Any over 35 moms elect for CVS/Amnio after negative NIPT results?

[Anonymous]

Anonymous wrote:Would you terminate? That usually is a deciding factor. If you would change course and terminate then it makes sense to have definite information.
If you would not, it serves less of a purpose. No judgement if you would.

OP here, yes, I meant to say that - we would absolutely TFMR depending on the condition, so that’s part of the calculus here.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why would you do the screening if you don’t the results?
The point is screen and then diagnose if screening is abnormal.

Yes, that’s the whole point. Talk to someone about your anxiety. No guarantees in life OP. They can pick up stuff at ultrasounds they can’t pick up through amino. Healthy fetuses can suffer oxygen deprivation at birth and end up with brain damage or cerebral palsy. If your NIPT was good, just relax. You’re not that old, and the risks are not that much higher at 37 than say, 30. If you were 47, maybe, but you’re not.

OP here, this isn’t about anxiety, it’s about the benefit of a diagnostic test versus a screening. I was looking for other moms who have considered this issue and wanted to get their thoughts. Obviously there are no guarantees with anything involving pregnancy and childbirth, or for that matter child rearing, but as a PP mentioned, there is an appeal to the level of comfort a diagnostic test provides as opposed to a screening. It sounds like several other PPs had similar concerns, so I’m hardly alone in thinking about these issues.

Seems like anxiety to me. I’d be surprised if insurance would cover an amino without a reason. That’s why they do the screenings first.

Most insurance companies have no problem covering amnio or cvs for women over 35. It's a normal test when you are AMA. As long as your OB orders it and states you are AMA it should be no issue.Because if there is in fact something that very wrong it saves them money in the long run.

Honestly I will never understand the reactions people give when moms want diagnostic testing. Why are you all so against it? The risk to the fetus is literally almost nothing with experienced MFMs. Get over it.

Thank you, I’m not sure why people are telling me to get treatment for my supposed anxiety over this. As I said, we would absolutely terminate in certain circumstances, so that is part of why I want definite information. My insurance company said they will cover either CVS or amnio based on my age, so that’s a non-issue. I’d be willing to pay OOP if necessary anyway.

[Anonymous]

So what does amnio test for that NIPT doesn’t?

[Anonymous]

Anonymous wrote:So what does amnio test for that NIPT doesn’t?

An amnio can see general problems with the chromosomes. Duplications, deletions etc...

It can see many more issues than the NIPT. Rarer syndromes and the like.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why would you do the screening if you don’t the results?
The point is screen and then diagnose if screening is abnormal.

Yes, that’s the whole point. Talk to someone about your anxiety. No guarantees in life OP. They can pick up stuff at ultrasounds they can’t pick up through amino. Healthy fetuses can suffer oxygen deprivation at birth and end up with brain damage or cerebral palsy. If your NIPT was good, just relax. You’re not that old, and the risks are not that much higher at 37 than say, 30. If you were 47, maybe, but you’re not.

OP here, this isn’t about anxiety, it’s about the benefit of a diagnostic test versus a screening. I was looking for other moms who have considered this issue and wanted to get their thoughts. Obviously there are no guarantees with anything involving pregnancy and childbirth, or for that matter child rearing, but as a PP mentioned, there is an appeal to the level of comfort a diagnostic test provides as opposed to a screening. It sounds like several other PPs had similar concerns, so I’m hardly alone in thinking about these issues.

Seems like anxiety to me. I’d be surprised if insurance would cover an amino without a reason. That’s why they do the screenings first.

Most insurance companies have no problem covering amnio or cvs for women over 35. It's a normal test when you are AMA. As long as your OB orders it and states you are AMA it should be no issue.Because if there is in fact something that very wrong it saves them money in the long run.

Honestly I will never understand the reactions people give when moms want diagnostic testing. Why are you all so against it? The risk to the fetus is literally almost nothing with experienced MFMs. Get over it.

Thank you, I’m not sure why people are telling me to get treatment for my supposed anxiety over this. As I said, we would absolutely terminate in certain circumstances, so that is part of why I want definite information. My insurance company said they will cover either CVS or amnio based on my age, so that’s a non-issue. I’d be willing to pay OOP if necessary anyway.

I'm the pp and Honestly anxiety about your child being healthy is normal. I'm surprised how many people don't seem to be concerned at all when they are older and having babies. I mean good for them but I'm all about information. It's available so I want it. It's pretty cut and dry to me. When are you due?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why would you do the screening if you don’t the results?
The point is screen and then diagnose if screening is abnormal.

Yes, that’s the whole point. Talk to someone about your anxiety. No guarantees in life OP. They can pick up stuff at ultrasounds they can’t pick up through amino. Healthy fetuses can suffer oxygen deprivation at birth and end up with brain damage or cerebral palsy. If your NIPT was good, just relax. You’re not that old, and the risks are not that much higher at 37 than say, 30. If you were 47, maybe, but you’re not.

OP here, this isn’t about anxiety, it’s about the benefit of a diagnostic test versus a screening. I was looking for other moms who have considered this issue and wanted to get their thoughts. Obviously there are no guarantees with anything involving pregnancy and childbirth, or for that matter child rearing, but as a PP mentioned, there is an appeal to the level of comfort a diagnostic test provides as opposed to a screening. It sounds like several other PPs had similar concerns, so I’m hardly alone in thinking about these issues.

Seems like anxiety to me. I’d be surprised if insurance would cover an amino without a reason. That’s why they do the screenings first.

Most insurance companies have no problem covering amnio or cvs for women over 35. It's a normal test when you are AMA. As long as your OB orders it and states you are AMA it should be no issue.Because if there is in fact something that very wrong it saves them money in the long run.

Honestly I will never understand the reactions people give when moms want diagnostic testing. Why are you all so against it? The risk to the fetus is literally almost nothing with experienced MFMs. Get over it.

Thank you, I’m not sure why people are telling me to get treatment for my supposed anxiety over this. As I said, we would absolutely terminate in certain circumstances, so that is part of why I want definite information. My insurance company said they will cover either CVS or amnio based on my age, so that’s a non-issue. I’d be willing to pay OOP if necessary anyway.

I'm the pp and Honestly anxiety about your child being healthy is normal. I'm surprised how many people don't seem to be concerned at all when they are older and having babies. I mean good for them but I'm all about information. It's available so I want it. It's pretty cut and dry to me. When are you due?

Thank you! Yes, like you, I prefer more information whenever possible. I’m due 9/25 but I’m sure I’ll be induced again since I have GD with this pregnancy as well.

[Anonymous]

Normal NIPS for both. Also did amnio for both because I wanted the microarray. NIPS only tests for a few “common” trisomies. Much more can be picked up with a microarray via amniocentesis. I didn’t want to do CVS because sometimes there’s weird placental mosaicism stuff, but had my NIPS been abnormal, may have done CVS instead of waiting for amnio. Also, FWIW, I didn’t thinks amnio was any worse than doing a flu shot.

[Anonymous]

It sounds like you should do it then. The NIPT is reassuring but does not exclude some things. CVS can be done earlier and since termination is considered I would do CVS and know earlier. If you have to wait for amnio, it shortens the window to decide what you would do. CVS will give you peace of mind that you have tested for what you can and have maximum knowledge

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why would you do the screening if you don’t the results?
The point is screen and then diagnose if screening is abnormal.

Yes, that’s the whole point. Talk to someone about your anxiety. No guarantees in life OP. They can pick up stuff at ultrasounds they can’t pick up through amino. Healthy fetuses can suffer oxygen deprivation at birth and end up with brain damage or cerebral palsy. If your NIPT was good, just relax. You’re not that old, and the risks are not that much higher at 37 than say, 30. If you were 47, maybe, but you’re not.

OP here, this isn’t about anxiety, it’s about the benefit of a diagnostic test versus a screening. I was looking for other moms who have considered this issue and wanted to get their thoughts. Obviously there are no guarantees with anything involving pregnancy and childbirth, or for that matter child rearing, but as a PP mentioned, there is an appeal to the level of comfort a diagnostic test provides as opposed to a screening. It sounds like several other PPs had similar concerns, so I’m hardly alone in thinking about these issues.

Seems like anxiety to me. I’d be surprised if insurance would cover an amino without a reason. That’s why they do the screenings first.

Most insurance companies have no problem covering amnio or cvs for women over 35. It's a normal test when you are AMA. As long as your OB orders it and states you are AMA it should be no issue.Because if there is in fact something that very wrong it saves them money in the long run.

Honestly I will never understand the reactions people give when moms want diagnostic testing. Why are you all so against it? The risk to the fetus is literally almost nothing with experienced MFMs. Get over it.

Thank you, I’m not sure why people are telling me to get treatment for my supposed anxiety over this. As I said, we would absolutely terminate in certain circumstances, so that is part of why I want definite information. My insurance company said they will cover either CVS or amnio based on my age, so that’s a non-issue. I’d be willing to pay OOP if necessary anyway.

I'm the pp and Honestly anxiety about your child being healthy is normal. I'm surprised how many people don't seem to be concerned at all when they are older and having babies. I mean good for them but I'm all about information. It's available so I want it. It's pretty cut and dry to me. When are you due?

Thank you! Yes, like you, I prefer more information whenever possible. I’m due 9/25 but I’m sure I’ll be induced again since I have GD with this pregnancy as well.

I'd be a lot more concerned and focusing my attention on the real risks and problems associated with GD than the unknown (and often indefinite) information an amnio could possibly provide beyond confirmation of the NIPT/ultrasound negative screens that, although small, presents a risk to the baby. You're apparently worried about the 1:10,000 (or whatever...) chance the screeners are "wrong," but not the 1:1,000 chance that this diagnostic test could cause an adverse outcome for the pregnancy?

Sorry if that sounds snarky, but having just been through the entire amnio/genetics process starting with non-negative NIPT results, I wouldn't jump into it after every zero-risk test and screener has told me there's no indication for it, and especially not being *that* AMA. If you proceed with just FISH/karyotyping, you will still only see chromosome-level abnormalities (mostly the same info as the 1st tri screeners are looking for). The microarray provides much, much more information, yes, but a lot of it is knowledge that we don't have full understanding of - and the potential to create a lot more worry and anxiety for someone who appears to be prone to that already. Your genetic counselor will likely discuss with you that a number of the deletions/duplications they can find in the results are not 'diagnostic' in the sense that we can tell these patterns have been found in individuals with say, schizophrenia or ADHD, but is it causative? We don't microarray reasonably healthy individuals or even every person with a particular condition, so there's no data to say that 50%, 70%, 95% likelihood of this genetic error resulting in your child developing this condition. What kind of decisions and worry are you faced with if you recieve THAT information? We microarrayed because our screening results were indicative that it could be a dup/del issue, but waiting on those results and considering what information we might find was really concerning - and I'm not generally a worrier.

[Anonymous]

Excellent post, PP. sometimes too much info is not a good thing.

[Anonymous]

Thanks to those of you who provided helpful responses. FWIW, I’m not really a “worrier” - as I said, I just want more information, not less. My GD is mild and completely diet and exercise controlled, and I’m otherwise fit with a low BMI, so I’m not worried about that (not is my doctor) since I know how to keep it under control, but thanks for the unsolicited advice on that. I understand completely that I might get more information than I know what to do with, but I prefer that to the alternative of not knowing, especially since I’m fully prepared to TFMR, so I guess I have my answer. If anyone else has considered this issue and came to a decision either way can chime in, would love to hear it! Otherwise, not interested in anyone’s thoughts about my level of anxiety.

[Anonymous]

Anonymous wrote:Normal NIPS for both. Also did amnio for both because I wanted the microarray. NIPS only tests for a few “common” trisomies. Much more can be picked up with a microarray via amniocentesis. I didn’t want to do CVS because sometimes there’s weird placental mosaicism stuff, but had my NIPS been abnormal, may have done CVS instead of waiting for amnio. Also, FWIW, I didn’t thinks amnio was any worse than doing a flu shot.

This is helpful, thanks!

[Anonymous]

My wife did, but it was because she had a previous pregnancy which she TFMR because of abnormalities. And the MFM she worked with had never lost a baby as a result of an amnio. She did opt for the amnio and not the CVS because she was on Lovenox and had bleeding off and on during the first trimester.

Amnio was normal, we finally breathed a little and enjoyed things after that. If you trust your doctor, why not just do it?

[Anonymous]

Anonymous wrote:Normal NIPS for both. Also did amnio for both because I wanted the microarray. NIPS only tests for a few “common” trisomies. Much more can be picked up with a microarray via amniocentesis. I didn’t want to do CVS because sometimes there’s weird placental mosaicism stuff, but had my NIPS been abnormal, may have done CVS instead of waiting for amnio. Also, FWIW, I didn’t thinks amnio was any worse than doing a flu shot.

Thank you! This perspective is helpful.

[Anonymous]

Anonymous wrote:My wife did, but it was because she had a previous pregnancy which she TFMR because of abnormalities. And the MFM she worked with had never lost a baby as a result of an amnio. She did opt for the amnio and not the CVS because she was on Lovenox and had bleeding off and on during the first trimester.

Amnio was normal, we finally breathed a little and enjoyed things after that. If you trust your doctor, why not just do it?

Thanks, this is also helpful. I have had one previous early miscarriage, but that was several years ago. I think I want the peace of mind an amnio gives.