Hormoni, trombofilije i putokazi

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Mislim da je ova tema vazna jer se u njoj nalaze bitne informacije koje mogu puno da pomognu.

Zahvaljujuci Bepcu i mojim dragim cekalicama (prijateljicama i najvecoj podrsci), uspela sam da pronadjem odgovore na mnoga pitanja.

Nisam doktor, ali sam se informisala tako, da meni kao laiku bude jasno i razumljivo i mislim da je ok da to podelim sa svima nama koje pokusavamo da nadjemo i razumemo uzroke za nase probleme.

U mom slucaju za spontani pobacaj.

 

Dakle, sve ove informacije sam dobila konsultujuci ginekologa, urologa, geneticara, endokrinologa i hematologe i po njihovoj preporuci radila navedene analize. Sta mi nije bilo bas jasno, objasnili su mi, a kod kuce je pomogla i Wikipedia. Sta nisam umela da objasnim svojim recima, konsultovala sam internet i Bebac :).

 

Pa, da krenemo redom.

 

Najcesci uzrok steriliteta su hormoni i sa njima se ne treba igrati jer mogu da nas uvedu u rani klimaks ili da izazovu mnogo vece probleme, pa i smrt. Hormone luce stitna zlezda, hipofiza, jajnici, nadbubrezna zlezda, pankreas..., a bitno je da je i jetra dobra, jer ih ona preradjuje i visak izbacuje iz organizma.

Ono najvaznije je dan ciklusa u kojem treba ispitivati hormone, jer u suprotnom, rezultati nece biti merodavni!

 

Ciklus se deli u 3 faze:

1. Folikularna faza - rast i sazrevanje folikula (i jajne celije u njemu). Traje od prvog dana menstruacije, 1. dc do 14.dc (ukoliko je ciklus idealan, na 28 dana). Dakle, ukupno trajanje ove faze je od 10 do 14 dana (kako kod koga).

2. Ovulatorna faza - traje 1 do 2 dana,

3. Lutalna faza (faza zutog tela) - traje 12 do 16 dana, tj., do sledece menstruacije. Zuto telo se stvara u jajniku, na mestu gde je pukao folikul koji je imao u sebi jajnu celiju. Ono ostaje do 4. meseca trudnoce, luceci progesteron, nakon cega tu ulogu preuzima posteljica.

 

 

Osnovno, sto svaka zena mora da uradi ako planira trudnocu je:

1. FSH

2. LH

3. ESTRADIOL

4. ESTROGEN

5. PROGESTERON

6. PROLAKTIN

7. TESTOSTERON

8. Hormoni STITNE ZLEZDE

 

 

1. FSH stimulise rast folikula u jajniku podsticuci proizvodnju estrogena, a lucenje estrogena dovodi do zadebljanja endometrijuma (odnosno, zida materice cija je uloga da prihvati oplodjenu jajnu celiju, koja stize iz jajnika). Njegova vrednost nam pokazuje da li su jajne celije kvalitetne i kolika je njihova zaliha (jer se svaka zena radja sa tacno odredjenim brojem jajnih celija, koje se tokom zivota ''trose'').

 

2. LH se luci u hipofizi, i on dovodi do prskanja folikula i ovulacije, odnosno izbacivanja zrele jajne celije u jajovod. Dakle, LH je pokazatelj da li je uopste doslo do ovulacije.

 

3. ESTRADIOL je pokazatelj da li endometrijum raste, tako da njegova vrednost ne sme da bude niska. Zato se njegova vrednost proverava pred samu ovulaciju.

 

4. ESTROGEN u ovalutarnoj fazi mora da bude visok, jer je u suprotnom folikul prazan (nema jajnu celiju).

 

5. PROGESTERON proizvodi zuto telo, odmah nakon ovulacije. Radi se 21. dc i njegova visoka vrednost znaci da je doslo do ovulacije.

(Wikipedia: Progesteron i estrogen zajedno uticu na pripremu gustog sloja krvnih žila na koje se oplođena jajna ćelija može pričvrstiti i dalje razvijati. Ako je jajna ćelija oplođena, taj sloj krvnih žila se pretvara u posteljicu ili placentu. Corpus luteum ili žuto tijelo nastavlja proizvoditi progesteron i estrogen. Embrinon započinje sa produkcijom humanog horionsko gonadotropina (HCG) koji djeluje na žuto tijelo produžavajući njegovu funkciju koja će obezbediti nesmetan razvoj trudnoće, a mensterualno krvarenje izostaje.)

 

6. PROLAKTIN je hormon koji se javlja u trudnoci, dajuci poruku mlecnim zlezdama da zapocnu stvaranje mleka. Ako je visok, organizam misli da trudnoca postoji i remeti ciklus, pa se desava i da izostane menstruacija. Ispituje se tako sto se radi PROFIL PROLAKTINA, odnosno merenje (vadjenje krvi) na svaka 3h (Na pr. U 8h, 11h i 14h) i samo tako pokazuje prave vrednosti. Radi se bilo kog dana ciklusa.

 

7. TESTOSTERON ne sme da bude visok jer je to muski hormon. Ako je njegova vrednost visoka, treba prekontrolisati hipofizu. Radi se bilo kog dana ciklusa.

 

8. Hormoni STITNE ZLEZDE (FT3, FT4, TSH, Anti TPO-antitela) su vazni ne samo zbog trudnoce, vec zbog opsteg stanja organizma. U trudnoci, stitna zlezda majke pravi stitnu zlezdu bebi, zato je vazno da je i ona u redu. Rade se bilo kog dana ciklusa.

 

Najnovijimm istrazivanjima se pokazalo da su jedini merodavni dani, za ispitivanje hormona, od 2.dc do 4.dc (dok su hormoni najmirniji), sem LH i ESTRADIOLA koji se rade pred samu ovulaciju, ESTROGENA u ovulatornoj fazi i PROGESTERONA koji se radi 21.dc!

Takodje, nije dovoljno samo jednom dati krv za ispitivanje PROLAKTINA jer je njegova vrednost prilikom prvog vadjenja krvi obicno netacna (posebno ujutru, jer je budjenje nekome stres, pa je njegova vrednost visoka).

 

Vrlo je bitan odnos FSH i LH!

FSH mora da bude nesto veci od LH (FSH>LH). To je dobro i znaci da dolazi do pucanja folikula.

Ukoliko je suprotno, LH>FSH, prisutna je inverzija sto znaci da NEMA ovulacije, folikuli ne pucaju ili prerastaju u cistu, sto je ukazatelj na policisticne jajnike.

Ukoliko se pokaze ova inverzija, radi se OGTT (Test opterecenosti na glukozu).

OGTT se radi tako sto se izvadi krv (ujutru, obavezno pre jela), a zatim se popije 75g (ili 100g) ciste glukoze na prazan stomak i onda vam vade krv na 30min, 60min, 90min i 120min, mereci nivo insulina u krvi.

 

Pored hormona, cije ispitivanje predstavlja polovinu puta do trudnoce, postoji i niz faktora koji mogu da otezaju ili potpuno sprece zacece, a u velikom broju slucajeva izazovu spontani pobacaj. Ovde su najdetaljnije analize koje mogu da ukazu na neki problem (dopunjeno izdanje teme Analize i testovi posle spontanog, sa kracim objasnjenjima :D )

 

Ovo su osnovne (pocetne) analize, koje je svako obavezan da uradi na samom pocetku pripreme za trudnocu i koje mogu da ukazu na nesto sire, ako postoji:

-Cervikalni i vaginalni bris

-Hlamidija, Mikoplazma, Ureaplazma

-PAPA test

-Urin i urinokultura

-Krvna slika (KS + LF)

 

Pokazatelji nekog zapaljenja, procesa ili prisustva bakterije:

-CRP

-C4

-C3

 

Devojke koje su svim, gore navedenim, analizama utvrdile da nemaju nikakvih problema, a i dalje ne mogu da ostanu u drugom stanju, posebno one koje imaju ceste pobacaje, OBAVEZNO moraju uraditi ispitivanja na trombofilije!!!

Postoje dve grupe trombofilija- URODJENE i STECENE.

 

 

-Za ispitivanje stecenih trombofilija, ispituje se:

 

Vreme krvarenja i koagulacije

Sedimentacija Er (citrat)

Protrombinsko vreme (citrat) INR

Brojanje trombocita

Aktivisano parcijalno tromboplastinsko vreme

Fibrinoliza

Protein C

Protein S

Rezistencija na aktivirani protein C

Antitrombin III

Lupus antikoagulans

Antikardiolipinska At IgM

Antikardiolipinska At IgG

Antifosfolipidna At IgM

Antifosfolipidna At IgG

Beta-2-glikoprotein IgM

Beta-2-glikoprotein IgG

Odredjivanje aCLA IgG klase

Odredjivanje aCLA IgM klase

 

D-dimer (mada se radi u trudnoci, ukoliko postoji mutacija)

Na osnovu ovih analiza se odredjuju faktori koagulacije, prohodnost krvnih sudova, predispozicija stvaranja krvnih ugrusaka itd.

Takodje, antifosfolipidna antitela (lupus antikoagulans i antikardiolpinska antitela) su čest uzrok habitualnih pobačaja kod trudnica sa sekundarnim sterilitetom. Lupus antikoagulans (LAC) je antitelo koje pripada grupi antifosfolipidnih antitela. U toj grupi se jos nalaze i antikardiolipinska antitela i antitela protiv beta2-glikoproteina I.

Povisena vrednost ovih antitela ukazuje na postojanje autoimunskog poremecaja, bolesti koja se naziva antifosfolipidni sindrom.

Kriterijumi za ovu bolest su: arterijske i venske tromboze (zgrusavanje krvi u krvnim sudovima), trombocitopenija (snizen broj trombocita) i ponavljani pobacaji (najcesce u II i III trimestru trudnoce).

Uz odgovarajuce lecenje i terapiju kroz trudnocu, (koriste se lekovi protiv zgrusavanja krvi) moguce je izneti trudnocu do kraja i roditi zivo i zdravo dete.

 

 

-Za ispitivanje urodjenih trombofilija (odnosno genetske predispozicije za duboke venske tromboze) analiziraju se odredjeni geni i ispituje se da li postoje mutacije:

 

MTHFR

Leiden V

Protrombin II

PAI

 

Pve tri mutacije zahtevaju terapiju Fraxiparinom kroz celu trudnocu, injekcijama, do 4 nedelje posle porodjaja (ukoliko je porodjaj prirodnim putem) ili 6 nedelja (ukoliko je izvrsen carski rez).

 

Detaljnije o trombofilijama pronasla sam na intenetu:

 

http://www.hdgo.hr/Default.aspx?sifraStranica=607

 

http://www.medfak.ni.ac.rs/Acta%20Facultat...roj/rada-10.pdf

 

Muzevi treba da urade spermogram i spermokulturu, kao i DNK fragmentaciju spermatozoida (koja kod nas jos uvek nije moguca).

-ASA test (antispermatozoidna antitela) - rade oba partnera. Iz sperme/sekreta i iz krvi.

-Kariotip (genetska kompatibilnost partnera) - nije obavezna (rade oboje)

 

-Listerija

 

-TORCH test, odnosno:

1. Toxoplasmoza,

2. Ostale infekcije poput hepatitisa B, sifilisa i varicele-herpes zoster,

3. Rubella-virus koji izaziva bolest slicnu rubeoli (German measles),

4. Cytomegalovirus ili CMV,

5. Herpex simplex virus-uzrocnik genitalnog herpesa.

 

Licno, TORCH i Listeriju nisam radila jer sam smatrala nepotrebnim (u svom slucaju).

 

(Nisam htela svaku stavku (analizu) da objasnjavam posebno, jer je vrlo kompleksno, pa da nesto ne bih pogresila, za detalje pitajte svog doktora ili pronadjite na internetu.)

 

Ovo je ono sto ja znam i mislim da je dovoljno detaljno. Verujem da nekome treba vise, a nekome manje, ali ako ce ovo ikome, bar malo, znaciti, bice mi drago da sam u tome pomogla.

Draga Emperess hvala ti na ovako iscrpnom tekstu o temi koja vecinu zena u nekom periodu zivota zanima.
Vidim da se dosta razumes, stoga bih ja imala nekoliko pitanje...

Uradila sam 4. dana ciklusa analizu hormona i rezultati su sledeci:

TSH  1.48 mIU/L   ref. vrednost (0.35-4.94)
T4     84 nmol/L     ref. vrednost (60-150)
T3     1.8 nmol/L    ref. vrednost (1.0-2.5)
FSH  4.7 IU/L        ref. vrednost (3.03-8.08) - folikularna faza
                                                   (2.55-16.69) - sredina ciklusa
                                                   (1.38-5.47) - luteinska faza
Estradiol   40.0 pg/mL ref. vrednost (21-251) - folikularna faza

                                                         (38-649) - sredina ciklusa
                                                         (21-312) - luteinska faza
Progesteron   1.20 nmol/L                (0.35-0.91) - folikularna faza
                                                         (3.82-50.56) - luteinska faza
Testosteron  2.53 nmol/L  ref. vrednost (0.48-1.85)
Prolaktin  17.2 ng/mL  ref. vrednost (5.2-26.5)

13. dana ciklusa sam uradila ponovo fsh, ih i estradiol, pa rezultate tek očekujem, dok 17. dana cillusa cu raditi estrogen a 23. dana ciklusa cu vaditi progesteron.

Zanima me da li u pravo vreme vadim polne hormone i ako mozes ukratko da mi izanaliziras vec odradjene?
Moram da napomenem da mi je ciklus uredno trajao 30 dana, a posto sam pre tri meseca imala spontani pobacaj sad traje 32,33 dana...


                                                        

 

 

 

 

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Poz svima, novi smo na forumu pa eto zelimo da cujemo i od vas po koju rec.

Naime poceli smo sa testovima jer u proteklih 2 godine ne mozemo da ostvarimo trudnocu. Ovde bi konkretno pitali u vezi prvog odradjenog testa da li su vrednosti dobre. Kako vreme bude odmicalo nadamo se da cemo vise moci podeliti sa vama a i ostali testovi su zakazani za ponedeljak. Sto se supruga tice odradjeno je sve sem spermograma koji ce biti odradjen za 5 dana. Njegovi rezultati su odlicni, (radjeni pre par dana) nema bakterija (u spermokulturi), negativan na HIV, HBsAg, HCV, nema hlamidiju ni ureaplazme ni mikroplazme. Poslednji spermogram koji je radjen (a to je bilo pre 2 godine) je bio odlican, evo nesto o tome:

Zapremina: 2ml
pH: 7.4
Viskoznost: normalna
Likvefakcija: 25
Spermatozoidi V: 120 (>50x106/cel. ej)
Leukociti: 0
Aglutinacije: 0
Brzo progresivni: 35
Sporo progresivni 30
Neprogresivni 10
Nepokretni 25
Normalni formi 80
Patoloskih formi 20
Glave 10
Vrata 0
Repa 10
 

Da li su ove vrednosti zadovoljavajuce? Test je radjen 3. dana ciklusa (slika u prilogu)

Unapred hvala.

P.s.(Ukoliko smo promasili sekciju molimo MOD-a da premesti na odgovarajuce mesto. Hvala!)

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    • Hormoni, trombofilije i putokazi
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      For the period of the sale, all 3 degrees of the 12-month Playstation Plus plans are 25% off for individuals who aren't already a part of the subscription provider. Even the ones presently part of the Essential plan can upgrade to the Extra or Premium ranges and keep 25% off, as properly.  Although the video games featured on PlayStation Plus plans in November are many, the PlayStation Black Friday sale capabilities upwards of 550 discounted products for gamers to take benefit of. The following are the exceptional game deals that PS4 and PS5 customers can indulge in this week. With the exceptionally expected sequel of the Spider-Man collection, Spider-Man 2, not set to release till 2023, some Marvel fans may be itching to pass the time with a chunk of adventuring. In truth, there may be plenty that Spider-Man 2 can analyze from its predecessor before its release.  The nice manner to accomplish that, of course, is to swing freely thru the streets of New York - like you possibly can do in Spider-Man: Miles Morales. This movement-packed open-global title has visible sparkling opinions from players and is a must-play for fans of the beloved man or woman.  With Spider-Man: Miles Morales receiving a 60% bargain this Black Friday, reducing its rate from $forty nine.99 to just $19.Ninety nine, the sequel sincerely has its work reduce out. Both PS4 and PS5 customers can take part in this deal. Hey, my friend. Want to know more comprehensive and detailed 2k23 mt purchase information? Can access https://www.mmoexp.com/Nba-2k23/Mt.html
    • Može li zakon da vaspitava našu decu?
      Započeo/la haoyun0367@gmail.com · Objavljeno
      As soon as players reach stage forty six, they release the capacity to do glassblowing. Each Unpowered Orb a player creates nets them a touch over 52 revel in. Even as this approach is slower than maximum other strategies, it's far by way of a long way the most inexpensive way to stage up the talent.  Players that need to maintain a decent budget ought to pick out this approach to degree up from degree 46 to stage ninety nine. For players additionally interested by leveling up their Magic skill, this might be the precise crafting technique.  Players must be at degree 54 before they gain the capability to begin this method, however it is able to be used to stage up to degree ninety nine and even make a earnings if gamers are inclined to price the Unpowered Orbs themselves. Water Battlestaff - offers one hundred exp in step with personnel Earth Battlestaff - gives 112.5 exp according to workforce fire Battlestaff - gives 125 exp in line with staff Air Battlestaff - gives 137.Five exp per body of workers 1 level Up With gems Gamers can pick out to degree up with gem stones but be warned: it's miles by way of a ways the most pricey way to train degrees. It leads to a internet loss of a mind-blowing 89,029,889 gold to accomplish. Still, if players need to take this on and have gold to burn, here is the maximum green approach. High-quality, comprehensive, 24/7 online, worry-free after-sales platform for selling OSRS gold, please visit https://www.rsgoldfast.com/
    • Humanitarne akcije
      Započeo/la haoyun0367@gmail.com · Objavljeno
      But, simply as it happens quite frequently with hyped-up games, Diablo three fell extremely quick of the legacy of its predecessor. Now, Diablo 4 is in the end coming to surpass it. Enter course of Exile, which via the early looks of it appeared like a first rate ARPG to play after the frustration in Diablo 3.  Diablo 3 acquired lots of positive reviews on launch, but it failed to take lengthy for folks that played the game to observe that it was lacking in terms of depth while compared to Diablo 2. Then there was the auction residence scenario, with players spending or promoting items for actual cash.  Right from the begin, all people who played path of Exile right now recognized its complexity. The skill tree changed into big (and it is somehow even larger now), the skills were many, and the options to build the characters have been even more. Will Diablo 4 stay up to that? Related: what to anticipate from the imminent direction of Exile: Ultimatum growth and Livestream declaration It is precisely what came about with Diablo 2, and this is going to reveal precisely what the ARPG community desires from new video games.  Path Of Exile's fulfillment, and how it modified the ARPG style Direction of Exile's success was possibly sparked with the aid of how much ARPG enthusiasts wished a game to play for a long time, getting to know its secrets and techniques, slowly getting to know every issue of it. To sell Diablo 4 Gold platform with high quality and comprehensive, efficient delivery and worry-free after-sales service, please visit https://www.p2pah.com/diablo-4-gold.html
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