Yes, as an “older mom”..I don't know how old you are, but I am going to be 44 at time of deliver. With my own eggs, I can totally relate to the concerns about defects....and for me, with twins, my OB reminded me in our first appt--that we “rolled the dice twice”. THANKS!!! Not. Sheesh. I totally agree about wanting to know, be prepared, have options--totally. But I was also pretty worried about risks with tests like CVS and amnio--especially since they are doubled for a twin pregnancy and all that we have gone through to get here. Decisions are of course completely yours--but what I did was this: (besides worry, of course. LOL. That goes without saying to an IVF'er).
1-First trimester blood screen
2-NT screen--this is non-invasive (advanced ultrasound) and measures the nuchal fold-behind the fetus neck. It can be done between 11-13.6 weeks. Some also recommend looking for nasal bone as well. These are indicators and can increase or decrease your odds of downs and other trisomies, especially when combined with results from the blood work.
3-We set a boundary. We wouldn’t consider an invasive test unless our odds were....or less. Different for everyone---personal decision--but we discussed this with our OB who agreed completely with us.
4- If you do decide to do a CVS (10-12 weeks)--risks vary with clinics. If you do go with one make sure to see how many your clinic or maternal fetal specialists have done. For us--our MFM did lots of amnios, but a lot less CVS’s which slightly increases the risk.
5-If you pass your own “benchmark” at the 1st trimester, there are more tests at 2nd trimester. I recently gave more bloodwork which combined with the first set of tests signficantly decreased our odds of Downs. Now some of the other trisomies are a bit more difficult because we have twins (for you this wouldn’t be the case), but she also assured us that there are many physical anomalies that show on u/s’s and we have yet to see any problems there.
6-Level II anatomy scan--scheduled around 18/20 weeks, but can be done sooner if there are concerns. Many if not most anomalies would be apparent by this time. Mine is late next week. But I am finally feeling more reassured by all the previous tests that I am not too worried about it--except for my hematoma, but that isn’t relevant to your situation.
7-So for us, we are comfortable not going with an amnio either. OB totally supports it given how low our risks have dropped.
Hope some of this helps!! These are suggestions and my experiences, not trying to say what is necessarily the best for you. Best of luck with what you decide!! Let us know what your OB says tomorrow.
