Friday, March 8, 2013

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. 

12 comments:

  1. I always said SIL, too LOL, it was too long explaining, yes she is the surrogate and yes she is my SIL as well.. I am AMA too and we didn't do any special testing except the NT scan at 11.5 wks.. The OB said only do the amnio/cvs if you would end the pregnancy if the baby was found to have downs, etc. I have also read that with multiples the AFP (I think!) is known for showing false positives, so keep that in mind or ask to make sure I am telling you the right test! I take the bw test with a grain of salt, a friend had a 1:75% test result and her baby was just fine, it just had her worrying needlessly for 8 wks! Hopefully everything is going well with your SIL and you, if you ever need to talk, drop me an email, been there done that! babydreams2011 at gmail dot com

    ReplyDelete
    Replies
    1. Thanks! Everything is going well so far. I think the main one we will do is either the cvs or amnio - preferably amnio. There were a couple of chromosomal abnormalities that resulted in death that I'd rather know now and deal with instead of putting everyone through a long process. With twins we have a 6.67% chance that one will have something (but extremely low for both.)

      Thanks so much! You will probably get an email from me down the line. :-)

      Delete
  2. So many test and such a scary moment. Wishing you guys the best!

    ReplyDelete
  3. The never ending stress of being a Mother has begun!! Wishing you lots of strength as you get past this next stress hurdle, and hoping everything is going well with your little ones :)

    ReplyDelete
  4. Those are a ton of tests. I'm also pregnant with twins, just a little behind you. I'm going to be crushed if I don't get an ultrasound at my OB appointment.

    ReplyDelete
    Replies
    1. Sorry for the late response. Hopefully you have gotten one by now. Hope everything is going well for you.

      Delete
  5. So many tests! It sounds like most can be covered with amnio? Deep breaths!!

    ReplyDelete
    Replies
    1. It can. I didn't know it at the time I wrote this. :-) The bonus with amnio is that you find out gender with the results (a few weeks later) and they are pretty definite.

      Delete
    2. Just checked in to see how your doing and saw this post - as a mom of 3 and a nurse. I'd pick the amino and skip all the other annoying testing ( unless you do the cvs). Amino can be done safely at 16week. And there is a way to get the results In 24 hours ( called the FISH) it's an extra fee but very worth while.

      Also maternity21 is a newer test at 12 week and has a food result with twins but basically my MD felt it was best to skip the stressful testing and wait for amino - bc if any of the testing had an abnormal result we would do the amino anyway so why stress over those few weeks - many " soft" markers are annoying and lead to endless worring

      Delete
    3. Thanks MGB. I have a post I have been debating on whether or not to post. Maybe I will in the next few days.

      Delete

I LOVE comments - feel free to join in!
Unless you are a spammer and hawking your wares. Then you will be booted immediately.