How do you decide whether to have a cvs/amnio?

[2or3]

My question is really hard to phrase, and possibly really basic, but I hope you understand..

How do you decide whether to have a cvs/amnio?

Do you decide by your age alone?
By genetic factors?
Or wait for the 12 week screening scan and go for more testing depending on your predictions?

I am 38 in 3 months and currently pg with dc3. I had a look at private cvs around here and am considering booking that.

But is it worth spending the money just to check if something is wrong based purely on my age?

I was offered amnio when pregnant with DS. This was after my blood tests came back indicating a risk factor. I was only 32 so age not a real risk.
We discussed it with the consultant. He said that the risk of a problem like downs etc was one in 250 from the blood tests. The amnio itself had a risk of miscarriage of between one in 50 and 1 in 100.

We talked about what we would do if amnio showed a problem and decided that we would have the baby anyway. Also the risk of harm to the baby was higher than the risk of a problem so we felt that it would pointless in having the tests.

It did mean I worried constantly until he was born though.
and no downs but he does have AS. Not that I would change him for the world.

I guess what I am trying to explain long windedly is that you have to go by your feelings - think about what you would do if a problem shows up. Would it make any difference to whether you continue the pregnancy or not.
What are the percieved risks at the moment? is there a greater risk of loosing the baby than finding a problem? If not is it worth it?

Personally I would wait for the nucal fold scan at 12 weeks, and decide whether to have amnio based on the result from that.

I'm 32, so my risk based on age alone is something like 1 in 500. However, after having the nuchal fold test my risk went down to 1 in 10,000. It wasn't worth having the amnio for such a low risk.

I think at my hospital they usually recommend you have an amnio if the nuchal fold test shows a risk of downs of greater than 1 in 250.

Good luck with whatever you decide.

Hello - I am 38, and in feb 2011 had a pregnancy which turned out to be t21 plus a few other probs. I am now p again, and gave the CVS a miss, and waited for the outcome of the 12 week scan then booked the amnio. I dont' think i would have a CVS purely based on my age, but had to know 100% even though the 12 week scan looked ok, and this decision was based on previous risk. There is a small risk with invasive testing (about 1% I was told), and it's whether you could bear to take that risk for something to go wrong, only to be told all was actually ok. Hard choices. HOpe all progresses well :)

I had similar circumstances to adivic (38 with a previous T21 pregnancy) but i didn't have to know for sure. i was happy not to have invasive testing once my nuchal deemed me to be 1 in 1700. I had many detailed scans looking at heart and for markers and was happy to conclude that I could be the one but it was long odds and my main concern was health related so the many scans would rule out health issues that often go with downs like heart problems and bowel issues. Just goes to show how it differs from person to person, I think you have to decide what you are prepared to risk.

afaik you can have cvs straight after nuchal anyway with T21 pg I had it after my nuchal scan showed big nuchal fold and hydrops.

Thanks for your generous advice. It is appreciated and makes sense to me. I guess I will just wait what the 12 week scan brings.

Hi, I'm 38 and decided not to have it. There is no history in our families and all the scans seemed fine. I personally made the decision, my DH backed me. I knew that if it came back positive I would not be able to get rid if it. My DH would have wanted me to tho. I'd bonded so much already with our special IVF baby that I couldn't have gone ahead with a termination. As it turns out we have a beautiful, perfect baby boy.

I was 36 with DC1 and 39 with DC2. We paid privately for a Nuchal Scan, although these might now be available on the NHS in your area, I'd ask your MW. Depending on the tests they do at the hospital, yours might come back as high risk just because of your age. Again, I'd check what blood tests they do.

Also, I think you both need to discuss and be really clear about what would happen if the results weren't what you'd hoped for.

Depends on what you would do with the result.

We would have terminated for some conditions described as incompatible with life, - for example anencephaly. In most cases this would show on a scan so there was no point having invasive testing.

DS1 actually is severely disabled - with a condition that cannot be picked up antenatally. So with ds2 and ds3 it seemed pretty pointless having invasive testing to pick up DS when the any child we had was going to be at high risk of something we couldn't test for anyway. (We could have terminated for DS, got pregnant again and ended up with a child more disabled anyway). DS2 and DS3 aren't disabled btw. Anyway in our case terminating would have messed me up emotionally more than having a disabled child so we weren't likely to terminate even if a disability was picked. Again we assumed that something like anencephaly would be picked up on a scan.

So point of all that is that it depends a lot on what you would do with a result. If you would continue with the pregnancy anyway you may decide there's no point having invasive testing. If you would terminate the pregnancy then there's more point having the invasive testing. Some people chose invasive testing so they can be prepared, but I'm not sure you can ever be prepared for a disabled child tbh.

I think it is wise to good idea of what you would choose given certain results when you start with scans etc (so discuss it with your partner beforehand) especially if you want to stop with scans, because if you are shown as being at high risk the medics tend to assume that you will want further invasive testing and I have quite a few friends who have found it quite hard to be listened to when they've said no to further testing. It has caused some upset at a difficult time.

My blood tests came back with a risk of 1 in 60, I was 34 at the time. Decided to go ahead with the amnio because we felt it was better to be forewarned and know what to expect, rather than worry all through the rest of the pregnancy. It was not about having a termination if the results were positive for Downs as I don't think we would even have considered it.

When the risk of miscarriage equalled the risk of a problem. About 1:100.
DH and I agreed that neither of us would be good parents to a disabled child before TTC.
DD1 hit the risk exactly (I was 29) and I had the amnio which was actually quite pleasant because we got a very good look at DD on the scan while they did it.
Can't remember DD2's figures, but much lower risk so no other tests.

Oh I was 33 so no huge age related risk.