PREGNANCY-BIRTH Messages for June, 1999: Re: Aging & M/C & Genetic Defects

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Re: Aging & M/C & Genetic Defects

From: William F. von Almen, II, MD (anonymous@obgyn.net)
Sun, 13 Jun 1999 14:40:18 -0500 (CDT)

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In reply to: Ann-Marie: "Aging & M/C & Genetic Defects"

At Sun, 13 Jun 1999, Ann-Marie wrote: >
>Background: I am currently 39 years old.
>My first pregnancy ended in a missed abortion at 8 weeks. A fetal
>heartbeat was never detected. I got pregnant right before we started
>actively trying. I was 36 years old.
>
>My second pregnancy ended in a healthy baby boy who is now almost two
>years old. I got pregnant at first attempt. I was 36 years old.
>
>My third pregnancy just ended at 14 weeks 1 day. Tests have determined
>that the baby had a genetic abnormality called Trisomy 18. I got
>pregnant at first attempt. I was 38 years old at time of conception.
>
>I understand that Trisomy 18 is much rarer than Trisomy 21 I have seen
>on the'net various statistics saying that the risk of having a pregnancy
>like this was anywhere from 1 in 378 to 1 in 2400 at age 38. I
>understand that the risk of having a T21 child is much higher something
>like 1 in 100 at my now age of 39.
>
>I am VERY worried that because I have had two m/c that there is
>something wrong with my eggs due to age. Yet I understand that the FSH
>test is only if you are having difficult conceiving...
>
>Any advice, comments would be welcomed as I so long to have a second
>child yet am terrified of having another genetic problem. DH and I have
>had genetic counseling and everything appears to be fine.
>
>Thanks,
>Ann-Marie
>
>P.S. I am currently waiting out two menstrual cycles to begin trying
>and am also terrifed that due to my age 39 that this won't happen as
>everything that I read on the net tells how fertility declines each
>month over 35 so I am also VERY anxious about waiting two WHOLE cycles
>to try again despite past history of no problems conceiving. So my
>second question is is it really necessary to wait to whole cycles, isn't
>this risky given my age?

Ann-Marie; You have truly opened Pandora's box with your questions. First off, the risk you have is due to the age of your eggs. With each passing year the risk of a chromosomal problem increases. The majority of these chromosomal anomalies are aneuploidy, the missing of a chromosome (usually 21, then 18, then 13) and this is due to the nondisjunction of the maternal chromosomes during its final division at fertilization. Your risk at 39 is around 1 in 100. Just because you have had one of these, I do not believe your risk is higher to have another, it is still the same as your age adjusted risk. To answer your second question, I feel you should wait the 2 cycles. In the over all scheme of things, even at your age, I do not feel 2 cycles is extreme (we used to tell patients to wait 6 months!!!). Yes, your ability to conceive is declining, but two months should not be that much of an issue. This was very long winded and rambling, but I hope it helps you, and good luck.

-- William F. von Almen, II, MD, FACOG Editorial Board, OB/GYN.NET Pregnancy and Birth New Orleans, La.

The above comments are for educational purposes only.

Next message: William F. von Almen, II, MD: "Re: severe toxemia"
Previous message: Michelle: "severe toxemia"
In reply to: Ann-Marie: "Aging & M/C & Genetic Defects"

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