Thursday, August 18, 2011

Advanced Maternal Age

Well it's official - I am an old lady.

Apparently when you're 35 it's time to hang up the towel - cause - chica you're old!  Because of my "advanced age" my OB wanted me to do a First Trimester Screening.  Thus the lovely ultra sound pic from my previous post.

In case you're a young whipper snapper, a First Trimester Screening is a combination of a fancy ultra sound and blood test which measure proteins produced by the placenta to determine your child's likely hood of having a chromosomal abnormality (i.e. Down's Syndrome).  It less invasive than a CVS or Amniocentesis.

Well on Monday we had said test done.  Our ultra sound came out wonderfully.  In the scan the technician measures the space in the neck for fluid and the bridge of the nose - too much fluid and a short nose are often indicators of Down's.  Well our scan was great.  The fluid was below normal and the nose was a cute as a button.

Today I got the blood work result...

Damn blood work.

According to the blood work my beta hCG is high ( I am in the 99 percentile) and my PAPP - A levels are low (30 percentile).  The high/low combination "can" be a marker for Down's Syndrome.

My baby's odds at having Down's are 1/37.  That's a 3% chance.

So the very nice lady (who was on the phone with me for over an hour) suggest and amnio.

Crap, @&(#$*)%, Shoot, &()$*@), Frack!

I am conflicted....

Do I have the amnio for peace of mind and risk a miscarriage (this clinic has a .25% miscarriage rate) or do I just go with it, roll the dice and wait until delivery. 

Oh, now I am also freaked out about low PAPP -A levels.  The genetic counselor said, "DO NOT Google low PAPP-A levels" - well darn it lady I did! My freak out factor has been raised!!

What do I do? I am looking for some other old ladies words of wisdom here.  I knew going into IVF my risks where always higher for certain problems - I also knew I was old (I mean I can count).

Perhaps the true irony of this whole situation is that 100 years ago (yes I am THAT old) my dear husband and I had planned that after we had a dozen biological children (as a result of moonlit walks on the beach and consumption of copious amounts of alcohol) we would adopt a child with special needs.  Now here we sit after years of struggling through infertility - perhaps pregnant with a special needs child and in the process of adopting a completely healthy child.  Oh, the irony!

So.............What do you think?  Is it worth the risk - knowing?  Papa don't preach I am going to keep my baby (let's see how old you are!)


Baby Smiling In Back Seat said...

I think there are benefits to knowing, whatever the outcome may be. If it is positive for Down's, you'd be able to prepare for the child's medical and psychological needs before arrival. If it is negative, that is a lot of stress that you can stop feeling throughout the rest of the pregnancy. That is a long time to wonder and worry.

Sorry that you have to go through this. Good luck.

Jill, Momma to Tanner, Josie, Will and Surprise Baby #4. said...

Welcome to my world! This happened to me with Will. :o) He is fine.

First of all, the blood test has a VERY HIGH "false positive." Granted 1/37 is NOT a positive but hopefully you get the idea.

I was torn also. We wouldn't terminate even if he had Downs but the other part of me wanted to know for medical reasons. I ended up just trusting God.

I would trust the measurements over the blood test.

Trust your heart. No one will judge you either way. OK, there may be some morons who do, but don't listen to them. They aren't in your shoes!

Hang in there!!!!

P.S. I declined the test with baby 4. :o) Didn't need that stress.

Anonymous said...

Yikes that's quite a decision you have on your hands. I think knowing ahead of time would make things so much better. I also think if it was negative you could relax and stop stressing out about it. I hope you make the best decision for your family.

Bea said...

If you are planning to not terminate I would be inclined to skip the amniotic. Don't forget you get a second look at 18-20 weeks which gives more accurate odds (though still not a yes/no like the amniotic). Also there is a 97% chance your baby is fine. You might like to talk to your doc about doing an amnio after the 20wk scan if risk still high. This might be too late to terminate (at least as safely) but in your case if you are after the info then still plenty of time for that and you might be able to find a time of less risk to baby? Worth a discussion with a pro.

Sometimes said...

A number of friends of mine have had this freak out and they've all been fine.

And then a friend specifically decline the test and the doc did it anyway - and told her that her baby would be down's. they did NOT terminate and their baby is 2 years old and PERFECTLY HEALTHY.

Whatever you decide, will be fine. If you choose not to do the test, you will probably worry. If you do the test, you will worry until the results come in. But there is a 97% chance - an A+ on a test! - that everything will be ok. Good luck.

Pam said...

As a infertilty survivor, I think I would go with the amnio, just for peace of mind. That way you know exactly what you are dealing with and "if" special preperations need to be made for the birth, they are in place. I was 34 when I was pregnant, so I had no special tests done. I suppose that advanced maternal clock shuts off the second I turn 35?? I had decided though if they recommended an amnio, I would do it.

Regina said...

I just stumbled upon your blog & had to comment. I am now 42, but got that "advanced maternal age" BS when I was pregnant w/my daughter. We did a nuchal ultrasound & opted not to do an amnio. I hope all is going well for you!

Regina said...

I just stumbled across your blog. I wanted to comment because I was also of "advanced maternal age" when I was pregnant with my daughter. I am now 42 & mom to a beautiful almost 6 year old named Lily. She just started kindergarten. We opted to only do a nuchal ultrasound with our pregnancy. The amnio came with risks I wasn't wanting to try (miscarriage). I hope all is well with you & your family.

Konoctilady ~ Jo Ann Brixie said...

I'm glad they didn't have all that advanced stuff when I had my babies. Of course, I was in my twenties, so it wouldn't have been an issue anyway.
My daughter went through this with her third (she was thirty-six) and cried during the amnio because she realized that she was risking the pregnancy, and wouldn't want to abort even if the baby had Downs. (He was fine.) That did make the rest of the pregnancy easier, though.
I know people who did find out their baby had Downs, and were glad they were forewarned.
Only you and your husband can decide what is right for you. I went through several years of infertility, even though I was young. It was a different time, different social pressures. I do remember the heartache of getting that period month after month when I wanted to conceive. God bless you in your journey.

BreastFeeding Top Shop said...

I would hate to be in your situation. I am 34 going on 35 and to be honest I don't feel that age is old. But what do I know. Anyway about your situation I do agree with baby smiling in back seat. It would be nice to know because you could benefit from knowing ahead of time, just to be prepared emotionally and to be prepared for what your child's needs would be.
Either way you shouldn't be judged for your decision. So make the right choice for you, the one you feel in your heart. Good Luck!

The hopeful homemaker said...

try not to stress i know its hard but its not good for the baby they wanted me to have one too with my 2nd child and i refused didnt want to take the risk. sorry you have to worry but everything will be ok