Monday, February 8, 2010

Decisions, decisions


Last week Thursday was my last day for the endometrin inserts and estrace pills.  I was worried that with the discontinuation of the meds, the baby would fall out.  So far so good =)  I know that they weren't what was making this stick, but you know me...All weekend I was going to the bathroom every 30 minutes just waiting for bad stuff to happen and all was good.  Starting yesterday I was feeling much more confident about it all and I think pregnancy enjoyment is right around the corner.

I have an appt with our OB tomorrow to discuss Fetal Chromosomal Abnormality Screening Tests.  Since I'm 36, they are letting us know our options, although it doesn't sound like they're pushing us to do anything.  I have 4 options, 2 are non-invasive and 2 are invasive.  From the little brochure they gave me (which looks like it's way old and has been reproduced 500 times), there are 3 things they are screening for:  Down syndrome (Trisomy 21), Trisomy 13, and Trisomy 18.  These chromosomal abnormalities can cause physical defects and cognitive delays (what the brochure calls mental retardation).  I strangely have not done any on-line research on these things (meaning the screening tools that are available to us).  I think I want to wait and speak with the doctor first.  OK, so here are my choices:

1.  Nuchal Translucency Screening
         This involves an ultrasound and blood test.  It's performed between 11w1d and 13w6d and it measures the fluid behind the neck.  From what I've read on the blog, I think many women get this done.  It has a 85% success rate at identifying Down syndrome, with a 5% false positive rate.

2.  Quad Screen
         This is a blood test performed between 16 and 18 weeks.  It also has a 85% success rate at identifying problems with a 7% false positive rate.

Now on to the ouchy stuff...

3.  Chorionic Villus Sampling
         This is performed between 10 and 12 weeks and a placental sample is obtained either through the cervix or abdomen (we're talking sticking needles in).  They say it's better than amniocentesis because it can be done so much earlier.  It's 99% accurate with a pregnancy loss rate of 0.6-0.8%.  I have many questions about this, primarily what the procedure involves specifically.  I don't like seeing any pregnancy loss rate, obviously it scares me.

4.  Amniocentesis
         This is done between 15 and 20 weeks and a needle is inserted into the abdomen to get a sample of the amniotic fluid.  There is a 99% accuracy rate with a 0.5% pregnancy loss rate.

OK, so here's my thing.  I can't think of anything they could possibly tell me that would make me say "OK, let's terminate".  And that's the whole point of the test right?  To find out if bad things are happening and terminating in case it's really bad.  I have heard way too many stories about women who were told that they're baby will be profoundly delayed or deformed or defected in some way and then they come out just fine.  I can't imagine a scenario where I would terminate, so why bother with the invasive tests?

Part of me is worried that since my IVF success rate was so very low - even with 3 rock star blasts, I only have one in there (for which I am so grateful!!), maybe it indicates that my eggs are bad and more prone to having chromosomal abnormalities (i sort of think the answer to that is a big DUH, of course there is).  So maybe something could be wrong with the baby in my case.  Does that make sense?  Or because it's now growing normally, I have the same chance of having issues as other women my age?  I'm not sure and I have to ask.  Again, I can't stop thinking that there's no way I'd terminate so what's the point?

What do you think???


  1. My take on it is...if you aren't going to terminate, what good does knowing do?

    You will love that baby whether or not it has downs or some other chromosomal abnormality and most of the biggie malformations can be seen on U/S.

    Just my take and what I plan on doing. Us IVF girls have enough to stress about without worrying that something is wrong with our baby!

  2. Ugh...this is tough. Like we IVFers need MORE to stress over. Just follow your heart, Mama!!


  3. There is no way you will terminate - there is no need to worry. I would not get anything done because you will love the baby no matter what!! All the testing will do is make you worry more. Love ya!

  4. I agree with you. It depends on what your going to do with the information. If nothing, then i don't see the point, but I would present that exact question to your dotor.

  5. I agree -- if you plan on bringing your baby to term then I don't see the need to do the "ouchier" tests since they carry risk of losing the baby (however small). However, if you want some information the blood tests/ultrasounds could at least give you a heads up for what's to come without being invasive. It probably depends on your personality. Think about how you'd feel if you get a false positive. Would you worry too much? Or maybe knowing something is better than nothing? Definitely a hard decision, especially since every person will feel differently about it.

    I am glad all is well since you stopped the endometrin, too!

  6. I don't think any outcome will change your mind about not terminating. I would do the less invasive test. Whatever the outcome, it will only help you prepare yourselves for your baby.

  7. Tracey I dont think I know what you should do, but if it was me I wouldnt be terminating either do I probably wouldnt be testing.

  8. Hey girl! It's me, Tammi :) I agree with everyone else. The tests are just invasive. You should trust your heart!!! Love you!!