ʻĀpana Luteal Pōkole: Nā kumu, nā ʻōuli, a me ka mālama ʻana

Anter

• Hōʻike Overview
• He aha ke kumu o ka pae luteal pōkole?
• Nā ʻōuli o kahi pae luteal pōkole
• Ke hōʻike nei i kahi pae luteal pōkole
• Hoʻomaʻo no ka pae luteal pōkole
• Nā hoʻopaʻapaʻa e pili ana i ka hemahema o ka pae luteal
• ʻAʻohe manaʻo kūkākūkā e pili ana pehea e ʻike pono ai i ka LPD
• ʻAʻohe hōʻike maopopo e hoʻokumu ka LPD i ka hānau ʻole
• Aia nā hōʻike palena palena e pili ana i ka pono o nā hoʻoponopono LPD
• Nā ʻanuʻu aʻe
• Q:
• A:

Hōʻike Overview

Loaʻa ka pōʻaiapuni ovulate i ʻelua mau hanana.

ʻO ka lā mua o kāu wā hope e hoʻomaka i ka pae follicular, kahi e hoʻomākaukau ai kahi follicle i kekahi o kāu ovaries e hoʻokuʻu i kahi hua manu. ʻO ka ovvation ke hoʻokuʻu ʻia kahi hua manu mai ka ovary i loko o ka Tube Fallopian.

Kapa ʻia ka ʻaoʻao hope o kāu pōʻaiapuni ka pae luteal, i mālama ʻia ma hope o ka hoʻoipoipo ʻana. ʻO ka pae luteal maʻamau mau ia. I kēia manawa, hoʻomākaukau kou kino no ka hiki i kahi hāpai keiki.

ʻO ka follicle i loko o kāu ovary i loaʻa ka hua manu ma mua o ka hoʻololi ʻana o ka ovulate i ka corpus luteum. ʻO ka hana mua o ka corpus luteum e hoʻokuʻu i ka hormone progesterone.

Hoʻoulu ʻo Progesterone i ka ulu ʻana a i ʻole ka mānoanoa o ka uhi o kāu kōpū. Hoʻomākaukau kēia i ka kōpū no ka implantation o kahi hua manu momona a i ʻole embryo.

He mea nui ka pae luteal i ka pōʻaiapuni reproductive. Loaʻa i kekahi mau wahine i kahi pae luteal pōkole, i ʻike ʻia ma ke ʻano he hemahema o ka pae luteal (LPD). ʻO ka hopena, ʻoi aku ka paʻakikī e lilo i hāpai.

He aha ke kumu o ka pae luteal pōkole?

ʻO kahi pae luteal pōkole kahi e mau ai 8 mau lā a ʻoi iki paha. Pono ka progesterone hormone i ka hoʻokomo a me kahi hāpai hāpai kūleʻa.Ma muli o kēia, hiki i kahi manawa luteal pōkole ke hāʻawi i ka infertility.

Ke hiki mai kahi papa luteal pōkole, ʻaʻole hūnā ke kino i ka nui o ka progesterone, no laila ʻaʻole ulu pono ka uhi uterine. He mea paʻakikī kēia no kahi hua manu momona e hoʻokomo i loko o ka kōpū.

Inā hāpai ʻoe ma hope o ka hoʻoipoipo ʻana, hiki i kahi manawa luteal pōkole ke hopena i ka hānau mua ʻole. No ke kākoʻo ʻana i kahi hāpai olakino, pono ka mānoanoa o ka uhi ʻana o ka uterine no kahi embryo e hoʻopili iā ia iho a ulu aʻe i pēpē.

Hiki ke kumu ʻia kahi pae luteal pōkole ma muli o ka holo pono ʻole o ka corpus luteum.

Inā ʻaʻole hūnā ka corpus luteum i ka progesterone, hiki i ka uhi ʻana o kou uterine ma mua o ka hoʻopili ʻana o ka hua manu i hoʻomomona ʻia. Hiki i kēia ke kumu i kahi pōʻai mua ma mua.

Hiki ke kumu ʻia ka LPD e kekahi mau ʻano, e like me:

• endometriosis, kahi kūlana kahi kino i loaʻa i loko o ka kōpū e hoʻomaka e ulu ma waho o ka kōpū
• polycystic ovarian syndrome (PCOS), kahi maʻi e hoʻonui i nā ovaries me nā cist liʻiliʻi
• nā maʻi thyroid, e like me ka overactive a i ʻole ka thyroid underactive, ka thyroiditis o Hashimoto, a me ka nele iodine
• momona
• anorexia
• hoʻoikaika kino nui loa
• ʻelemakule
• hoʻoluhi

Nā ʻōuli o kahi pae luteal pōkole

Inā loaʻa iā ʻoe kahi manawa luteal pōkole, ʻaʻole paha ʻoe e ʻike aia kahi pilikia. I ka ʻoiaʻiʻo, ʻaʻole paha ʻoe e kānalua i nā pilikia o ka momona a hiki i ka wā ʻaʻole hiki iā ʻoe ke hāpai.

Inā pilikia ʻoe i ka hāpai ʻana, hiki i kāu kauka ke hoʻokolokolo hou aku e ʻike inā he LPD kāu. Pākuʻi ʻia paha nā ʻōuli:

• ma mua o nā pōʻaiā maʻamau
• ke kiko ʻana ma waena o nā wā
• hiki ʻole ke hāpai
• hāʻule hāʻule

Ke hōʻike nei i kahi pae luteal pōkole

Inā ʻaʻole hiki iā ʻoe ke hāpai, ʻo ke kuhi ʻana i ke kumu kumu ke kumu mua e hoʻomaikaʻi ai i kāu kuhi o ka hapai ʻana. E kamaʻilio me kāu kauka e pili ana i ka infertility.

Hiki iā lākou ke hana i nā hoʻokolohua like ʻole e hoʻoholo ai inā pili ka infertility e kahi lā luteal pōkole a i ʻole kahi kūlana ʻē aʻe. E loaʻa paha iā ʻoe nā hoʻokolohua koko e nānā i kāu mau pae o nā hormones aʻe:

• follicle-stimulate hormone (FSH), kahi hōmona i hoʻokuʻu ʻia e ka pituitary gland e hoʻoponopono i ka hana ovary
• luteinizing hormone, ka hōmona e hoʻoulu ai i ka hoʻoipoipo
• progesterone, ka hōmona e hoʻonāukiuki i ka ulu ʻana o ka uhi ʻōpū

Eia hou, hiki i kāu kauka ke koi aku i kahi biopsy endometrial.

I ka wā o ka biopsy, ʻohiʻohi ʻia kahi mea liʻiliʻi o kāu uhi o ka uterine a nānā ʻia ma lalo o kahi microscope. Hiki i kāu kauka ke nānā i ka mānoanoa o ka pale.

Hiki paha iā lākou ke kauoha i kahi ultrasound pelvic e nānā i ka mānoanoa o kāu uhi uterine. ʻO kahi pelvic ultrasound kahi hōʻike kiʻi e hoʻohana i nā nalu kani e hana i nā kiʻi o nā meaola i kou wahi pelvic, me kāu:

• ovaries
• kōpū
• pāpū
• paipu fallopian

Hoʻomaʻo no ka pae luteal pōkole

Ke hōʻike koke kāu kauka i ke kumu kumu o kāu LPD, hiki paha i ka hāpai ʻana. I nā manawa he nui, mālama i ke kumu he kī i ka hoʻomaikaʻi ʻana i ka momona.

ʻO kahi laʻana, inā hopena kahi pae luteal pōkole mai ka hoʻoikaika kino a koʻikoʻi paha, ʻo ka hōʻemi ʻana i kāu pae o ka hana a me ke aʻo ʻana i ke koʻikoʻi hiki ke hoʻihoʻi i kahi papa luteal maʻamau.

Nā ʻenehana e hoʻomaikaʻi ai i nā pae koʻikoʻi e komo pū:

• e hoʻēmi nei i nā kuleana pilikino
• hoʻoikaika hanu hohonu
• noʻonoʻo
• hoʻoikaika kino

Hiki paha i kāu kauka ke koi aku i ka gonadotropin chorionic kanaka āpau (hCG), kahi hormone hāpai hāpai. Lawe i kēia waihona hiki ke kōkua i kou kino e hūnā i kahi pae kiʻekiʻe o ka hormone progesterone.

Paipai paha kāu kauka i ka lawe ʻana i nā mea hoʻopihapiha progesterone hou ma hope o ka hoʻoipoipo ʻana. Kōkua kēia i kāu lining uterine e ulu a hiki i kahi e hiki ai iā ia ke kākoʻo i ka implantation o kahi hua manu momona.

ʻO nā ʻano hana ʻē aʻe e hoʻonui ai i kou manawa e hāpai ai e hoʻopili i nā lāʻau, e like me ka clomiphene citrate, kahi e hoʻoulu ai i kāu mau ovaries e hana i nā follicle hou a hoʻokuʻu i nā hua hou.

ʻAʻole kūpono nā hana hoʻomaʻamaʻa āpau no kēlā me kēia wahine, no laila pono ʻoe e hana pū me kāu kauka e ʻike i ka lāʻau kūpono a i ʻole ka hoʻopihapiha.

Nā hoʻopaʻapaʻa e pili ana i ka hemahema o ka pae luteal

Aia kekahi mau hoʻopaʻapaʻa e pili ana iā LPD, me kekahi poʻe loea e nīnau nei i kāna kuleana i ka infertility a inā paha he ola maoli ia.

E nānā hou i kēia.

ʻAʻohe manaʻo kūkākūkā e pili ana pehea e ʻike pono ai i ka LPD

Ua hoʻohana lōʻihi ʻia ka biopsy endometrial ma ke ʻano he mea hana diagnostic no LPD. Eia naʻe, ua hōʻike ʻia nā noiʻi i hala iho nei ua hoʻopili maikaʻi ʻole ʻia nā hopena biopsy me ka momona.

ʻO nā pono hana ʻē aʻe no ka ʻike LPD me ke ana ʻana i nā pae progesterone a me ka nānā ʻana i ka mahana o ka basal kino (BBT).

Eia nō naʻe, ʻaʻole i hōʻoia ʻia kekahi o kēia mau ʻano i ka hilinaʻi ʻia ma muli o ka loli o nā pae hoʻohālikelike a me nā ʻokoʻa ma waena o nā kānaka.

ʻAʻohe hōʻike maopopo e hoʻokumu ka LPD i ka hānau ʻole

I ka 2012, ua hoʻokuʻu ka American Association of Reproductive Medicine i kahi ʻōlelo e pili ana i ka LPD a me ka infertility. I loko o kēia ʻōlelo, ua ʻōlelo lākou ʻaʻole lawa nā hōʻike noiʻi i kēia manawa e kākoʻo i kēlā LPD na lākou iho i kumu i ka infertility.

Ua ʻike ʻia ma hoʻokahi noi 2017 he pōʻaiapuni kaʻawale me kahi pae luteal pōkole i maʻa mau, ʻoiai he pōkole loa nā holo hou ʻana me kahi pae luteal pōkole. Ua hoʻopau ʻia e hiki i kahi wā luteal pōkole ke hoʻololi i ka wā pōkole, akā ʻaʻole pono ka lōʻihi, ka momona.

ʻO kahi noi ma 2018 i nā wahine e hana ana i ka vitro fertilization (IVF) i ka lōʻihi o ka luteal a me ka helu hānau. Ua ʻike lākou ʻaʻohe ʻokoʻa o ka helu hānau ma nā wahine me nā lā pōkole, awelika, a lōʻihi paha.

Aia nā hōʻike palena palena e pili ana i ka pono o nā hoʻoponopono LPD

Ua kūkākūkā ka ʻAmelika Hui Pū ʻIa o ka Reproductive Medicine i nā ʻano lapaʻau LPD like ʻole ma 2012. Ua ʻōlelo lākou ʻaʻohe lapaʻau i kēia manawa e hōʻike mau ʻia e hoʻomaikaʻi i nā hopena hāpai i nā wahine me nā pōʻaiapuni kūlohelohe.

Kuhi ʻia kahi loiloi 2015 Cochrane i ka hoʻohui me hCG a i ʻole progesterone i ka hana kōkua kōkua.

Ua ʻike ʻia ʻoiai ke alakaʻi ʻia ʻana o kēia mau ʻano hanau i nā hānau hānau he nui aʻe ma mua o kahi placebo a ʻaʻohe lāʻau lapaʻau.

Hoʻohana ʻia ʻo Clomiphene citrate i kekahi manawa e mālama iā LPD. Eia nō naʻe, aia i kēia manawa ka hopena.

Nā ʻanuʻu aʻe

ʻAʻole hiki ke hāpai a i ʻole ke ʻike ʻana i ka hāpai keiki hiki ke hoʻonāukiuki a hoʻonāwaliwali hoʻi, akā loaʻa ke kōkua.

He mea nui ʻaʻole ʻoe e nānā i nā kānalua o ka momona.

Ke ʻimi koke ʻoe i kōkua mai ke kauka e ʻike pono i ke kumu kumu, ʻo ka hiki koke iā ʻoe ke loaʻa i ka lāʻau a kōkua e hoʻonui i kou manawa e loaʻa ai kahi hāpai maikaʻi.

Q:

Pehea e hiki ai iā ʻoe ke haʻi inā ke ʻike nei ʻoe i kahi pae luteal pōkole a pono e ʻimi i ka lāʻau?

- hoʻomanawanui inoa ʻole

A:

He paʻakikī e ʻike inā ke ʻike nei ʻoe i kahi pae luteal pōkole ʻoiai ʻaʻohe ou mau hōʻailona a hōʻailona paha. Inā ʻoe e hoʻāʻo nei e hāpai a loaʻa ka pilikia, a i ʻole ke ʻike nei ʻoe i nā hāʻule ʻole, pono ʻoe e kamaʻilio me kāu kauka e ʻike inā he kūpono e hoʻāʻo ʻia no nā kumu o ka hānau ʻole. Pākuʻi paha kēia i ka hoʻāʻo ʻana no ka hemahema o ka pae luteal.

- Katie Mena, MD

Hōʻike nā pane i nā manaʻo o kā mākou loea loea. Hoʻomaopopo ʻike ʻike ʻole ʻia nā ʻike āpau a pono ʻole e noʻonoʻo ʻia he ʻōlelo aʻoaʻo olakino.