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Pregnant after IF
may2806
member
Not so great NT results
may2806
member
This is unbelievable. The scan went fine, baby is ok, measuring on track and all measurements look good. But apparently my b/w results were not so good - I have really high HCG and really low Papp-A, which apparently puts me at a high risk for Downs (1 in 81).
Apparently this could have some connection to the bleeding, because the other issue with the low Papp-A could be because my placenta is not functioning properly or attached well or something. But also, I guess placenta problems are more common for Downs babies so it's just hard to tell.
Next step is CVS or amnio. I can only do the CVS if I haven't had bleeding for a week prior, so I scheduled it but I'm not sure what to do. The m/c rate will be higher because of my bleeding episodes; however if I have to wait for the amnio...I just want to know as soon as possible.
Honestly I tend to think it's my crazy body not being able to create a good placenta rather than the baby having Downs, but who knows. Has anyone had low Papp-A?
Any thoughts on CVS vs amnio?
Dx: High FSH, stage IV endo, homozygous C677T MTHFR and PAI-1
Early loss 10/08
Lap 1/09
IVF #1 "natural IVF" - 1 egg retrieved, missed m/c
Tried several mini-stim cycles with no response
Switched clinics - dx'd as carrier for Fragile X
IVF #2 MDL protocol Jan/Feb converted to IUI, BFN
IVF #2 take 2: Antagonist, one embie, BFN
IVF #3: Antagonist, no fertilization
One last ditch effort at OE IVF (antagonist with Clomid) cancelled
DE cycle #1 Jan/Feb 2011, BFP, ectopic
DE cycle #2 June/July 2011 - BFP
10/28/11 Baby girl lost at 17 weeks due to pre-term labor. We love and miss you.
DE cycle #3 June/July 2012 - BFP, twins, both heartbeats stopped, D&C
2 frosties but don't know what's next
FET Dec 2012: BFP! Praying this one sticks for the long haul!
Early loss 10/08
Lap 1/09
IVF #1 "natural IVF" - 1 egg retrieved, missed m/c
Tried several mini-stim cycles with no response
Switched clinics - dx'd as carrier for Fragile X
IVF #2 MDL protocol Jan/Feb converted to IUI, BFN
IVF #2 take 2: Antagonist, one embie, BFN
IVF #3: Antagonist, no fertilization
One last ditch effort at OE IVF (antagonist with Clomid) cancelled
DE cycle #1 Jan/Feb 2011, BFP, ectopic
DE cycle #2 June/July 2011 - BFP
10/28/11 Baby girl lost at 17 weeks due to pre-term labor. We love and miss you.
DE cycle #3 June/July 2012 - BFP, twins, both heartbeats stopped, D&C
2 frosties but don't know what's next
FET Dec 2012: BFP! Praying this one sticks for the long haul!
This discussion has been closed.
Re: Not so great NT results
I have no advice... just wanted to say I am so sorry to hear this - and exhausted for you just thinking about it! My gut reaction is to agree with you, that it seems likely there is some underlying placenta issue that is at the root of all of this (as opposed to something like Downs). And you may just need extra monitoring as the pregnancy progresses to make sure the baby is growing properly. Either way, I know it must be a lot to think about, and the last thing you need is another reason to worry.
Oh hon, best of luck as you decide on what testing to pursue and as you process all of this. (((HUGS)))
Because we're fancy like that.
Hi there...
This is my response from a similar post:
"I mostly lurk and cheer on "itsbabytime", but wanted to share my experience. During my 1st trimester screening, the measurements were fine as well as my HCG, but I was given a 1:50 chance of DS due to an extremely low PAPPA-A. I want to say it was maybe 1%. I opted for an amnio because MH and I figured if our baby had DS, I wanted the best care once it was born. Amnio came back normal. I spoke with my OB about the results and she said the test is so new and not very reliable. Also, the ratio is based off of all results as well as your age, race, and weight. Well it didn't help that I was pushing 35 and a little overweight.
I did not have any issues with my placenta and I delivered a healthy baby boy. I read somewhere that a low PAPPA-A can sometimes indicate a boy (not sure how true this is)."
I hope everything works out for you. GL!
Oh may. You seriously cannot catch a break with this pregnancy. I'm sorry for the less than great news today. I really hope it turns out to be nothing.
Keeping you in my T&Ps. I really want you to have an uneventful healthy rest of your pregnancy.
2/21/11: IVF #1 Begins and results in TWINS!
11/4/11: The twins are born at 36w4d!
11/5/11: We said goodbye to our sweet baby girl as she was born with multiple complications and a severe heart defect, Hypoplastic Left Heart Syndrome.
I'm sorry you're dealing with this. I did want to say that the MFM who did my NT scan did not draw blood that day- I had a SCH and she said that it could affect the bloodwork. Maybe your bleeding issues could be affecting the b/w? I don't have any advice about the CVS or amnio, but good luck with whatever you decide!
After 2 1/2 years TTC, 3 IUI's, endo, and a lap, a surprise BFP brought us Alexandra Marie!
THis makes me so annoyed and sad for you. I hope everything works out. And please remember it still very much could. As far as placenta.... that all comes from the embryo, part of the cells make placenta and part make a fetus. So it isn't your body necessarily working against you.
I'm thinking good thoughts for you that this is all just confusion and you'll go on to have a perfectly normal pregnancy. HUGS!!
My PAPP-A is also low (.34). My HCG was normal though. My OB said the connection between low PAPP-A and placenta/growth problems is not very strong. Sounds to me like they are still researching it and are trying to make the connection. Mine did not seem overly concerned about it but I do have to meet with the perinatologist at 28 weeks and have a growth scan at 34 weeks. She also mentioned that they are the only Kaiser in the region even using the test and following the "high risk" guidelines.
I'm also pushing 35, overweight and did IVF. I have read there may be some connection there, but who knows. I'm trying not to worry about it but may ask for a doppler study to be conducted on the umbilical cord to see if we have any blood flow issues.
I'm sorry you're dealing with it too ... sounds like it's getting more "common."
Our Journey to Brenden
IVF #1: 4/11(Follistim/Menopur/Ganirelix) 10 retrieved/8 mature and all 8 fertilized / 2 embies transferred ... nothing to freeze Beta 5/10 = BFN
IVF Take 2 Long Lupron July 2011
ER 7/3/11 (our 6th anniversary) - 8 retrieved/7 mature/fert ....ET 7/6/11 - 2 beautiful grade A 8 cell embryos
Beta 7/18/11 - 149!!! Beta 7/21/11 - 311 Beta 7/28/11 - 2,000 8/5/11 - Empty Sac 8/8/11 - There's a yolk sac and maybe a heartbeat 8/12/11 - Fetal pole, yolk sac, heartbeat 8/18/11 - Baby looks GREAT!
3 babies waiting on ice
IVF#1 Oct 2009 (CCRM) - BFN
IVF#2 March 2010 - Poor response/cancelled
DE IVF#1 Aug 2010 - BFN
DE IVF#2 Dec 2010 - Transferred 1, 2 frozen - BFP!
TTC#2 FET Jan 2013 - Transferred 1 - BFP!
DE IVF #1= 04/11 - BFP
TTC since July 2008
IUI 1,2,3 BFN
IVF #1 C/P, FET 1,2,3 BFN
IVF#2 BFP
it's a girl!!
I was given a 1:40 chance of DS based on my bloodwork. My HCG was 1.71 and my Papp-A was 0.58. I was also 39 yo at the time which increased my risk. My NT measurement was in the normal range at 1.9mm.
We decided to pass on the CVS b/c of the risk of miscarriage and when I looked at the odds as a 97.5% chance that my baby did NOT have DS, it didn't seen so bad. We decided we would wait and see if there were any additional markers at the 20-week anatomy scan to decide whether or not we'd do an amnio.
Our anatomy scan looked perfect and they bumped up our odds to 1:80 so we passed on the amnio as well. Our daugher was born without DS.
If I had to do it again, I would probably do the amnio. I feel like I spent most of my pregnancy worried and didn't have a good birth experience because of it. The moment she was born should have been joyful, but all I could think about was whether or not she had DS.
As for CVS vs amnio... if termination is an option, then CVS is really your only option. If termination is not an option, then wait for an amnio since the risk for m/c is lower. Either way, make sure you find a doctor who has a lot of experience doing them.
I'm so sorry you're having to face this decision. I know it's a tough one and I remember how stressful and difficult that time was. ((((((hugs)))))) good luck!!
I'm so sorry--it is so scary to hear those words from your doctor. Like you, my NT scan was perfect, so I was completely shocked when my OB called a few days later to tell me my bloodwork was abnormal. I can't remember my numbers, by I do know that my PAPP-A was really low. (I can't remember about the HCG, but it was "off" a little bit.)
Based on my bloodwork, my DS risk was 1:120 and my risk of Trisomy 18 was 1:40 I believe. I opted to have a CVS because I was so upset about the Trisomy 18 risk--I figured that all the stress, worry, and lack of sleep couldn't be good for LO, and I didn't want to have to wait several weeks to have an amnio. I think I would have had to wait till 18 weeks or so to have a more detailed u/s. (I was around 12 or 13 weeks at the time.)
What also helped me make my decision to have the CVS was that my risk of having a child with Trisomy 18 was higher than the risk of miscarriage from the CVS. It was the scariest decision that I have ever made though. Fortunately, all was well, and we are having a healthy baby girl.
Since my PAPP-A was low, I had a follow up u/s with MFM at 18 weeks to check the placental blood flow (normal), and I go back again at 30 weeks to make sure she is still growing properly. I wish you the best of luck in your decision, and hope all is well with LO. Like others have said, more likely than not, everything is fine with the baby, and you will just need closer monitoring to check for proper growth.