Testing, Testing . . .

As I may have mentioned, I had some labwork done earlier in the week, including some baseline kidney function stuff, as well as the prenatal "quad screen," which is essential the same "triple screen" that the perinatologist had already done, plus one additional test.

Most of the testing looked great, including results that put our Down Syndrome risk at something like 1/1800 - even better than the 1/1200 or so that the perinatologist told us a few weeks ago.

(Add in the 90% certain PGD results saying that Peeper is chromosomally normal, and the risk is probably even lower.)

So, yay to that.

However, my alpha-fetoprotein is a bit elevated, which can be an indication of an increased risk of neural tube, abdominal wall or kidney defects. (That's the 4th test of the "quad screen.")

When the midwife called this morning to tell me all that, she started by saying, "Don't worry, I'm not calling with bad news - people always get nervous when we call them" and then, after telling me about the great results on the Downs screen, said, "You do have an increased risk of neural tube defects, though - but it's still a very low risk."

She quantified our risk as only about a 1/200 chance that there is actually a problem (well, I didn't write down the actual number, but it was one in two-hundred-something, so actually even lower than that) which means there's a better than 99.5% chance that everything is just fine.

(Emphasis for my benefit.)

She said that they want me to "have an ultrasound - but not here, you want to do that with a maternal-fetal medicine specialist."

When I reminded her that I already have an ultrasound scheduled with my perinatologist for June 25, she said that sounded great, and that she'd send my lab results over to them and ask if they want to see me any sooner than that.

The more I thought about it, though, the more I realized that I would really prefer to get this checked out sooner, rather than waiting two weeks.

When I called the perinatologist's office, the scheduler checked with the doctor to make sure that he'll be able to "see everything he's looking for" in the regularly-scheduled ultrasound as well at 17 weeks as he'd be able to at 18 weeks, and then moved me up to next Wednesday - June 18.

He did tell her that although we should be able to tell a lot and be pretty confident that everything is okay next week, we'll probably need to do two ultrasounds (how far apart? back on 6/25 or later?) to be sure that we can "rule it out."

When I told Shrike about it this evening, she asked, "So, how worried should we be?"

I told her, "I dunno. 0.5% worried? Actually, I don't think you should worry at all. I can handle that for both of us."

I'm actually pretty confident that this will all turn out to be fine, but of course, that doesn't stop me from worrying - or from being really glad that it's only five days til we get to take a look, rather than twelve days.

There are a couple of reassuring things from our previous ultrasound - one is that, among other parts, we looked at the cranium and the abdomen, so I would think that any defects in either of those areas would have shown up then. I could see Peeper's backbone, as well, when we were doing the nuchal translucency measurements, and I'd think that anything funky there would have been noticable.

(Then again, what the hell do I know.)

The other reassuring thing is that the perinatologist actually mentioned then that my protein levels might be a bit (innocently) elevated, although I don't know if that would still be applicable a month later.

This is something that I don't think I've actually blogged about before, but although our 6 week ultrasound only showed us Peeper, at the 7 week ultrasound, we also saw a second gestational sac, with nothing going on inside.

In other words, both transferred embryos actually implanted, but while Peeper is going gangbusters, Not-Peeper didn't make it past the first couple of weeks.

That could explain why my beta levels were kind of borderline between what you'd expect from one baby and what you'd see with two. At that point, we definitely had the one healthy one, but probably also one not-so-healthy one.

We are so so so glad that we didn't spot that second sac at the 6-week ultrasound, when the lack of a fetal pole or heartbeat wouldn't have been as definite a sign of nothingness.

It was much better to have a week to get used to having just one baby (we'd kind of been hoping for both to stick), then see that we'd almost gotten both of them.

I'm very relieved that we avoided having a week of wondering whether the other would make it or not, then finding out that it hadn't.

But, enough about that - my point is that, at 12 weeks, the perinatologist said that my various protein levels that they test could be higher than would be expected with a singleton pregnancy, because of what might have been produced very early on by the second embryo.

I don't know if that would still be the case, at 16 weeks, but it makes me a little less worried about what we'll see on Wednesday, so I'm going with it.

Oh - and the upside of all this: While, of course, the most important thing that we'll be looking for on Wednesday will be for all Peeper's parts to be correctly formed and securely sealed up and fully functional, we will be looking at all his/her parts - so, unless s/he's being shy, we should no longer have to use awkward wording like "s/he" and "his/her" and such - a week sooner than we'd expected!

So, there's that.

PS: If you ever had an elevated alpha-fetoprotein level while pregnant with your perfectly normal, absolutely healthy, how-could-we-have-ever-worried baby, please feel free to share in the comments. I could do with some false alarm / happy-ending stories.