Testing... 1,2,3

Yesterday we went to the new OB/GYN with SIL.* Excited in our anticipation for another ultrasound, we weren't prepared for the possibility of NOT having one and were a little disappointed when it didn't occur. Not sure if it was because the appointment ran long, if the doctor felt it wasn't necessary, or she was holding off because she knew the perinatologist would want to do one. You know....because of all the testing coming up.

Testing? What testing?

Since I am of AMA, there are about a zillion tests that should be done to test for chromosomal abnormalities. Great another reminder that if something goes wrong, it's probably because we used my old-ass eggs. Thursdays doctor was not the first doctor to count me as 41, even though my birthday is not until the end of April. Seriously - I am waaaayyyyyyyyyyy over hearing the tut-tut regarding my age.

We elected not to do the chromosomal testing on our eggs/embryos. Not sure why, but it was one of the things I just didn't focus my laser (some say obsessive) research skills on during the IVF process. A part of me thought that a small biopsy could endanger our chances of implantation and thus we weren't really interested in lowering our chances (no matter how small) or spending extra money unnecessarily. Now, unlike congress, our proverbial bill is due and it is time to pony up (i.e. take all the tests).

Here is the nice handy-dandy chart for us to stress over for the next 6 or 8 weeks. Look a bit overwhelming? Yea, me too. Fortunately some of them overlap, so it's not like we have to do all. But we DO have to weigh the pros and cons of each and decide which we think is best.  Right now we are weighing more towards the amnio vs the CVS. Hubby says CVS is slightly riskier for miscarriage and the doctor mentioned something about loss of limbs(!!!). I haven't had the heart to look.

RISK ASSESSMENT CHART FOR DOWN SYNDROME AND TRISOMY 18 Screening parameters First Screen 11-14 weeks Integrated Screen Combines first screen & Quad Quad Screen 15-18 weeks Amniocentesis After 15 1/2 weeks CVS Chorionic Villi Sampling 10-12 weeks Down syndrome detection rate 83% 92% 81% 99.9% 99% False positive rate 5% 5% 5% 1% 1% Trisomy 18 detection rate 80% 90% 80% 99.9% 99% Biochemical Markers PAPP-A Free Beta hCG PAPP-A AFP hCG uE3 Inhibin-A AFP hCG uE3 Inhibin-A Diagnostic evaluation of hundreds of types of chromosomal anomalies Early Diagnostic evaluation of  chromosomal anomalies Nuchal Translucency NT NT NT *** *** Timing 1st Trimester 1st & 2nd Trimester 2nd Trimester 2nd Trimester 1st Trimester Open Neural tube defects Detection Rate *** 80% 80% 99.9% *** Fetal Nasal Bone presence Preliminary results/ significance *** *** *** ***

All this and we know we are at higher risk because of twins. I should be celebrating and instead I feel like a big bag of worry. At least the appointment went well.

*I never know whether to put SIL or surrogate. Some days it feels more appropriate to put surrogate for a number of reasons, but other days it seems so impersonal for such a great thing my SIL is doing. Bear with me.