CVS vs. amnio

[nextgen901]

I am 43 years old and 14 week pregnant. Due to my age, I was offered to go through an integrated testing. I did nuchal and first blood test at 11th week. Both results came out fine. I am going to draw blood again around 3/15, a second part of the integrated testing.

For some reason, I was not asked around 12th week if I want to take CVS. Isn't CVS done around 12th week? Last time I saw my doctor, which was early February, I asked her the difference between CVS and Amnio. She explained but she didn't advise me anything about if I want to do CVS, then I need to schedule it by when, where etc.  I am planning to do an amnio regardless but I didn't share this decision with my doctor yet. Well, since I am going to take an amnio test, it doesn't really matter but what bothers me is what other things did she omit to tell me? What if I had wanted to take CVS instead of amnio or even worse, do both and lost the timing for CVS?

I know there are many people who have more serious concerns here but this really bothers me a lot. I could have found the results at least two weeks earlier if I had done CVS. Now I have to wait another month to get the amnio done and the results back with this unknown. It just makes me wonder if I should change my doctor since she doesn't seem to take me seriously and I do want to be taken seriously of course. I am a firm believer that we all should demand to be taken seriously, each and all of us. Am I being too sensitive or paranoic?

[Dee77777]

No you are not paranoid, change the doctor if you're not comfortable.  Congrats on the pregnancy, you are blessed.

[Annie7737]

Just got a call from the dr for a 1/30 chance for downs, with the first screen, the measurements were fine, but im 42 so she is thinking the age factor squed the results.......she didnt tell me what my levels were so im going to a counselor tomorrow...........too much worrying!

[adgal]

I'm glad I could help a little.  One thing to remember with the first trimester screen results.  It is not so much that is is a false positive, but that it's important to remember this test is in no way intended to be diagnostic.  It simply gives you information that you may (or may not) want in order to decide whether or not you want further testing.  I hate that they use words like positive as that just scares the heck out of us, and usually for no reason.  I really think they need to do a better job of explaining what it means.  I know a women on MH who had her screen come back at something like 1:600.  Her son does in fact have DS (and she is in her 20's).  Then there is me who came back with odds of 1:13 and my son is typical.  So yes, in order to know for absolute certain, amnio or cvs are currently the only options.  I am like you...I want to know for sure and given that my first experience with amnio was not a bad one, I am going to do it again.  That's why I will probably skip that first set of tests.  

Best of luck to you.  I am interested to hear what your Dr. says when you have this conversation with her.  She should never be annoyed with questions..your baby, your right to ask.  Take care.

[nextgen901]

Thanks very much and I totally agree with you. Educate ourselves. In fact, that was what I did. When I first go over with the doctor what kind of testing I need to take etc. in the beginning of the pregnancy, she did not even mention CVS. I found it out only after I read several books and through this site. When I asked her about CVS, she looked a little annoyed that I ask questions about something that she did not mention but she did say the risk associated with CVS has been reduced from 1:200 to 1:300 or almost close to the one of amnio. But she conveniently forgot to ask if I wanted CVS instead of amnio before it was too late!

Well, my doctor has been good otherwise till now but this episode just tells me that no matter how nice a doctor is, a doctor is a doctor :).

I wanted to go for an integrated testing first and then, amnio because I didn't want to do amnio if the nuchal measurement and blood tests result show I am fine. But now, I want to do amnio anyway because I cannot totally trust this integrated testing technology and want to know for sure. I hear horrible stories about first trimester screening tests are false negative (screening test results show fine but the baby born has down syndrome etc.). When you are pregnant, your emotions get on rollercoaster even at a little negative possibility.

Again, thanks for your kind words and advice adgal. I read your comments to many others who appreciate them as well. Thanks for keeping this forum positive and informative.

[adgal]

Yes you are correct in that CVS is done earlier.  Around week 13 I think.  This seems to happen a fair amount and the only explanation I can come up with is the assumption Dr.'s make that we want to see the NT/blood results prior to making the decision as to whether or not to do further testing.  I think many Dr.'s also lean toward amnio as the risk factor is slightly lower then CVS.  I know amnio is quoted at 1:400.  I think (but not 100% certain) that CVS is 1:200 or perhaps 1:300.

All that being said, I happen to agree with you and do not feel you are being sensitive or paranoid.  My belief is that we should be educated on our options, the pros, cons and risks of each, then be able to make the choice that is right for us.  I have an issue when a Dr. (or anyone for that matter) assumes they know what I want when it comes to such a very personal and important decision, or what is best for us.  I believe information is power.

If this were me I would have a very frank discussion with your OB as to why this option wasn't offered up front, especially when she offered the other testing.

I had my son at almost 41.  I am 42 now and we are trying for another.  When we did our first trimester testing the results came back as 1:13 for DS.  This time around (if I am lucky enough to have a this time around) I am considering skipping all testing and going straight to the amnio.  My reason for this is that I worried so much between the time of the first trimester screen and the amnio, it was awful.  I am comfortable with the amnio process, the risk and feel very confident in the Dr. who did it last time as his record is excellent.  I wish Dr's would take all of that into consideration and put our options on the table.

Congrats on your pregnancy!  I wish you a healthy and happy one.