Ukungabi nalutho kwe-Endocrine kungumphumela wenkinga enkulu ye-hormonal eyabangela ukuvuthwa okungavamile noma ukungabi khona kwabo bonke abesifazane. Emadodeni, lesi sifo sibonakala ngokuphulwa kwe-spermatogenesis nokunciphisa ikhwalithi yesidoda. Enhliziyweni ye-endocrine ukungakwazi ukuhlukumezeka kukhona ukuphulwa ekusebenzeni kwegciwane le-thyroid, uhlelo lwe-hypothalamic-pituitary, i-gonads.
Ukwelapha okwesikhashana kwezifo ezinjalo emzimbeni kuholela ekusungulweni kokukhulelwa okufunayo ku-70-80% yazo zonke izimo ze-endocrine infertility. Ngaphandle kwalokho, indlela yodwa yokufeza umqondo ophumelelayo wengane yindlela yokufaka umanyolo we-in vitro. Ukukhethwa kwendlela yokwelashwa kwabantwana abangenasikhathi sinokuthi kunqunywe kuphela emva kokuhlola okuphelele kwabashade. Kubalulekile ukuthi bobabili bomshado baqede ukuhlolwa bese bahlaziya. Futhi njengoba zingabonakala izimbangela ezihlukahlukene zokuphulwa kwemisebenzi yesistimu yokuzala, ukwelashwa kuvame ukuqala ngalezo zizathu ezibaluleke kakhulu ekukhulelwe.
Ukwelapha kwe-endocrine infertility kufanele kuhlukaniswe futhi kukhethwe ngabanye. Imigomo yokukhetha indlela yokwelapha yilezi: izimbangela, ubude bokungabi nabantwana, ukutholakala kwezifo ezihambisanayo.
Ukungakwazi ukusebenza kwesigaba sokuqapha
Esinye sezimbangela zokuphulwa kwe-ovulation. Lezi zifo zihambisana nokungafaneleki komzimba ophuzi, okwenza kube nezinguquko zemfihlo e-endometrium. Ngamanye amazwi, i-endometrium enjalo ayifanelekile ukufakelwa kwe-ovum. I-pathology ingahlakulela ngezizathu ezihlukahlukene: ngenxa yokungasebenzi kahle kwe -roid, hyperprolactinemia esebenzayo, ukuvuvukala okungapheli kwezitho zangasese, hyperandrogenism. Cishe ngaso sonke isikhathi, ukwelashwa kuqala ngokusetshenziswa kwe-estrogen-progestogen, okusiza ukufeza i-ovulation. Ngokuvamile inhlanganisela yamakhoophyic amalungiselelo anqunywe. Isikhathi sokwamukelwa kwabo ngu-3-5 imijikelezo. Esikhathini esizayo, kungenzeka ukuba ukhethe ukwelashwa usebenzisa ukuvuselela okuqondile kwe-ovulation.
Uma kungabikho umphumela omuhle, amalungiselelo aqukethe ama-hormone e-gonadotropic (i-menogon, i-humegon) afakwe emgodini wezokwelapha, futhi i-chorionic gonadotropin inikwa umthamo ovulatory ngaphansi kwesiqondiso se-ultrasound. Uma ukungakwazi ukusebenza kwesigaba se-luteal kungumphumela we-hyperprolactinemia noma i-hyperandrogenism, i-ergot alkaloids noma i-dexamethasone (i-norprolac, i-parlodel) ifakwe ngaphezu kwalokho.
I-Syndrome ye-anovulation engapheliyo
Lesi sifo singabangelwa izifo ze-endocrine ezifana ne-hyperprolactinemia ye-non-tumor, umsuka we-polycystic ovary syndrome, i-hyperandrogenism ye-adrenal origin, ukungasebenzi komzimba we-hypothalamic-pituitary, kanye nesifo se-ovaries esimelana nesifo noma ama-ovaries aphelile. Inhloso yokwelashwa kwezifo ezinjalo ukugqugquzela i-ovulation. Endabeni ye-polycystic ovary syndrome, umphumela wokuvimbela utholakala okokuqala, futhi ukugqugquzela ama-ovarian kukhuthazwa ngokusebenzisa i-gonadotropin noma ama-anti-estrogen. Isikhathi sokwelashwa namahomoni kungumjikelezo wesi-3-5. Uma kungabikho umphumela omuhle, ukungenelela okuhlinzekwayo kwenziwa ngendlela yokuthengiswa kwemigodi, i-ovarian biopsy, kanye ne-electrocautery yama-ovari. Lezi zenzo zenziwa nge-laparoscopic ukufinyelela.
Ngokuphelelwa yisikhathi kwama-ovaries kanye nokuthuthukiswa kwama-ovarie anomelana, ukwelashwa okukhuthazayo akusebenzi. Ngakho-ke, ukwelashwa kokungabi nabantwana kungenziwa ngokusebenzisa i-egg donor ngemuva kwelashwa lokufaka endaweni, okwenziwe ngokusebenzisa ukwethulwa kobuchwepheshe be-in vitro kanye nokudlulisa ubuchwepheshe embryo ekusebenzeni kwezokwelapha.
Kuzokwelapha kukhona umbono wokuthi impumelelo engamaphesenti angu-100 ekwelapheni ukwelashwa kwe-hormonal kungalindelwa nge-diagnostic efanelekile etholakele uma kwenzeka ukwephulwa kwe-ovulation kubangwa imbangela eyodwa emndenini. Kodwa ngokwenza lokhu le nkhomba iyancipha futhi ingaba ngu-60-70%.