzaleni kwabesifazane ngokuvumela, uma kwenzeka ukukhulelwa, ukufakwa kweqanda nokugcinwa kokukhulelwa. Kuhamba kanjani? Kufanele isekelwe nini? Ezinye izici zencazelo.

Umjikelezo wokuya esikhathini uhlukaniswe izigaba eziningana, ezibalulekile ekukhiqizeni i-oocyte kanye nokugcinwa kokukhulelwa ngemva kokukhulelwa:

• isigaba sokulandelana ihlala cishe izinsuku eziyi-14 kusukela osukwini lokuqala lwesikhathi sakho sokugcina. Phakathi nalesi sigaba, ama-oocyte amaningana ambozwe ku-follicle yawo yesibeletho, ingqamuzana elifana nesaka elincane, liqala ukuvuthwa ngaphansi kwethonya lehomoni ye-pituitary (FSH). Munye kuphela wabo ozoxoshwa.
• i-ovulation: Phakathi nalawa mahora angu-24 kuya kwangu-48, aphawula phakathi nomjikelezo we-ovarian, ukukhiqizwa kwehomoni ye-luteinizing (LH) kukhula kakhulu. Indima yayo: ukubangela ukuphuka kwe-follicle nokuxoshwa kwe-oocyte evuthiwe. Lokhu kubizwa ngokuthi i-ovular laying noma i-ovulation. Emahoreni alandela i-ovulation, i-oocyte iya eshubhuni ye-fallopian lapho ilinda khona ngaphambi kokuvundiswa ... noma ukuphuka.
• isigaba se-luteal yakha ingxenye yokugcina yomjikelezo wesibeletho. Lesi sikhathi esiphakathi kwe-ovulation kanye nesikhathi esilandelayo sithatha phakathi kwezinsuku eziyi-12 neziyi-14. Phakathi nesigaba se-luteal nangaphansi komphumela wokukhulelwa kwama-hormone, i-ovarian follicle iguqulwa ibe indlala ethatha igama layo ekushintsheni umbala wayo: umzimba ophuzi. Le corpus luteum iyisici esibalulekile ethembeni lokukhulelwa kwesikhathi esizayo. Ngempela, ngokukhiqiza i-estrogen ne-progesterone, ilungiselela ulwelwesi lwesibeletho (i-endometrium) ukuze lwamukele iqanda uma kwenzeka kuvuthwa. Kungenxa yalesi sizathu ukuthi ukuqina kakhulu phakathi nale ngxenye yesibili yomjikelezo kuze kube usuku lwama-20.

Ngemuva kwe-ovulation futhi ngakho-ke phakathi nesigaba se-luteal, izimo ezimbili zingenzeka:

I-oocyte ivundiswa.

 Kulokhu, umbungu uhlala ku-endometrium cishe izinsuku eziyi-8 ngemuva kokukhulelwa. Kuwukufakelwa. Khona-ke amahomoni amaningana adlala indima ebalulekile:

• i-hormone HCG, noma chorionic gonadotropin, ifihliwe ukuze i-corpus luteum iqhubeke nomsebenzi wayo izinyanga ezi-3. Yile hormone "ehlolwe" ekuhlolweni kokukhulelwa futhi ikuvumela ukuthi wazi ukuthi ukhulelwe yini.
• i-estrogen ne-progesterone zikhishwa yi-corpus luteum ukuze kugcinwe ukukhulelwa. Lokhu kukhiqizwa kwamahomoni kuqhubeka amasonto ambalwa kuze kube yilapho i-placenta isilungele ukuqinisekisa ukushintshana kwegesi nezakhi phakathi kukamama nengane.

I-oocyte ayivundisiwe.

 Uma kungazange kube khona ukuvundiswa, i-oocyte ayihlali ku-endometrium futhi i-corpus luteum ayisakhiqizi i-progesterone. Nge-desimpregnation yama-hormone, imikhumbi emincane ye-endometrium iyacinana futhi ulwelwesi lwamafinyila luyaphuka lubangele ukopha. Lena imithetho. Isigaba se-follicular siqala futhi.

Uphawu olusikisela kakhulu lwesigaba se-luteal ukwanda kwezinga lokushisa lomzimba. Lokhu kungenxa yokuthi ukukhiqizwa kwe-progesterone yi-corpus luteum kubangela ukuthi umzimba ufudumale cishe ngo-0,5 ° C. Ngemva kokwehla kwezinga lokushisa ngesikhathi se-ovulation (umzuzu omncane "oshisayo" womjikelezo), izinga lokushisa lomzimba lihlala likhona. cishe ku-37,5 ° C (ngokwesilinganiso) kuso sonke lesi sigaba sokugcina somjikelezo. ukuya esikhathini.

Esinye isici esimangalisa kakhulu sesigaba se-luteal: ukuvela kwesifiso sokudla. Ngempela, ukukhiqizwa kwama-hormone, ngokusho kocwaningo oluthile, kunomthelela ekwakhiweni kwekhalori phakathi nomjikelezo. Ngaphansi phakathi nesigaba se-follicular, izokwanda ikakhulukazi esigabeni sangaphambi kokuphuma kweqanda kanye nasesigabeni se-luteal sekwephuzile. Okubuzwayo: ukukhulelwa kwe-progesterone ne-estrogen, okungasho ukwehla kokukhiqizwa kwe-serotonin (ihomoni yokuzijabulisa) futhi ngenxa yalokho into "yesinxephezelo sokudla" lapho abesifazane bethanda ama-carbohydrate, i-calcium ne-magnesium.

Isigaba se-luteal siyisihloko sokubhekwa okukhethekile kwabesifazane abanobunzima bokukhulelwa noma abalahlekelwe yizisu ngokuphindaphindiwe. Isixazululo somugqa wokuqala siwukwenza ukuhlolwa kokuzala kanye nokuhlonza okungase kube khona ukuphazamiseka kokuvuthwa kwamaqanda, ikakhulukazi ngokubheka amajika okushisa kanye/noma ukuhlola amahomoni kanye ne-pelvic ultrasound.

 Uma kusolwa ukuthi i-subfertility, ukukhuthazwa kwe-ovarian kungase kunconywe kwezinye izimo. Kungaphakathi kohlaka lwalezi zindlela zokusiza ekuzaleni (ikakhulukazi i-IVF ne-IVF ICSII) lapho ukusekelwa kwesigaba seluteal kunquma khona. Ngempela, ngokugqugquzela ama-ovari ukuba athole amaqanda amaningi ngangokunokwenzeka (ngaphambi kokukhulelwa kwe-in vitro), ukwakheka okungalungile kwesigaba se-luteal kubangelwa. Imizimba ephuzi ephindaphindeka ngokukhuthazwa isuke isingakwazi ukukhiqiza i-progesterone eyanele, engabeka engcupheni ukufakwa kombungu (ama-embryo). Ngakho-ke, ukwelashwa kwenziwa ukuze kuthuthukiswe ukugcinwa kokukhulelwa. Khona-ke ama-molecule amabili athandwa:

• i-progesterone, evame ukunikezwa ngesitho sangasese sowesifazane,
• ama-agonists e-gonadotropin-releasing hormone (GnRH) akhuthaza ukukhiqizwa kwe-GnRH, ihomoni ekhuthaza ukuthuthukiswa kwe-corpus luteum.