Isigaba seLuteal esifutshane: oonobangela, iimpawu, kunye nonyango

Umxholo

• Ushwankathelo
• Yintoni ebangela isigaba se-luteal esifutshane?
• Iimpawu zesigaba se-luteal esifutshane
• Ukuchonga isigaba esifutshane se-luteal
• Unyango lwesigaba esifutshane se-luteal
• Iingxabano malunga nesiphene sesigaba se-luteal
• Akukho sivumelwano malunga nendlela yokufumanisa i-LPD
• Akukho bungqina bucacileyo bokuba i-LPD ibangela ukungachumi
• Kukho ubungqina obulinganiselweyo ekusebenzeni konyango lwe-LPD
• Amanyathelo alandelayo
• Q:
• A:

Ushwankathelo

Umjikelo we-ovulation uvela kwizigaba ezibini.

Umhla wokuqala wexesha lakho lokugqibela uqala isigaba sokulandelwa, apho ifollicle kwenye yamaqanda yakho ilungiselela ukukhupha iqanda. I-Ovulation kuxa iqanda likhutshwa kwi-ovary lisiya kwi-Fallopian tube.

Inxalenye yokugqibela yomjikelo wakho ibizwa ngokuba sisigaba se-luteal, esenzeka emva kwe-ovulation. Isigaba se-luteal sihlala ukusuka. Ngeli xesha, umzimba wakho ulungiselela ukubakho kokukhulelwa.

Ifollicle ekwisibeleko sakho equlethe iqanda ngaphambi kokutshintsha kwe-ovulation kwi-corpus luteum. Umsebenzi ophambili we-corpus luteum kukukhupha i-hormone progesterone.

Iprogesterone ivuselela ukukhula okanye ukuqina kwebala lesibeleko sakho. Oku kulungisa isibeleko ukuze kumiliselwe iqanda okanye umbungu.

Isigaba se-luteal sibalulekile kumjikelezo wokuzala. Abanye abantu basetyhini banokuba nesigaba esifutshane se-luteal, ekwabizwa ngokuba sisiphene sesigaba se-luteal (LPD). Ngenxa yoko, kuya kusiba nzima ukukhulelwa.

Yintoni ebangela isigaba se-luteal esifutshane?

Isigaba esifutshane se-luteal sesinye esihlala iintsuku eziyi-8 okanye ngaphantsi. Ihommone progesterone ibalulekile ekumiliseleni nasekumitheni ngempumelelo.Ngenxa yale nto, isigaba esifutshane se-luteal sinokufaka igalelo ekungachumi.

Xa isigaba esincinci se-luteal senzeka, umzimba awufihli ngokwaneleyo iprogesterone, ngoko ulayini wesibeleko awukhuli ngokufanelekileyo. Oku kwenza ukuba kube nzima ukuba iqanda elichumileyo lifakwe kwisibeleko.

Ukuba ukhulelwe emva kokuvuthwa, isigaba esincinci se-luteal sinokubangela ukuphuma kwesisu kwangoko. Ukugcina ukukhulelwa okunempilo, ulwelwesi lwesibeleko kufuneka lutyebile ngokwaneleyo ukuze umbungu uzincamathele kuwo kwaye ukhule ube lusana.

Isigaba esifutshane se-luteal sinokubangelwa kukusilela kwe-corpus luteum.

Ukuba i-corpus luteum ayifihli ngokwaneleyo iprogesterone, ulwelwesi lwakho lwesibeleko lunokuphalaza ngaphambi kokufakwa kweqanda. Oku kunokubangela ukuba sexesheni kwangoko.

I-LPD nayo inokubangelwa ziimeko ezithile, ezinje:

• i-endometriosis, imeko apho izicwili zifunyanwa ngaphakathi kwisibeleko ziqala ukukhula ngaphandle kwesibeleko
• i-polycystic ovarian syndrome (i-PCOS), isifo esibangela ukwandisa ii-ovari kunye nee-cysts ezincinci
• Iziphazamiso ze-thyroid, ezifana ne-thyroid okanye i-thyroid engasebenzi, i-Hashimoto's thyroiditis kunye ne-iodine
• ukutyeba kakhulu
• ianorexia
• umthambo ogqithisileyo
• ukwaluphala
• uxinzelelo

Iimpawu zesigaba se-luteal esifutshane

Ukuba unesigaba esifutshane se-luteal, awunakuqonda ukuba kukho ingxaki. Ngapha koko, usenokungayikrokeli imiba yokuzala de ube awukwazi ukukhawula.

Ukuba unengxaki yokukhulelwa, ugqirha unokuphanda ngakumbi ukubona ukuba unayo i-LPD. Iimpawu zingabandakanya:

• ngaphambi kwexesha eliqhelekileyo lokuya esikhathini
• ukubona phakathi kwamaxesha
• ukungakwazi ukukhulelwa
• ukuphuma kwesisu

Ukuchonga isigaba esifutshane se-luteal

Ukuba awukwazi ukukhulelwa, ukuqonda unobangela oyintloko linyathelo lokuqala lokuphucula amathuba okukhulelwa. Thetha nogqirha wakho malunga nokungachumi.

Banokuqhuba iimvavanyo ezahlukeneyo ukumisela ukuba ukungachumi kubangelwa sisigaba esifutshane seLuteal okanye enye imeko. Uya kuba novavanyo lwegazi ukujonga amanqanaba akho kula mahomoni alandelayo:

• i-follicle-evuselela i-hormone (FSH), ihomoni ekhutshwe yi-pituitary gland elawula ukusebenza kwe-ovary
• luteinizing hormone, ihomoni ebangela i-ovulation
• iprogesterone, ihomoni evuselela ukukhula komtya wesibeleko

Ukongeza, ugqirha wakho unokucebisa i-endometrial biopsy.

Ngexesha le-biopsy, isampulu encinci yolusu lwakho lwesibeleko iyaqokelelwa kwaye ihlolwe phantsi kwemicroscope. Ugqirha wakho unokujonga ubungakanani bethumbu.

Banokuyalela ukuba i-ultrasound ye-pelvic ivavanye ubungakanani bembumba yakho yesibeleko. I-pelvic ultrasound luvavanyo lokucinga olusebenzisa amaza esandi ukuvelisa imifanekiso yamalungu kwindawo yakho ye-pelvic, kubandakanya eyakho:

• amaqanda
• isibeleko
• umlomo wesibeleko
• Imibhobho

Unyango lwesigaba esifutshane se-luteal

Nje ukuba ugqirha wakho achaze unobangela we-LPD yakho, ukukhulelwa kunokwenzeka. Kwiimeko ezininzi, ukunyanga unobangela kubalulekile ekuphuculeni ukuchuma.

Umzekelo, ukuba isigaba esifutshane se-luteal sisiphumo sokuzilolonga kakhulu okanye uxinzelelo, ukunciphisa inqanaba lomsebenzi wakho kunye nolawulo loxinzelelo lokufunda kunokubangela ukubuya kwesigaba esiqhelekileyo se-luteal.

Iindlela zokuphucula amanqanaba oxinzelelo zibandakanya:

• ukunciphisa uxanduva lomntu
• imithambo yokuphefumla nzulu
• ukucamngca
• umthambo ofanelekileyo

Ugqirha wakho unokucebisa ngokuxhasa i-chorionic gonadotropin (hCG), eyihomoni yokukhulelwa. Ukuthatha olu ncediso kunokunceda umzimba wakho ukhuphe inqanaba eliphezulu lehomoni yeprogesterone.

Ugqirha wakho unokucebisa ukuba uthathe iipilisi zeprogesterone ezongezelelweyo emva kokuvuthwa. Oku kunceda ulwelwesi lwakho lwesibeleko ukuba lukhule luye kwinqanaba apho lunokuxhasa ukumiliselwa kweqanda elichumileyo.

Ezinye iindlela zokunyusa amathuba okuba ukhulelwe zibandakanya amayeza, anjenge-clomiphene citrate, evuselela amaqanda akho ukuba avelise iifollic ezininzi kwaye akhulule amaqanda amaninzi.

Ayizizo zonke iindlela zonyango ezisebenza kuwo wonke umntu wasetyhini, ke kuya kufuneka usebenze ngokusondeleyo nogqirha wakho ukufumana elona nyango liphumelelayo okanye isongezelelo.

Iingxabano malunga nesiphene sesigaba se-luteal

Kukho iimpikiswano ngokubhekisele kwi-LPD, ezinye iingcali zibuza ngendima yazo ekungachumi nokuba sele ikho.

Makhe sijonge koku ngakumbi.

Akukho sivumelwano malunga nendlela yokufumanisa i-LPD

I-biopsy ye-endometriya kudala isetyenziswa njengesixhobo sokuqonda isifo se-LPD. Nangona kunjalo, izifundo ezidlulileyo zibonise ukuba iziphumo ze-biopsy zihambelana kakubi nokuzala.

Ezinye izixhobo zokuchongwa kwe-LPD kubandakanya ukulinganisa amanqanaba eprogesterone kunye nokujonga ubushushu bomzimba osisiseko (i-BBT).

Nangona kunjalo, akukho nanye kwezi ndlela engqinisisiweyo inokuthenjwa ngenxa yokwahluka kweenqobo kunye nokwahluka phakathi kwabantu.

Akukho bungqina bucacileyo bokuba i-LPD ibangela ukungachumi

Ngo-2012, uMbutho waseMelika woNyango lokuZala wakhupha ingxelo malunga ne-LPD kunye nokungachumi. Kule ngxelo, bathi okwangoku akukho bungqina bophando baneleyo bokuxhasa ukuba i-LPD ngokwayo ibangela ukungachumi.

Olunye uphononongo luka-2017 lafumanisa ukuba umjikelo ozimeleyo onesigaba esifutshane se-luteal wayeqhelekile, ngelixa imijikelo ephindaphindayo enesigaba esifutshane se-luteal yayinganqabile. Igqibe kwelokuba isigaba esimfutshane se-luteal sinokuchaphazela ixesha elifutshane, kodwa hayi ixesha elide, ukuchuma.

Isifundo se-2018 kwabasetyhini abaphantsi kwe-vitro fertilization (IVF) bajonge ubude besigaba se-luteal kunye nenqanaba lokuzalwa. Bafumanise ukuba akukho mahluko kwinqanaba lokuzalwa kwabasetyhini abanezigaba ezimfutshane, eziphakathi, okanye ezide.

Kukho ubungqina obulinganiselweyo ekusebenzeni konyango lwe-LPD

Umbutho waseMelika woNyango lokuZala uxoxe ngeendlela ezahlukeneyo zonyango lwe-LPD ngo-2012. Baye bathi okwangoku akukho nyango lubonakaliswe ngokungaguqukiyo ukuphucula iziphumo zokukhulelwa kwabasetyhini abanemijikelezo yendalo.

Ukuphononongwa ngo-2015 kweCochrane kuvavanye ukongezwa kunye ne-hCG okanye iprogesterone kuncediso lokuvelisa kwakhona.

Kufumanise ukuba nangona olu nyango lungakhokelela ekuzalweni ngakumbi kunaleyo ye-placebo okanye kungabikho nyango, ubungqina obupheleleyo bokusebenza kwabo babungangqinelani.

I-Clomiphene citrate ngamanye amaxesha isetyenziselwa ukunyanga i-LPD. Nangona kunjalo, ngoku zisebenza ngokukuko.

Amanyathelo alandelayo

Ukungakwazi ukukhulelwa okanye ukuphuphuma kwesisu kunokuphazamisa kwaye kudimaze, kodwa uncedo luyafumaneka.

Kubalulekile ukuba ungazikhathaleli ukukrokrela ukuchuma.

Ngokukhawuleza ufuna uncedo kugqirha ukuze ufumanise unobangela, kwakamsinya unokufumana unyango kwaye uncede wandise ithuba lakho lokukhulelwa okunempilo.

Q:

Ungazi njani ukuba ufumana isigaba esifutshane se-luteal kwaye kufuneka ufune unyango?

-Isigulana esingaziwayo

A:

Kunzima ukwazi ukuba ngaba ufumana isigaba se-luteal esifutshane njengoko usenokungabinazo iimpawu okanye iimpawu. Ukuba uzama ukukhulelwa kwaye unobunzima, okanye ufumana ukuphuphuma kwesisu, kuya kufuneka uthethe nogqirha wakho ukuze ubone ukuba kufanelekile na ukuvavanywa koonobangela bokungachumi. Oku kunokubandakanya ukuvavanywa kwesiphene sesigaba se-luteal.

-Katie Mena, MD

Iimpendulo zimele uluvo lweengcali zethu zonyango. Yonke imixholo inolwazi ngokungqongqo kwaye akufuneki ukuba ithathelwe ingqalelo njengengcebiso yezonyango.