CVS AND Amnio? Other questions too :)

[JoSophie]

Hi Ladies,

I am currently 8 weeks pregnant with my second child after undergoing 3 fet and 1 fresh ivf. I finally made it to this board! LOL

I have a few questions I am hoping you guys can help me out with.

First, I am still taking progesterone shots and will be done on Thursday 1/29 after on & off since last April and straight since 12/11 (day of retrieval).

I am VERY constipated even after taking stool softeners and metamucil daily. I did have this issue with my first pregnancy as well....but yesterday after straining quite a bit, I noticed some blood.....do you think that I am ok?

I did not have any more the rest of the day or today....do you think it's just from straining even though the blood was seen about 2 hours after the straining episode?

Also, I would like to have a cvs test, but should or do I have to have an amnio too? What do you girls recommend?

I would appreciate any help/tips as I am a bit nervous about the spotting. I did not call the doctor, but I plan to on Monday just to see if they can see me next week. I was just discharged from the fertility dr. and do not have an appt. with my ob until feb. 6th b/c he's on vacation.

Ok....thanks so much all!!

Jo

[LMKH]

I would pick one and do only that one. The tests are pretty redundant and there is no need to put yourself or the baby at risk to run it twice.

Congratulations on the pregnancy!

I am really struggling with the same exact decision you are struggling with.

I know if something really serious were wrong, I would terminate. But I also know the tests have their limits big time. CVS and amnio ONLY test the chromosomes. Amnio also does neural tube defects. Neither do structural defects. By this, I mean things like heart defects. Some heart defects are fatal 100% of the time. But, termination services are very limited here in the state where I live. As a result, the doctor told me I really should have the CVS. That will rule out the bulk of stuff. BUT...I don't know...CVS has twice the risk of amnio and would DX less stuff. I am so torn! Plus, I don't think the chances of anything be wrong are THAT high. But the one doctor says 2% chance, but I have read elsewhere that actual chromosomal problems that CVS would detect is more like 1% for my age. The extra percent the doctor listed was for everything put together, not just the things CVS would detect.

[daisygirl11]

Cvs is really only slightly riskier than an amnio and it is done very early to where you can look at you options. Amnio is just too late. As far as neural tube defects high res. ultrasound is how they can diagnose that, they will see fluid in the brain often and a spine that is not completely closed. We had quads so early cvs at 12weeks was my best option. It really depends on who is doing the cvs testing. Travel to a big city we went to NYC to a doc that does it every week. That is what is most important. We had a great perinatologist group but chose this doc and paid out of network for it. We had the results in less than 24 hours which meant alot to us. It was done transabdominal and I had no spotting whatsoever. It was worth it we are pregnant with twins 25 weeks. Wishing you the best in your decision.

[JoSophie]

Hi Ladies,

Thanks so much for your advice I keep reading that cvs is only SLIGHTLY riskier than amnio too Daisygirl, but why would it be? Also, does my ob do that test?

I think I said earlier that I was recently discharged from the fertility doctor, but will not be able to see my ob b/c he's on vacation, so I haven't spoken to him yet nor do I know what he will recommend, but I am really leaning towards cvs. When I called the office to make the appt.., I told the nurse that I wanted to have the cvs test and she told me to make sure I tell him when I am on the table, so he can take more samples.....does that mean he will do it? Also, I will only be 10 weeks and 1 day when I see him and is that too early for a cvs?

Thanks so much!! Too many decisions to make and I am stressed. I appreciate any help

JO

[4cats]

I went with the amnio because the CVS risk was double the amnio (though it's still REALLY small). Also, you can get an amnio done at 16wks, you don't have to wait as long as a lot of people do. It was an extra month of waiting but I figured this is my one shot to have a baby so I waited. Good luck whatever you decide.

[Tia38]

Risk: ask at YOUR clinic what THEIR numbers are... most folks talk in generalities about the national numbres... it matters how much experience the person doing your procedure has

Timing: CVS has an earlier time window associated with it... if you want to do it (or think you might) get info now as soon as you can

Another thought: I fully thought I wanted to do CVS when I became pg at 39... after some reading and discussion I decided to wait until after my nuchal scan and b/w to make the decision. With no red flags we skipped CVS and decided to postpone amnio question until after level 2 u/s. Again, no red flags so we skipped amnio. DD had no problems. Currently pg with #2 at 41 we took the same approach. Our numbers were worse (mostly due to age) and our level 2 u/s had us more concerned (our interpretation, not the docs) and so we skipped both amnio and CVS this go around as well. Currently 29w pg.

What will you do with the info: Several folks have raised this question. There is no right/wrong answer, but you should absolutely think about it ahead of time. (You can of course change your mind later, but at least thinking through the paths/options ahead of time can be helpful.)

Most of all, congrats on your pg! Best wishes for a happy, healthy and uneventful pg.

-Tia

[daisygirl11]

Jo, normally a re or obgyn does not do the cvs. You need a perinatologist or maternal fetal medicine specialist. We flew to see Mark Evans in NYC he pioneered this testing and has published many articles. We had four babies to test and wanted to make sure the doc knew what he was doing. He does this 30 times a month. Hope this helps.

Tia-Congrats on the pregnancy you are the exception at your age to even conceive twice. I know many over 38 moms to be that are heartbroken. God Bless.

[JoSophie]

Thanks so much Daisygirl!

I still have to talk to my dr. next Friday and as I want to do the cvs more than the amnio, I am unsure b/c I have to have a cervical stitch put in at 13 weeks and I am somewhat afraid that with the cvs being right before that, it may be too much activity down there for my little one. I'll see what the doc says about that. I may have to do the amnio though for that reason....what do you think? I live on Long Island, one 30 minute ride from NYC, so maybe I'll look up your guy if I need to.

Why do you think the nurse told me to tell the dr. though that I wanted to do the cvs so he can take more samples from me while I'm on the table? Does your dr. take samples prior to the cvs? Also, should I do the ultrasound and blood test (where they measure the fluid behind the neck)?

Thanks so much!
Jo

[BC-GoMom]

So your having a cerclage? BTDT- no fun but it worked. Let us know how it goes and which test you decided to do.

[JoSophie]

BC- What does BTDT mean? Going to the ob tomorrow, so I'll have more info and hopefully an informed decision. I'll let you know