Sunday, June 28, 2009

NT Scan at 12 Weeks

Here are our little poppets. We know that it's a girl and a boy because of the microarray testing that was done on the embryos before they were transferred. But now we're almost certain that Baby A is the girl and Baby B is the boy.

We went in for our Nuchal Translucency Screen at exactly 12 weeks on Thursday. The purpose of this screen is to determine the babies' risks for Down Syndrome and Trisomies 13 and 18. It's a combination of ultrasound and blood test. The blood results will be back this week so we're waiting for the final risk assessment for each baby.

In terms of the ultrasound, we believed it was just the one parameter, measuring the fluid behind the neck - the nuchal fold. I didn't do any research before this screen and, as it turns out, there are other parameters as well, such as crown to rump length, limb length and presence of a nasal bone structure. Both babies look prefectly sized for their age and their nuchal folds were 1.4mm (Baby A) and 1.6mm (Baby B). These are great results, given that a normal nuchal fold measurement is below 3mm. We breathed a sigh of relief at those measurements and thought that was it, but when it came to Baby B's nasal bone measurements, they had difficulties finding the bone structure. The peri told us that this could be because the baby was not in a good position (it looked like a good position to me), because it was hypoplastic (small) or because it simply wasn't there. Since the absence or reduced size of a nasal bone is a soft marker for Down Syndrome, we were suddenly very concerned. To be fair, the doctor told us this happens "all day long" and usually everything is ok. Unfortunately we were both too stunned to ask any meaningful questions, so, once he had told us we were coming back in four weeks for our 16 week scan, we said our goodbyes. He must have seen that we were very worried because he came to find me in the nurses' station five minutes later to reassure me that everything will be ok. I wish he'd explained more about why he thinks that. He did earlier say that the nuchal fold measurement was the more useful one.

Since we participated in microarray testing in Denver and both embryos came back normal, we ought to be confident, however microarray and cgh do carry a 10% error rate. I spoke to the genetic counselor in Denver on Friday and she told me they've seen a much lower error rate than that in the 30 to 40 live births they've had from microarray and cgh tested embryos so far. So if we look at it statistically, it's unlikely that Baby B is affected, but of course we now have some doubt in our minds. We're preparing for Baby B's risks to come back extrememly high this week, based on the nasal bone and my age. Apparently all the measurements from Thursday's scan, the blood results and maternal age are fed into a computer program and it spits out a 1 in x risk for Down Syndrome or other trisomies. Given that this program won't take into account the fact that we had the embryos pre-tested, I think the risks will come back high, though they will in fact be lower, due to our microarray tests. I've seen different numbers for my age, but the highest risk assessment purely based on age I've seen was a 1/38 risk for DS. I don't know whether that will now go up based on the nasal bone issue. I suspect if we do get a high risk result for Baby B we'll be asked to come in to see the peri for a meeting soon. We're pretty sure that, either way, we won't be doing amnio or CVS due to the risk factors those tests present for miscarriage.

On a positive note, my sickness seems to be gradually declining, though it's still very unpredictable. Usually I'm ok in the mornings now, but get gradually worse as the day goes on. The late afternoons and evenings are still very difficult. I'm hoping to be much better in the next ten days, since I have a business trip coming up the week of the 6th. I can't imagine how I'll manage if I'm still feeling like this then.

Happily, I've suddenly started dreaming about drinking alcohol! I dreamt I was drinking a beer one night this week (despite my Bavarian upbringing I'm not a beer drinker) and another night this week I dreamt that I was out wine-tasting and eating blue cheese. Very civilised.


  1. I'm going to pray hard for clear results for Baby B! Good luck!

    Glad your sickness is subsiding a bit!

  2. Ahhh, what a cute little boy and girl Jessica! I think the odds are in your favor that baby B is just fine, but hoping and praying that he is and you have a clear answer next u/s. That's great that that your starting to feel better. Enjoy and keep us posted with those cute belly shots.

  3. I feel confident that Baby B is going to be perfect! I'm praying for a good outcome. I wish the morning sickness would disappear soon. i miss you lots & lots. B.

  4. Thinking good thoughts for you.

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  6. I feel certain that Baby B will be great! I'm petitioning God for a decent result. I wish the morning ailment would vanish soon. i miss you parts and parcels.

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  7. It's amazing to your sympathetic wife that's prepared to keep up your falter morale every time in your life! You do have such an interesting blog. Thank you!

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