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Questions and Answers
Dr Peter Chew, Consultant Obstetrician Gynaecologist, Chairman of the Board of ALife, answers some frequently asked questions. The questions are listed in alphabetical order of the highlighted key word/phrase. Click an alphabet from the menu below to see a listing of the corresponding questions. To see the answer, click the icon preceding the corresponding question. You can click another icon to read the answer to that question, or click the icon to close the answer box, or select and click another alphabet.
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I'm in my third trimester and 33 weeks pregnant and I'm a bit worried to see that my
belly does not show as big as other pregnant woman. Will every woman experience differently
in their pregnancy? Does it mean that my baby might not be growing well? My friend
told me it could be growth retardation. What should I do?
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I am 32 years old and my wife is 28 years old. We have been married for 2 years and only thinking
of having a baby 2 years later. What is the best age for a woman to have a baby if
there is such an "age"?
There is no such a "magical age" for woman to conceive. However, the age of the wife can
certainly affect the chances of conception considerably. This is because the quality of egg
decline significantly in the 30s and faster in the 40s. Statistics have shown that the optimal
age for conception in the females is between 22-26 years old. Fertility decreases steadily
after 30 years old with a rapid decline after 40 years old. However, these statistics serve
only as a general guideline and there are exceptional cases. It is estimated that one in every
3 couples in which the wife is aged 35 and above will have problems with fertility and 2/3 of
women will not be able to conceive after 40 yrs of age. From the above studies, I would advise
you not to delay starting a family.
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What is B-HCG?
Beta-HCG is a hormone produced during pregnancy by the placenta (after-birth), which is
a flat spongy structure developed from the fertilized egg. The placenta grows on the
wall of the womb and attaches the baby to the mother by the umbilical cord. It carries
oxygen and nutrients from the mother to the baby and transports the waste products from
the baby to the mother for disposal. The placental hormone is excreted into the urine
and when it reaches a certain level, the home pregnancy test becomes positive. It can
be estimated more accurately by the blood test.
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I heard from my friend that the latest methods of birth control are ring and skin
patch. Can you explain how they work? Are they suitable for every woman?
Vaginal ring is a new birth control method for women. It is a small flexible contraceptive
ring, containing the same hormones as birth control pills. It is inserted manually into
the vagina, where it is left for three weeks. There, a continuous, low dose of hormones is
released and ovulation is suppressed. The ring is then removed after the 3rd week and
menstruation will resume. When used correctly, it is 98%-99% effective in preventing
pregnancy.
The Birth Control Patch is a tiny skin patch with the same hormones as in contraceptive
pills. Women can wear this patch on the buttocks and tummy or part of the upper arm. It
should not be placed on skin that is red, irritated, or cut, or skin where makeup, creams,
or powders are applied.
It works like oral contraceptive pills by delivering continuous amount of hormones through
the skin into the blood stream thus suppressing the ovulation. A patch is worn for one
week and then replaced on the same day of the week for three consecutive weeks. The fourth
week is a "patch-free week". This is when the period resumes.
The contraceptive patch is 99% effective when used correctly.
Please see page on New Birth Control Methods
for more details.
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I have heard of birth control method using injection either monthly on 3 monthly.
How does it work? Is it safe?
These are hormonal injections that work by suppressing the egg from coming
out of the ovary every month (ovulation). Protection begins immediately after
the first shot if given during a menstrual period. They are 99% effective in
preventing birth.
Most common side effect is irregular bleeding or spotting. After about a year of
use many women will not have periods. Their periods usually return when the
injection is stopped. Women who continue to get their periods often have lighter
bleeding.
Please see Hormonal
Injection Birth Control for more details.
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Do most women with breast cancer have a family history? What are the risk
factors of breast cancer?
It is estimated that between 5% and 10% of breast cancer have a genetic component.
The genes involved are BRCA1 and BRCA2. Abnormal changes (mutations) in the BRCA1
and BRCA2 genes are present in about 70% of all inherited breast cancers. It is
not clear how much these gene changes increase a woman's risk of breast cancer.
However, it has been estimated that these women have between a 40% and 85% chance
of developing breast cancer during their lifetime. The lifetime risk of women
without genetic mutations is about 13%.
Please see Breast Cancer
Risks for further details.
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I have a breast lump removed. The doctor told me it is fibroadenoma with fibrocystic
diseases. Can you explain?
The breasts are made up of 2 types of tissue: The supporting tissue (fibrous tissue with fats)
and milk glands with ducts. Fibroadenoma is a solid lump composed of fibrous tissue only
It may cause discomfort and can become larger over time or if you become pregnant. It can be
removed surgically.
Quite often, fibroadenoma is accompanied by fibrocystic diseases or fibroadenosis. This is
the most common cause of breast lumps in women between 35-50 years of age. They are usually
cystic (containing fluid). Put it simply, they are overgrowth of the fibrous tissues that
surround the milk glands and ducts causing one or more painful lumps in the breasts. Their
sizes and frequency of pain usually vary with the menstrual cycle. These lumps very rarely
become cancer. Drugs such as danazol and bromocryptine are usually helpful in reducing the
size and pain.
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I am 25 years old, single. Recently, I found a lump in my left breast when bathing.
It is mobile and not painful. What Should I Do?
Eighty percent of breast lumps are benign i.e. not cancerous. Benign breast lumps
usually have smooth edges and can be moved slightly when you push against them.
However, you should be checked by a doctor to make sure the lump is benign.
You can find more information such as the common causes of benign breast lumps in web
page Breast Lumps.
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