Advised not to carry again

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caryn
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Re: Advised not to carry again

Postby caryn » Fri Apr 10, 2015 03:43 pm

Ah! That makes complete sense - thanks.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

KetchupSpud
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Re: Advised not to carry again

Postby KetchupSpud » Thu Apr 09, 2015 10:51 pm

Figure'd I mention for anyone who might be reading this later, I did come across a mention about frozen vs fresh IVF and their rates of pre-e. A US study found that frozen IVF had much lower rates of pre-e, but they referenced a Swedish study that found the opposite. The US study pointed out that more of the people doing a frozen cycle had been pregnant before, thus lowering their risk already. The said the Swedish study didn't attempt to explain their results. I'm guessing the RE I talked to was referencing the US study and not mentioning the possible explanation.
Mama to Logan Patrick (8/23/14-8/26/14) & Bryce Anthony (8/23/14-9/13/14), frateral twins born at 23w5d due to severe pre-e turning into HELLP.
Hoping for a rainbow in Sept '16.

KetchupSpud
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Re: Advised not to carry again

Postby KetchupSpud » Sat Nov 08, 2014 06:40 pm

No idea. He said it very authoritatively, but he had that tone about a lot of things that were just his opinions or guesses (like naming the number of weeks I was *guaranteed* to make it next pregnancy), so I'm not sure how much stock to put into it. Figured I'd mention it anyway. And no, I won't be seeing that RE again. :)
Mama to Logan Patrick (8/23/14-8/26/14) & Bryce Anthony (8/23/14-9/13/14), frateral twins born at 23w5d due to severe pre-e turning into HELLP.
Hoping for a rainbow in Sept '16.

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caryn
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Re: Advised not to carry again

Postby caryn » Sat Nov 08, 2014 06:36 pm

That's got to be unpublished data, because I haven't seen that substantiated anywhere. It seems like you'd need to enroll/observe a *lot* of IVF patients to say that for sure. Maybe it's from an RE conference and I haven't seen it yet!
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

KetchupSpud
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Re: Advised not to carry again

Postby KetchupSpud » Fri Nov 07, 2014 06:52 pm

Ha - dangerous partners. Somehow that sounds like something men would take as a compliment, if they didn't know better. ;)

Thanks for all the info. It's funny how I can be amazed about what we know, but at the same time be amazed about what we still don't know.

(note - when I say "fault" I don't mean in a guilt kind of way - this is no one's fault - but I can't think of a better word for it)
I guess the way I look at it is this - if it's my husband's fault, then he and I are going to have trouble and so would he and someone else. That other person may have more or less trouble - more maybe because it's a new combination, less maybe because they've had previous pregnancies that did some of the hard work well/successfully. But if it's my fault, then someone else will likely have much better success than I would. So no guarantee, but I'd suspect the chances of them fairing worse than I would are fairly small.

Interestingly, the RE I spoke with said that fresh IVF cycles do increase the changes of pre-e, but frozen don't. Hadn't heard that before and can't fathom why that would be true.
Mama to Logan Patrick (8/23/14-8/26/14) & Bryce Anthony (8/23/14-9/13/14), frateral twins born at 23w5d due to severe pre-e turning into HELLP.
Hoping for a rainbow in Sept '16.

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caryn
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Re: Advised not to carry again

Postby caryn » Fri Nov 07, 2014 05:52 pm

Right, so far as we know, it has nothing to do with the genetics of the mother, because although the blastocyst is half genetic Mom's genes, those genes are not expressed in the part of the blastocyst that becomes the placenta - the trophoblast - because they are epigenetically silenced by the genetic father's genes.

But that doesn't necessarily mean the surrogate's risk is in-line with the generic risk, because the partner contribution to preeclampsia can be pretty significant. Some men are just "dangerous partners", they think, and it's hard to tell with just the sample we tend to get whether or not that's the case. I know we've a few posters whose partners had prior relationships that resulted in preeclamptic pregnancies, and who developed PE in a third pregnancy with that new partner even though their first two pregnancies were textbook. Possibly those cases are cases where the partners are coding for a placenta that doesn't cooperate as well with the uterine environment, although the mothers could also be developing underlying conditions that would predispose them to preeclampsia. We've had a few posters who have changed partners and had easy pregnancies, although there the fact that they're not in a first pregnancy could explain a bunch of the success. We have too many competing auxiliary hypotheses to say which thing is going on in any individual case and it's all about the population of preeclamptics as a whole, still. Someday we will have better genetic data. :)

At the moment, the best that can be said is that any form of reproductive assist raises risk of preeclampsia, including donor sperm, IVF, and surrogacy.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

KetchupSpud
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Re: Advised not to carry again

Postby KetchupSpud » Fri Nov 07, 2014 03:33 pm

Thanks for all the warm welcomes, everyone. It's nice to have a place where people understand what you're going through and your fears. :)

Regarding surrogacy, caryn brought up an interesting point that I understood a little bit differently. You mention that some women experience pre-e for the first time during a surrogate pregnancy. I'd even read that the chances for a surrogate to get pre-e are even higher than the general population, either due to the change in partners or the increased risk associated with ivf, or both. But my understanding was that the surrogate's risk for pre-e had nothing to do with the genetic mother's history. Meaning, if I have a history of early, severe pre-e and I use a surrogate, while she may have an increased chance overall of getting pre-e just because she's a surrogate, the severity and timing of the onset would be in-line with the general risks rather than being related to my risk. So, while I'm more likely to have it again early and severely, because of the severity and early onset in my history, even if she's more likely than the average woman to get it, it's much less likely to come on as early or be as severe as mine would be. Is that your understanding as well?
Mama to Logan Patrick (8/23/14-8/26/14) & Bryce Anthony (8/23/14-9/13/14), frateral twins born at 23w5d due to severe pre-e turning into HELLP.
Hoping for a rainbow in Sept '16.

MomTimesThree
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Re: Advised not to carry again

Postby MomTimesThree » Wed Nov 05, 2014 00:16 am

Thanks for the update- and thanks for the trust given to share your journey with us. It's quite a safe and supportive community. :)
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w

vaneseltinejl
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Re: Advised not to carry again

Postby vaneseltinejl » Tue Nov 04, 2014 11:19 pm

Thank you for your responses. I have not yet seen an MFM and that is going to be my next step. I was iffy about posting on here and now I am very happy that I did. Thank you all for contributing you knowledge or experience! I will keep you updated. Thanks again :)

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caryn
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Re: Advised not to carry again

Postby caryn » Tue Nov 04, 2014 08:18 pm

I would definitely consult with MFMs about this, simply because we scare regular OBs. You may have already done that; I can't tell!

For what it's worth, the risk is highest in first pregnancies - which carry unique risk for preeclampsia - because the placenta remodels the uterine arteries when it implants. That means that later pregnancies don't have to do that initial work, which is probably the explanation for why, if it happens again, it tends to happen later and more mildly. In an early-onset case like yours, that isn't a particularly reassuring idea, since it could happen a few weeks later and still be scarily early, but it can mean that you take home a baby.

Surrogacy isn't a surefire way to avoid preeclampsia unfortunately. It's related to immune responses to foreign placentas, and while we've had a few posters who had children via successful surrogacy we've also had a few posters who developed preeclampsia for the first time while acting as surrogates for others.

Please keep us posted as you think about this. It's a tricky call for everyone.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy


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