Stressed about CVS vs Amnio decision

Stressed about CVS vs Amnio decision

Gym girl
Gym girl

August 13th, 2012, 5:01 pm #1

Hi everyone,
Im a bit stuck on a decision I have to make and would appreciate your help. I know this topic has come up so many times, but I just dont know what to do.

I had my first OB appt today (10 weeks) and he asked why I did a CVS when I was pregnant with my DD a few years ago. I explained that my RE had mentioned simply because I was already 35 at the time and would be 36 when I delivered. He referred me to Dr. Wapner and I had no problem going out of state at the time.

This time around, Im older, so its almost a given for me that I will have the CVS done... my 40th birthday is around my due date. My OB, though, said that theres really only one doctor locally who does CVS and he actually prefers to refer AMA patients to a doctor to do amnios because of the m/c odds (I think he said 1:200-300 for CVS vs 1:400-500 for amnio generally, not specific to any of these local doctors).

Fine odds-wise, its a no brainer to me. However, and I hate to actually verbalize/write this, but the truth is that in doing a CVS we would know sooner if there was a major problem... and all of the decisions that might have to come with that knowledge depending on the severity of the situation.

Anyway, I was wondering if any of you who have done CVS or amnio could tell me why you ended up choosing one over the other?
For the record, DH is inclined to go with CVS because of how late, relatively, an amnio is done.
Thanks for your help!
Gym Girl
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Joined: August 6th, 2011, 6:43 am

August 13th, 2012, 7:20 pm #2

I would go with CVS because it is earlier than an amnio. I would look for the best doctor I could find at a clinic that has tons of experience with them and make the drive to the clinic if I had to. I've never had CVS or an amnio. but that is what I would do.
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Gym girl
Gym girl

August 13th, 2012, 7:32 pm #3

Hi,
Thanks for replying! Yes, that's definitely what my preference is. This one doctor is only about a 45 minute drive away and is basically the only one in the area (other than the one my RE recommended, but that one is actually an RE partner in my IVF clinic and doesn't do these everyday, so I'm less tempted to go to him).

Otherwise, I have no idea how to find out who the "best" ones are. I wish there was a list online or something, but other than the few key players I've heard of, like Wapner and Evans in NY, I'm not sure who else is out there. What's even more frustrating is that when I called various doctors to ask about their m/c rate, the nurse or assistant's response was along the lines of "Oh, not many..." That doesn't make me feel good regardless of which option we choose.

So my OB and the MFM I went to for my DD pregnancy and whom I will go to for this pregnancy both refer patients for CVS to this one doctor (the MFM does amnio, not CVS). So since I was a patient previously, I called the MFM's office to see if he'd be willing to call me for 5 minutes whenever he has time in the next day or so as I make this decision and the reception basically said, "Oh, he doesn't do that..." I said, "Really? As a medical professional with a question from a past/soon to be present patient, he wouldn't take a question about this big decision?", so when I said that, she took my number, but with no guarantee that he'd agree to call.

So annoyed and confused. Hope we make the right and safe choice!

Thanks!
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jkl
jkl

August 13th, 2012, 8:40 pm #4

Hi everyone,
Im a bit stuck on a decision I have to make and would appreciate your help. I know this topic has come up so many times, but I just dont know what to do.

I had my first OB appt today (10 weeks) and he asked why I did a CVS when I was pregnant with my DD a few years ago. I explained that my RE had mentioned simply because I was already 35 at the time and would be 36 when I delivered. He referred me to Dr. Wapner and I had no problem going out of state at the time.

This time around, Im older, so its almost a given for me that I will have the CVS done... my 40th birthday is around my due date. My OB, though, said that theres really only one doctor locally who does CVS and he actually prefers to refer AMA patients to a doctor to do amnios because of the m/c odds (I think he said 1:200-300 for CVS vs 1:400-500 for amnio generally, not specific to any of these local doctors).

Fine odds-wise, its a no brainer to me. However, and I hate to actually verbalize/write this, but the truth is that in doing a CVS we would know sooner if there was a major problem... and all of the decisions that might have to come with that knowledge depending on the severity of the situation.

Anyway, I was wondering if any of you who have done CVS or amnio could tell me why you ended up choosing one over the other?
For the record, DH is inclined to go with CVS because of how late, relatively, an amnio is done.
Thanks for your help!
Gym Girl
do the first tri screen as early as possible, if something looks bad do cvs, otherwise do the amnio? The first tri screen is pretty good at detecting possible problems, particularly for us 40 somethings. Or do the materni21 screen, that will detect things pretty early and you can still do aminio to follow up. I think most severe problems (and most of the other trisomies are pretty severe) will be detected at the u/s, and the downs can be picked up with the materni21 screen.

jkl
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Gym girl
Gym girl

August 13th, 2012, 9:43 pm #5

The Materni21 test hasn't been brought up by anyone here, so I wonder if it's as well known as the other options yet. Thank you for the idea, though. I'll look into it. In truth, though, I had a positive experience with CVS last time. DH is now wondering if I really can't go to NY, but I think that would stress me out more than anything. My DD starts school next week (week 11) and DH will be traveling out of state, so I don't know how feasible it is for me to be away for 2 days or whatever.

Re. finding a great doc to do CVS, does anyone here know of anyone completely trustworthy in Orlando or anywhere else in FL? Just trying to think of the bigger cities and Orlando is the first one that came to mind.

Thanks!

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Denise
Denise

August 13th, 2012, 10:42 pm #6

NT scann, Matri T21 bloodtest, and quad screen bloodwork should be enough good luck!!
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Kris
Kris

August 15th, 2012, 9:26 pm #7

Hi everyone,
Im a bit stuck on a decision I have to make and would appreciate your help. I know this topic has come up so many times, but I just dont know what to do.

I had my first OB appt today (10 weeks) and he asked why I did a CVS when I was pregnant with my DD a few years ago. I explained that my RE had mentioned simply because I was already 35 at the time and would be 36 when I delivered. He referred me to Dr. Wapner and I had no problem going out of state at the time.

This time around, Im older, so its almost a given for me that I will have the CVS done... my 40th birthday is around my due date. My OB, though, said that theres really only one doctor locally who does CVS and he actually prefers to refer AMA patients to a doctor to do amnios because of the m/c odds (I think he said 1:200-300 for CVS vs 1:400-500 for amnio generally, not specific to any of these local doctors).

Fine odds-wise, its a no brainer to me. However, and I hate to actually verbalize/write this, but the truth is that in doing a CVS we would know sooner if there was a major problem... and all of the decisions that might have to come with that knowledge depending on the severity of the situation.

Anyway, I was wondering if any of you who have done CVS or amnio could tell me why you ended up choosing one over the other?
For the record, DH is inclined to go with CVS because of how late, relatively, an amnio is done.
Thanks for your help!
Gym Girl
I sorta drift in and out of the boards (had to give myself an Rx of minimal Internet research because I just got too nervy!). Anyway, saw your post and thought I'd offer my own experience, for what it's worth. I'm 36 yrs old and 29 weeks with our first, after lots of acupuncture and IUIs with stims. We did a CVS and it was a no-brainer for us for the same reasons you state -- we just preferred to know sooner than having to wait for amnio. I just didn't want to wait that long. If you know you wouldn't do anything about bad results anyway, then there's not much reason to do either a CVS or amnio, at least I think. But we felt we would, so a CVS it was!

We are lucky in that we're in the LA area, where John Williams practices at Cedars Sinai. He is hands down THE best doctor in the country for CVSs. People travel to him for it. I think he's done like over 20,000 or more of them and is the authority on the procedure. If you really, really wanted to go for the best, it's him. If I lived out of state, I would fly in for it. You probably already know that they're done in two ways -- vaginally, or through a needle in your belly. It all depends on where your placenta is located. I had to do it with the needle through the abdomen (like an amnio would be), and it wasn't bad at all! He's done so many that it took no more than 2-3 minutes. I had not a single side effect. Best rest for 2-3 days as a precaution.

We talked to him about CVS risks (vs. amnio) and the reason, at least in large part, that the risk is slightly higher with a CVS mostly has to do with 1) the doctor's actual experience in performing CVSs, and 2) that they can't statistically carve out those miscarriages that had nothing to do with the CVS procedure itself. In other words, it's done much earlier than an amnio and there's not a great way to account for which of those miscarriages "would have happened anyway," for a reason other than the CVS. The procedure is done during a window when miscarriages happen normally. That aside, you want to go to a doctor who performs them regularly and who has done lots of them.

If you can't travel to LA to see Dr. Williams (not sure I saw where you're located), then maybe call his office and see who they recommend near you? You never know!

Hope that helps a bit! Good luck.
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Gym girl
Gym girl

August 16th, 2012, 2:29 pm #8

Thank you for sharing your experience! My first one with Dr. Wapner sounds a lot like your with Dr. Williams (funny how they're both considered THE authority It was a very positive experience for me, too.

I ended up making the appointment for next week with the doctor locally who does all of them. He has years of experience and does anywhere from 3-10 a day, so that's reassuring. Thank you also for pointing out that m/c's that would have happened anyway are factored in... that makes complete sense and makes me feel better.

Wish me luck!!

Thank you and good luck with the rest of your pregnancy!

Gym girl
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