Dr. Silvio Aladjem Answers Your Questions

The doctor is in!

This past December we announced that Imperfect Women would be partnering with Dr. Silvio Aladjem to bring you a column featuring Dr. Aladjem answering your questions of medical interest related to pregnancy.  We are excited to bring you this new feature and hope that you are able to benefit from it.

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Question from N. C:

My fiancé & I are trying to have a baby, around 2 years ago I had surgery because I had a large cyst on my left Fallopian tube. I just started to go to an obstetrician and they found 2 smaller cysts and a 14 cm cyst. I am worried that because these cysts are developing it will hurt my chances of getting pregnant. I am 26 yrs old plus-sized women with a family history of perfect pregnancies.

Dr. Aladjem:

Having repeated cysts in the tubes, is not very common. Do you know if  you have a condition known as “endometriosis”? This condition may be the cause of tubal cysts. Endometriosis in itself, may be the cause for not getting pregnant.  Tubal surgery may compromise your ability to conceive. I would suggest you see and seek the opinion of a Fertility specialist before doing anything else.

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Question from G. M.: 

Dear Dr. Aladjem, my daughter is pregnant after two miscarriages. She is 16 weeks pregnant and we recently found out that the prenatal DNA tests show only one x chromosome. She subsequently had an amnio and will have a high level US within the next two weeks. No results of the amnio. My daughter has told me that she will terminate the pregnancy if the dx is shown as Turners Syndrome. Can you please tell me if the amnio will show anything different than the blood test?  I cannot find information on the overall accuracy of the blood test. I am heart broken. I know that Turners is not a death sentence but I do not know how to convince her.  Can you please provide me with anything information I would be so grateful.  Thank you so much.

Dr. Aladjem:

Thank you for your question. As you by now know, women with Turner syndrome have only one X chromosome (X0) inst3ead of two (XX) . Because of that, such women have no ovarian function. Most are of shorter stature, and may have other associated abnormalities including heart defects

For more information I would suggest you check the following: National Human Genome . Research Institute ( http://www.genome.gov/19519119 )  the Turner Syndrome Society (http://www.turnersyndrome.org), .Medline (http://1.usa.gov/1j4BlFI)  and NIH – (http://turners.nichd.nih.gov).

A high level ultrasound should be able to determine what, if any, other abnormalities this baby may or may not have. The amniocentesis should determine the chromosomal configuration of the baby.

Turner syndrome is not a lethal malformation. Its severity will depend in part on associated abnormalities, if any. For example, a major cardiac abnormality may require heart surgery sometime after birth.  By the time the girl reaches puberty, she will need hormonal replacement, so that her feminine characteristic should be able to develop, like breasts, for example. She will need to be under the care of a pediatric endocrinologist. I am sure all such information will be given to your daughter by her physicians.

It would be important that the parents consult with a pediatric endocrinologist and I also would suggest a consult with a genetic counselor. These are difficult decisions and should be made only after having obtained in depth information from specialists dealing on a day to day basis with such problems. While the genetic basis is the same in all Turner Syndromes, not all patients that have Turner Syndrome are the same and one cannot establish an absolute universal pattern

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Question from S.P.:

Hi, I’m 4 days late 4 my period have taken pg test but coming up negative I’m going 2 be 40 in 2 weeks do u think I’m going through the change?:(

Dr. Aladjem:

You are probably too young to think menopause, although early menopause can happen. At your age pregnancy has to be considered first.  I suggest you seek the opinion of your obstetrician/gynecologist who can examine you.

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Do you have a question for Dr. Aladjem that you would like to see answered in our next “Ask Dr. Silvio Aladjem” feature? Please submit your questions below.

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This column is for the purpose of education and information only. It is not medical advice and should never be used instead of your doctor’s or other health care professional’s advice. Please note that you will find the answer to your question identified by your initials only and confidentiality will be maintained.

Dr. Silvio Aladjem, an obstetrician/gynecologist and Maternal Fetal Medicine (high risk obstetrics) specialist, is Professor Emeritus in obstetrics and gynecology at Michigan State University, College of Human Medicine, in Lansing, MI. He is the author of “10,000 babies: my life in the delivery room” now available on Amazon, Barnes and Noble and other book stores. Dr. Aladjem is published extensively in Scientific Medical Journals and wrote several textbooks in the specialty.