CVS: to do it or not to do it? That's the question...

[Anonymous]

I'm 9 weeks pregnant wth my second baby and I'm about to turn 41. I did not do any invasive test with my fisrt child, even though I was 37 at the time. The odds of the nuchal test were very good and we trusted that everything was going to be alright (and it did, our DD is now 2.5 years old and very healthy). This time around I feel more insecure, I had a miscarriage 5 months ago and I went through an IUI to get pregnant with this one, so this time I want to be sure that everything is fine. I'm debating whether to do the nuchal test again or go directly to a CVS which will give me a peace of mind early on and will let me enjoy this pregnancy (so far I'm very detached). So what have been your experiences with CVS? Did you decided to do it because you wanted certainty or because your nuchal test showed something wrong? Also, what is the real risk of m/c, it is really higher than amnio? Any input or advice will be greatly appreciated. TIA!!!

[Anonymous]

I'm in the same boat you are. I'm 40 and this is my first and considering CVS very seriously. Mainly for peace of mind. I talked to my OB about it at length--peppered him with questions, in fact, about risks. There was an article (I couldn't find it but will keep looking and post it if I do) that recently came-out about how in areas where CVS is done frequently (so our's) the risks are actually much lower (same with amnio) than the over all national average. Makes sense. The risk of having a child with problems is greater than the risk of having the CVS so for me, that made the decision. I am a big worrier and for my own mental health, we've decided to do it. I think the key is to find a Dr. who does them every day and has a lot of experience....

[Anonymous]

I had one with my son and so glad I did. I had the procedure at Thomas Jefferson Hospital in Phili-and yes, we drove from DC to PA for the procedure. TJ are pioneers in the procedure and my dr. took his wife to TJ for her CVS-we felt comfortable going with TJ. It wasn't bad, it really didn't hurt, and we had the prelim results in 2 days. I'd do it again.

[Anonymous]

I was 43 when I got pregnant with my daughter. We had been trying for 3 years (failed IVF, many miscarriages) then finslly got pregnant au natural!
A CVS was highly recommended by my OB because of my age. I knew it would be a long fearful pregnancy if I did not know that everything was ok. We did decide to have the CVS, can't remember the name of the doctor...but she was great, highly respected (did some research) and was in Maryland.
Everything turned out to be fine and now we have a very healthy 21 month old. I am glad I did the test...after so many miscarriages it did help me to enjoy my pregnancy.

[Anonymous]

PP--I have heard they are great. What was the name of the Dr. who did your CVS?

Thank you.

[Anonymous]

Sorry, I didn't send the message quick enough--PP who went to Thomas Jefferson...

[Anonymous]

13:13 here. Dr. Baxter.
http://www.jeffersonuniversityhospital.com/gw-cgi/gateway_appjhs_inner.cgi/?url=f%3D5041.html&formaction=http%3A%2F%2Fwww.jeffersonhospital.org%2Fcgi-bin%2Fphysiciandirectory%2F%2F%2Fsearch.cgi%5E&shw=phys&id=51e903&ohp=0&hos=0&affiliation=&specialty=&qids=51e903&recNumStart=1

[Anonymous]

dr. karsen in md is great; dr. pinckert is also superb (and you get results in 2-3 days with him). do the cvs if you need to know and would terminate if you found out something bad OR if you found out something bad that you wanted to prepare for. i've had two -- one was fine with my first child and the peace of mind was huge; second one revealed a fatal chromonsonal abnormality (not age related) and i was so thankful i knew and could terminate before deliverying a still born or misscarrying late in the pregnancy -- which is what was going to happen. it was still a horrible decision to make but i was glad i had the option. everyone is different though...

[Anonymous]

I was 39 when I was pregnant with DD 2 and we did CVS. I absolutely wanted to know ahead of time if we were going to be faced with anything. I didn't want to spend 40 weeks and every appt living in fear of something. I figured if we were going to have a special needs child I wanted to be as mentally prepared as I could - it that's even possible. Thankfully, all is well and DD 2 is a happy healthy 15 month old! Best of luck to you with your decision.

[Anonymous]

13:21 poster here...
I also went to Dr Karson in Maryland. She was great...made me feel very comfortable.

[Anonymous]

I'm 35, first pregnancy, and we chose to do CVS testing. Probably out of sheer paranoia over my "advanced maternal age", since we don't have any risk factors except my being 35. My husband and I really wanted to know as much information as early as possible. We just aren't those people who would choose to continue a pregnancy "no matter what." We knew there were circumstances where we would terminate the pregnancy, and so we chose CVS to have as many options as early on as possible. The statistical risk of miscarriage from CVS (as far as they can tell) is about the same as amnio - 1 in 250, I think it is, but don't rely on that. Do your own research and ask the practicioner/genetic counselor for stats at the place where you are considering getting it done. My procedure was done by Dr. Gallagher at Greater Washington Maternal Fetal Medicine in Silver Spring/Forest Glen. The genetic counselor there, Jill Fonda, was excellent. She will spend as much time with you as you want answering questions. Dr. Gallagher has done lots and lots of these procedures, and is very experienced. (You may read that the risks for miscarriage go down the more experienced the physician is.) I think I would do CVS again - it's hard for me to contemplate ANOTHER pregnancy at the moment, since I'm not done with this one! But my experience was positive, and the peace of mind was worth it for us. Good luck with your decision.

[Anonymous]

PP here - website for Dr. Gallagher, et al is http://www.gwmfm.com/

Also, we did the procedure on a Friday (so I could have the weekend to rest - you have to limit your activity for a couple of days afterwards), and got the prelim results (which are 99% accurate) on the following Tuesday.

[Anonymous]

I say do it. I did it about six weeks ago due to my age, and it was not a big deal and SUCH a relief. Plus, putting aside getting the health clearance, we loved getting another great ultrasound and finding out the baby's sex so early. We had no risk factors but knew we would terminate for a select reason.

I opened a thread on CVS before I went and got great responses, all of which were accurate representations of the testing and follow-up procedure, so I suggest you search for that.

I went to the Genetics and IVF Institute in Fairfax. My doctor told me they basically perfected the technique worldwide, and boy were they professionals! Dr. Stern (MD/PhD) did the procedure, and I believe Mary was our genetics counselor. It was a very impressive experience from start to finish.

I did a lot of research beforehand about miscarriage rate and decided it was not a compelling risk factor. Yes, it exists, but it is negligible from the procedure itself. And I definitely did NOT want to wait for amnio -- until I had bonded with the baby in utero any longer -- so that sealed the deal for me.

Honestly, I'm a first-time mom and was worried like you, but it should have been the least of my worries. Good luck.

[Anonymous]

I'm 40 and chose not to do the CVS. I've posted on these threads elsewhere, as have lots of others, so it's worth a search. I'd had an amnio with my first child and expected to go for all the testing again. But I'd also had a m/c in between, and a combination of subtle discouragement from my Dr., very good NT results, and our preference not to terminate unless there were truly devastating abnormalities made me change my mind. I'm a huge worrier, and never would have expected that I could live for 9 mos without certainty. But the risks - minor though they are - loomed larger this time around; somehow having had one healthy baby and lost one pregnancy makes me all that much more conscious of all the things that can go wrong. Plus I had a lot of bleeding early in this pregnancy, and read that one of the frequent side effects of the CVS was spotting/bleeding - and even if it was not going to be dangerous for the pregnancy I knew experiencing anything that reminded me of m/c would drive me to hysterics. The final factor for me was the fact that CVS can very occasionally be inconclusive - which means you have to do an amnio. In the end I opted to move up my 20w u/s to 18w -- which gave me plenty of time to do an amnio if the drs. saw something to worry about. Everyone makes their own decision, but I just thought I'd offer a different outcome than most of the PPs.

[Anonymous]

I did the CVS with my second because our prenatal blood test came back with a higher than average risk for Trisomy 13 and 18. I hate to say it, but in my case the CVS didn't work so I also then ended up doing an amnio. Everything turned out just fine and I'm due to deliver our baby very soon.
Just so you know, there is only a very small chance that the CVS will not retrieve the correct cells (in my case they only got maternal cells) and it appears that I was this one person that it happened to. I went to Greater Washington Maternal Fetal Medicine and saw Dr. Gallagher for the CVS and then Dr.Matia for the amnio.
One of the most difficult things about the CVS was that I had to stay off my feet as much as possible for 24-48 hours and then refrain from lifting more than 10 Lbs. Well, my daughter is 26 lbs. so I was really struggling with this. I had mild cramping and I was definitely exhausted and bruised after the procedure. For me, it also wasn't totally painless, but it's different for different women. It also depends on how they "go in" to take the sample; through the vagina or through your stomach. I heard the vaginal way hurts more (mine was through the stomach).
We would have terminated had the baby had either of the trisomies so doing the CVS was pretty important for us. I had several conversations with my Ob/Gyn about termination, just in case, and just so I could understand what happens exactly and how much risk termination carried esp. if done during the second trimester (which would have been our case since we waited for the amnio).
By the way, I was offered another CVS after my results came back inconclusive, but opted to wait for the amnio. I felt that the CVS was invasive enough to do once and the recovery of 5-7 days was too long.
Good luck with your decision. It was a tough road for us to take-CVS, then amnio...but it's good to be certain that our baby is healthy. I personally couldn't have spent my entire pregnancy wondering. We are waiting to find out the gender though. At least one surprise remains.