Definitions

Amenorrhea - a condition in which a woman has no menstrual periods.

Primary amenorrhea - a woman who has never had a spontaneous menstrual bleed in her life.

Secondary amenorrhea - a woman who has menstruated spontaneously in the past but then has had no periods for six months or more.

Anovulation - failure to ovulate.

Assay - a test to measure the concentration of a substance contained in a fluid or other substance.

Basic research - studies limited to the laboratory or to animals and aimed at understanding the human body and its diseases at the most fundamental level

Bimanual examination - with the HCP (health care provider's) finger(s) inside your vagina, s/he puts the finger on the cervix and slowly moves it. The other hand is placed on the abdomen. As slow pressure is placed on your abdomen, the uterus is slowly rotated to determine the position and size of your uterus. The free hand is then moved to either side of your abdomen and s/he tries to find the area of the fallopian tubes. They are normally slightly tender when squeezed. While moving up from the fallopian tube the HCP will outline the ovary. Again, there will be some tenderness when the ovary is squeezed. This is repeated on the other side.

Bone mineral density - (BMD) - the amount of mineral in any given volume of bone.

Chromosomes - the thin strands of material found in the nucleus of each cell. They contain the genes that determine each person's characteristics. Every individual has 22 pairs of chromosomes and 1 pair of sex chromosomes (called X and Y). The sex chromosomes determine whether and individual is male or female. A female ordinarily has 2 X-chromosomes, while a male has one X and one Y chromosome.

Dominant follicle - the largest ovarian follicle that develops during each menstrual cycle. It is the follicle that will ovulate.

Estradiol - one of the 3 major estrogen hormones which women produce. This estrogen dominates from puberty to menopause and is by far the most powerful estrogen. The ovarian follicle produces it as it develops during the first half of the menstrual cycle and by the corpus luteum after ovulation.

Follicle - stimulating hormone (FSH) - the hormone produced by the pituitary gland in response to GnRH released by the hypothalamus. It stimulates the follicles in the ovary to develop.

Galactosemia - a rare genetic metabolic disorder. A gene for Galactosemia must be inherited from both parents who are carriers. It is an autosomal recessive condition. Normally when a person consumes a product that contains lactose (for example, milk), the body breaks galactose down into galactose and glucose. Glucose is the sugar used by the body for energy. Galactosemia means too much galactose in the blood caused by the individual missing the enzyme to convert galactose into glucose. Men with Galactosemia have normal gonadotropin function. In women it is still unclear if the POF is due to follicle depletion or follicle dysfunction.

Gonads - in women these are the ovaries.

Gonadotropins - the hormones produced by the pituitary gland that regulate the gonads. In women they regulate the development of the eggs. The most important ones are follicle-stimulating hormone (FSH) and Luteinizing hormone (LH).

Gonadotropin releasing hormone (GnRH) - a hormone which is produced by the hypothalamus in the brain. It stimulates the pituitary gland to produce and release both LH and FSH.

Human menopausal gonadotropin (hMG.) - a hormone preparation used to stimulate ovulation in women who do not ovulate and who don't respond to Clomid. It is recovered from the urine of postmenopausal women and contains equal amounts of FSH and LH.

Hypothalamus - a part of the brain located just above the pituitary gland. It produces and secretes gonadotropin-releasing hormone (GnRH) that influences the pituitary gland and regulates the development and activity of the ovaries.

Hysterosalpingogram (HSG) - a test most commonly done to determine whether or not the tubes are blocked. It is a x-ray test that involves an injection of dye through the cervix and into the uterus.

Iatrogenic cause - after successful treatment of cancers (such as Hodgkin's disease) with radiation or chemotherapy, a large number of women develop reduced fertility. The younger the woman, the better the chance for return of ovarian function after chemotherapy. Radiation effects are dependent on exposure. Generally, a total of 800 rad will lead to permanent infertility.

Luteal phase - the second half of the menstrual cycle. It occurs after ovulation takes place and the corpus luteum is formed. It in turn causes the uterine lining to secrete substances to support the implantation and growth of the early embryo.

Luteinizing hormone (LH) - produced by the pituitary. This increases near the middle of the menstrual cycle and causes the maturation of the egg. Ovulation occurs approximately 24 - 36 hours after the LH surge.

Ovaries - female reproductive organs which contain the eggs and produce the female hormones, primarily estrogen and progesterone. There are two, one located on either side of the uterus. Each is about the size of the end of your thumb. However, women with POF often have smaller than normal sized ovaries.

Turner syndrome - a genetic disorder the results from an abnormality of a chromosome. Chromosomes are the strands of material found in the nucleus of each cell. They contain the genes that determined each person's characteristics. Each individual has 22 pairs of chromosomes and one pair of sex chromosomes called 'X' and 'Y'. The sex chromosomes determine whether in individual is male or female; they influence height as well as development of sex organs. A female ordinarily has 2 'X' chromosomes, while a man has one 'X' and one 'Y' chromosome.

In Turner syndrome, one of the 'X' chromosomes is missing or misshapen in most of the cells in the body. The reason for this total or partial loss of the chromosome usually cannot be found, but the loss occurs soon after that baby is conceived. There is nothing either parent can do to prevent this from happening; it is a biological accident for which no one is responsible.

Because only one 'X' chromosome is present, the ovaries do not develop normally nor do they usually function fully. This means that they do not produce adequate amounts of female hormones, so the young teenager will not go through puberty (develop breasts and menstruate) unless these hormones are provided. Pubic and axillary hair may grow, however. Having undeveloped ovaries also means that the woman is quite likely to be infertile, although there are rare cases of women with Turner syndrome conceiving children. Only the ovaries are affected; the uterus and vagina are normal, so adult sexual function is unaffected. The missing or abnormal chromosome does not mean that girls with Turner syndrome are not really female; they are women with a condition that causes poorly developed ovaries and short stature. Source - Turner Syndrome brochure - 1/94.