Pregnancy Screen Testing

Since I'm AMG, that is "Advanced Maternal Age," the first time we went to see the obgyn she presented us with options and choices to do various screening tests, standarly offered to pregnant women over 35.

After some thought, Andy and I decided to do the nuchal translucency screen testing, which tests for Down Syndrome and Trisomy 13 and 18. It's the earliest test available, at 10-12 weeks, and the least invasive one, I thought. It basically consists of a finger prick for blood and a sonogram. It's a screening test, not a diagnostic test like CVS (not the drug store) or the amnio. So the test can give you the odds but not tell for sure.

We went in for testing two Fridays ago. I went it very confident and nonchalant about it. (Just like I did for Ivan's first sonogram.)

Before the sonogram, the doctor walked us through everything, including the chart that hung on the wall, which basically spelled out the odds of a woman carrying a child with those defects solely based on her age.

I was aghast. At 36 my odds of having a child with Down Syndrome were 1/295. I found those odds dismally low. At 33, the odds were 1/650 (or something along those numbers). So in three years, the odds doubled. Scary. While I obviously know that fertility takes a dive at 35 and then a serious nosedive at 39, I really wasn't well aware of these health stats. I knew the risks increase with age, but I never knew exactly what that meant. And since at 33, the medical establishment doesn't recommend or really suggests these tests, I was blissfully ignorant.

Now, I know more than a half of dozen of women who had their first and second child late into their 30s or early 40s. All the children have been born healthy. (If there were some pregnancies in between where the testing didn't show positive results and other measures were taken, that's obviously a private matter that I wouldn't be aware of).

I started thinking about all these healthy professional colleagues and friends who had relatively healthy pregnancies, gave birth easily and now have beautiful children. So natural and normal. But sitting in that sonogram room, my confidence and views slowly started to unravel. The odds just aren't good. Is it possible that all these women I know just simply beat the odds? Will I beat the odds as well?

The sonogram went fine. The nuchal thickness, which the doctor was measuring for, measured at 1.7 mm (I think), which is well within the normal range. (2.5mm is cause for concern).

All that was left was to wait for the blood test. I didn't think about it at first, until I came home a few days later and the genetic counselor left a message to call her. Anxiety set it. What it things aren't good?

I called her first thing in the morning. Everything is fine, she said. Based on the testing, the Down Syndrome odds decreased to 1/1195, which is well within the normal range. To refer back to the chart, I asked her how do those odds compare to a woman's age. Like a woman in her early 20s, she said.

(The Trisomy odds decreased by alot too. They went down from 1/1000 to 1/7000, or something. Since that risk is so much smaller, I didn't catch the precise numbers.)

Right around this time--after the sonogram and before the blood test results--I had lunch with a colleague, who's a year older and who had a baby a year after I had Ivan. Turns out she's also pregnant. She's due three days before I am. But she wasn't telling anyone yet. She did the nuchal translucency, but at a different hospital. Her results were also good. I guess instead of giving her exact numbers, she just got a very general statement about the test being positive or negative. I don't recall the precise wording.

When we spoke, she was up in arms and torn with anxiety whether to do the amnio or not. Just to be sure. She wasn't sure what she'd do if she found out that the result wasn't good. On the other hand, since there is a risk of miscarriage with amnio, she couldn't forgive herself if amnio were to trigger the miscarriage. She was really torn about what to do.

While initially I had made up my mind not to do anything else if the nuchal test comes out OK, talking to her shook me up a bit. While I really hadn't give these issues post-nuchal test any thought---I was going to wait for the nuchal results and then take it one day at the time--she had overthought the issue.

We parted without any clear resolution. I don't now what she's decided to do. She's away now. I'll ask her when she returns.