Refusing scans

[backonthewagon]

Has anyone else refused scans after IVF? There has been quite a few studies regarding the safety of multiple scans and I was thinking of refusing them unless there is a medical reason to indicate one is necessary.

As far as I'm aware, the NHS has neither the money or inclination to offer scans that aren't medically necessary.

A lot of hospitals only offer the 20 week one. Which imo is adequate. But with ivf you have an early one around 7 weeks, then in some areas you have a dating scan at 12 weeks (why is this necessary when you know the exact time you conceived) and then there are often multiple growth scans as ivf babies can be smaller than average. The information gathered from the scans is often wrong (in up to 1/3 of cases) and can cause unnecessary distress as opposed to it detecting serious problems in only 2% of pregnancies.

So which scans would you opt to have?

babies conceived via ivf have a 10x greater risk of genetic abnormalities. so the additional scans would seem helpful not harmful.

Isn't the 12 week scan an anatomy scan? And they look at the nucheal fold (fluid at the base of the neck) to indicate likelihood of Down syndrome. The scan at 7 weeks would be the dating scan IMO and is done so the nucheal scan is done on time - there's only a window of about 12 days in which they can read this accurately. The 20 week scan is then done to ensure things are developing as they should be. I'm 29 weeks pregnant with DC2 so have recent experience of scans.

Marsbarmarsbar that is exactly my understanding too. When I had my son I paid for at least three extras too.

Pretty sure my anxiety of something going wrong (which the scans abated) was a hell of a lot more dangerous to me and DS than the scans themselves.

You don't need to have scans if you don't want them. My understanding is that the early scan often offered after IVF is for reassurance and to check the pregnancy is developing in the right place as the risk of ectopic is higher. I found the first tri to be very long so I was happy to have them but you are not obliged to. It won't be for dating purposes as they know exactly when conception happened in IVF pregnancies!

The 12 week scan checks anatomy and looks at indicators for chromosomal abnormalities. The 20 week scan looks at all the organs, the skeleton and blood flow to the baby to make sure everything is developing properly. My 20 week scan picked up a problem with blood flow to the baby which led to careful monitoring and an early section at 34 weeks as she was struggling. Without the scans I might not have realised anything was wrong until it was too late as I was healthy and my bump was growing. I read up on the effects of lots of scans as I ended up having dozens. The only well documented effect seems to be a tendency towards left handedness. I'll take that over the alternative. It's personal choice but the downsides are small and the upsides potentially very significant.

Hospitals do use scans for dating purposes for IVF babies. Their procedure will be to use the scan date, they will not take into account the known and documented conception date. It seems mad to me, but there you go.

You really only need a 12 week and 20 week scan. Why would you go through ivf and all that that involves and not want to ensure the baby is ok? I get that you want to protect and do anything to minimise risks to your baby but in my opinion you would be a fool to not have the scans. Im an ivf mother so understand your fears.

"There has been quite a few studies regarding the safety of multiple scans and I was thinking of refusing them unless there is a medical reason to indicate one is necessary."

Could you link the studies? The only one that I'm aware of is the Swedish one, which found a tiny rate of increase of left-handedness, but there is doubt as to whether that was statistically significant. There have been no further studies because the overwhelming benefits to mother and baby of scans in pregnancies mean it is held to be unethical to withhold them. Also, I am not aware of any observational studies which link number of scans to any adverse outcomes, hence request for links.

Babies which have problems in utero are more likely to be scanned. So it takes very careful epidemiological study to remove that as a confounder and show that a particular condition is linked to certain levels of exposure to ultrasound and at what stage of gestation.

That said, 12 week scan (with option of nuchal measurement) and 20 weeks scan seem to be all that the NHS offers for low risk pregnancies, and you could take that down to the 20 week main anomaly scan only.

You don't need to have if you don't want. You could do the new blood test ones if you wanted (harmony?) to avoid the 12 week one I think

Scans show lots more than just if the baby has an abnormality or restricted growth though - like if you had low fluid, or your placenta was in a risky place for a natural birth, that sort of thing...

I don't think there's a necessity to have all you are offered, but I do think there's a benefit to ultrasounds

I read a really crap science article once that scared the beejeezus out of me having any more scans.

Anecdotal but this article said there was research that proved ultrasounds causes boys to be more likely left handed and finding that research led me to then believe the rest of the crap science about mice in the article - anyway my boy is ambidextrous (!!!) and was scanned a million times before I came across crap science article that scared the pants off me

I can't remember the names of the studies I read now. Will try to find them. I would have scans if there was concern about growth, being behind/ahead of dates, fluid loss, lack of movement, bleeding, placental position, fetal position etc. I just think that each woman should be scanned on her indiviudual needs not you get a scan at this many weeks just in case there is a problem, there probably won't be a problem but we will probably think there is and cause you months of worry that you don't need.

If it was in midwifery today

Ignore it! Seriously!

PTick my hospitals (two major London teaching hospitals at which I was seeing the heads of foetal medicine because of the problems that were discovered) went by the IVF date. It is daft not to as the scans can only estimate dates within a window whereas with IVF you know with certainty on what date sperm met egg!

PTick Not all hospitals use the 12 week scan for dating purposes in IVFs.

Ours hasn't. I should have been exactly 12 weeks on my scan date and measured 12+6. They left me with my IVF due date though.
The hospital has a policy of offering induction at 40 weeks so if they'd have moved the due date I'd have been fighting induction 6 days earlier. This baby has measured consistently ahead of dates all the way through.

OP there may be a correlation between number of scans and outcomes, doesn't mean there is causation though. Higher risk pregnancies are more like to have more scans anyway and therefore more chance of finding an issue.

This pregnancy I have had scans at 7, 9, 12, 19, 28 and 34 weeks and will have another this week at 38+1.

Sorry to be blunt, but the reason for a first scan at around 12 weeks is both nuchal screening (if the parents want that) and also a check for gross anomaly, when there is still time for a medical TOP if that is chosen.

The important one is at 20 weeks, because the baby is so much larger by then, and many conditions can be picked up. If everything looks normal at that stage, then you can be optimistic of a normal newborn.

IMO, it's perfectly reasonable to go for 20 week scan only.

I think it's reckless not to be scanned at all.

Pigeonpoo said something that rang a bell actually, don't they like to see the location of the placenta in case it's blocking the birth canal?

You were happy enough to have an invasive high tech conception presumably being fully aware of the increased risks IVF pregnancies may face yet you want to decline scans? Why?

It's fine to make decisions on an individual basis and go against the accepted norm for your baby but please don't be needlessly scared into or out of beneficial healthcare that's available.

Not all studies are equal, some are very bad science even.

Your midwife or obstetrician should be able to give you the pros and cons on your individual case and help you make an informed choice

I ruined my pregnancy because I believed some very bad science studies. There's risk in everything, weigh up the risks carefully

My anecdotal evidence is multiple scans (like every fortnight till third tri) caused no harm to my child who's developmentally ahead at 3 years old now.

I have an ivf baby and had placenta praevia, it is much more common in ivf pregnancies.
I would suggest that you have the 20 week scan to check that your placenta isn't low lying as if you go into labour with a praevia you could die.

Also yes my son had 12 scans and is tall, healthy and his nursery teacher says he's brighter than average also.

I would have scans if there was concern about growth, being behind/ahead of dates, fluid loss, lack of movement, bleeding, placental position, fetal position etc.

*But how would you know there was any of the above issues without having first been scanned?

Growth - can't rely on tape measure as it has a huge margin for error.

Dates - again, can't rely on tape measure so how will you check this?

Placental position - do you have X-ray vision? No other way other than scanning to check it.

Fetal position - a midwife generally can tell of baby is head done but again this can be misinterpreted.

How will you feel if you refuse scanning and baby is born with a problem, life threatening or not? What if you are considered low risk and it all goes hideously wrong at birth because placenta was blocking cervix? Willing to take that risk for the sake of your baby? Don't be selfish.*

Much more risk to baby from not having scans than having them imo, but it's your decision.

Obstetric scans save lives. It's that simple.

As a sonographer I would be interested to see these studies, I have yet to come across any solid evidence that multiple obstetric scans carry adverse effects.

Google is a very dangerous thing when it comes to medical research. You can choose virtually any aspect of medicine and will find "research" spouting absolute nonsense.

I'm all for keeping pregnancy and childbirth as natural as possible when it's safe to do so but this sort of mistrust of medical care, which is based of decades of vigorous research, just seems so unnecessarily risky and misguided.

There is zero evidence for ultrasound scans causing problems.

I was very very nervous while pregnant with DD1 after multiple miscarriages. So I had 5 early scans including the NHS 12 week one. Then some eeeejit told me this nonsense about scans and I had a few sleepless nights trawling through scientific journals reading and reading and reading. I'm talking full on Medline literature search. There is nothing. So please don't be afraid of scans.

As an aside.. even though I had loads of them scans did b*gger all to reassure me anyway. After the temporary high of seeing the baby wriggling happily on screen, the doubts and worries quickly resurfaced.