Amnio vs. CVS

[Anonymous]

I am waiting for the results from my first trimester screening (NT + blood test). My husband and I have decided not to go forward with more invasive diagnostic tests (i.e., CVS or amnio) unless the screening comes back with a problematic result. The difficulty is that I will be out of the country for a period of time and will have passed the window for a CVS by the time I get back. Assuming the worst case scenario (don't we always do this?!), and the screening results come back indicating chance of an issue, I am trying to decide whether to cancel my trip and have the CVS or just wait and do an amnio. I would love to get feedback from others that chose a diagnostic test, which one you chose and why. I like the idea of getting results back earlier with a CVS, but my doctor told me the risks of miscarriage with amnio are lower (1 in 700) versus CVS (1 in 300). FWIW, I think it is unlikely that we would terminate the pregancy, unless the baby was diagnosed with a problem that would make carrying it to term unlikely. I am 32, healthy with no family history of genetic problems, and this is my first pregnacy.

[Anonymous]

Went thru this same calculation and you'll find lots of people who argue that with an experienced practitioner, the risks are pretty close to equivalent. Not sure if that's true but it seems to be a line of argument that people use quite a bit to argue for CVS. I was swayed against CVS for purely personal reasons - I found one study that indicated a higher risk of bleeding after the procedure which was not said to be dangerous for the pregnancy, but which I knew would freak me out because of a past history of m/c and bleeding during pregnancy. Also, I believe that occasionally the CVS will come back as inconclusive, and then you have to do the amnio anyway. Finally, the doctors I was seeing performed amnios at 15w, only a couple of weeks later than CVS, so the timing question didn't really seem like that big a deal.

All that said, the CVS has a lot of fans, including on this board, who make very good positive arguments, including the timing and the fact that it scans a wider range of potential genetic issues than the amnio does. In the end, my odds came back very good - not off the charts but moved me from a 39yo risk level to a 20yo risk level, so I've opted for neither but am doing my 20w u/s at 18w just in case they spot something that raises concerns and motivates me to do the amnio. Fwiw, I did do an amnio with baby #1 and had no problems at all - it was painless and complication-free.

[Anonymous]

Just keep in mind that the blood test have a VERY high false positive result.

[Anonymous]

Also in terms of risk of miscarriage, pay attention to the stats of the person actually performing the test, not just those published stats. In reality, the risk of these tests, I believe, is much lower than 1 in 700 or 1 in 300 you mentioned. I had amnio with first, and CVS with second. I was 39 with my second so I wanted to know sooner and not wait until 20 weeks to see if anything was wrong so we could be adquately prepared. Also, I wouldn't classify either of these as "invasive". Just saw your age -- at 32, I'd probably just go with an amnio - or nothing at all.

[Anonymous]

Sorry for my ignorance, but does it mean false positive, and falso negative?

Thanks,

[Anonymous]

I chose CVS because, as a PP pointed out, with an experienced doctor the risks are similar with amnio and CVS. I liked that the CVS could be done much earlier and the results only take a few days to a week to come back. From what I understand, amnio results take a few weeks. We also chose CVS because we decided not to tell anybody about the pregnancy until we knew that all was okay. I was starting to show at 10 weeks so it would have been difficult to wait another month. I don't understand why CVS is considered more invasive - I think puncturing the amniotic sac is pretty invasive. I didn't have any cramping or bleeding during or after the CVS.

[Anonymous]

I'm the OP from the recent CVS thread, and we are doing CVS for the same reasons as the PP. But I am 35 and just want a clean bill of health for the baby (as much as possible). I have a family member who had a sad experience with a Down's baby, and so it is very important for me to know. The bonus is finding out the sex earlier!

Anyway, I am having the CVS done on Monday at one of the most experienced clinics in the world, according to my doctor. It's the Genetics & IVF Institute in Fairfax. While there is a risk of miscarriage, it is extremely small.

Now, would I cancel a trip out of the country to do CVS if I was not likely to terminate? No. Since you say you would probably not terminate, I would just wait and have amnio when you get back, if the screening indicates a reason to do so at that time. Again, for me, I just want to know a.s.a.p. to consider all options, and so I can relax and get on with enjoying this pregnancy! Good luck with whatever you choose.

[Anonymous]

Anonymous wrote:Went thru this same calculation and you'll find lots of people who argue that with an experienced practitioner, the risks are pretty close to equivalent. Not sure if that's true but it seems to be a line of argument that people use quite a bit to argue for CVS. I was swayed against CVS for purely personal reasons - I found one study that indicated a higher risk of bleeding after the procedure which was not said to be dangerous for the pregnancy, but which I knew would freak me out because of a past history of m/c and bleeding during pregnancy. Also, I believe that occasionally the CVS will come back as inconclusive, and then you have to do the amnio anyway. Finally, the doctors I was seeing performed amnios at 15w, only a couple of weeks later than CVS, so the timing question didn't really seem like that big a deal.

All that said, the CVS has a lot of fans, including on this board, who make very good positive arguments, including the timing and the fact that it scans a wider range of potential genetic issues than the amnio does. In the end, my odds came back very good - not off the charts but moved me from a 39yo risk level to a 20yo risk level, so I've opted for neither but am doing my 20w u/s at 18w just in case they spot something that raises concerns and motivates me to do the amnio. Fwiw, I did do an amnio with baby #1 and had no problems at all - it was painless and complication-free.

Totally agree with you. Amnio can be done at 15 weeks! i wish i new that before doing the cvs ! which for me was inconclusive. Btw i am 30 yrs old my results were 1 in 15 chance that my baby had downs syndrome. I did the cvs after 14 days they told me that they think it was maternal blood so i did another blood test waited 2 weeks and my results were inconclusive so i had to do the amnio it was a nightmare ! if i had known earlier i would have done the amnio right away.

[Anonymous]

You should consider doing either only if the outcome could result in your terminating the pregnancy. I opted for CVS since I know my own worry level and felt it would be a very long time to wait and emotionally could not (had also many m/c's before) - and because I'd be showing later on for amnio and would not want to have to explain to anyone our decision. i went to a top cvs dr- performs so many- risk level was extremely close to amnio..

[Anonymous]

Can anyone share the names of their docs for cvs and/or amnio with the low M/C rates?

[Anonymous]

Anonymous wrote:Sorry for my ignorance, but does it mean false positive, and falso negative?

Thanks,

I don't think so, but ask the doc to be sure. Why are you worried, you are younger than the rec. age for anything really. I would not get the blood test is you are not willing to go all the way because it will most likely come back as down positive and then you will really be freaked out. I know so many people this happen too and the baby was fine, very high false positive. From what I have researched, CVS has to b e done exactly at a certain time or it can cause limp defects if the timing is off. I would find the absolute best if I were having anything done other than an ultrasound. but that is me, I would hate myself if I lost my baby trying to figure out if he/she were perfect or not

[Anonymous]

I had my CVS with Dr. Stern at GIVF. He has a lot of experience and does several a day. He had a great bedside manner and really put me at ease.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Sorry for my ignorance, but does it mean false positive, and falso negative?

Thanks,

I don't think so, but ask the doc to be sure. Why are you worried, you are younger than the rec. age for anything really. I would not get the blood test is you are not willing to go all the way because it will most likely come back as down positive and then you will really be freaked out. I know so many people this happen too and the baby was fine, very high false positive. From what I have researched, CVS has to b e done exactly at a certain time or it can cause limp defects if the timing is off. I would find the absolute best if I were having anything done other than an ultrasound. but that is me, I would hate myself if I lost my baby trying to figure out if he/she were perfect or not

CVS had some minor (meaning very few) side effect a decade ago where some limbs could be knicked by the needle.. Now- CVS is not performed that early in the pregnancy to eliminate that risk. If you're concerned about that - I would read up on this. I was and then wasn't after reading more.

[Anonymous]

Anonymous wrote:I had my CVS with Dr. Stern at GIVF. He has a lot of experience and does several a day. He had a great bedside manner and really put me at ease.

Same here. He's fantastic. Has tremendous experience and a wonderful manner!

[Anonymous]

CVs here with Dr stern too- he was top notch but a dorky bedside manner- no way rude or intimidating- but he's got his own style- he's just fine overall since he's done cvs so many times- and you do feel confident in him..