Results from Anora Test

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My husband and I were debating whether to do the Anora test from this pregnancy loss. We’ve done the test before with two of our other miscarriages. Both of those tests determined that the embryos had a chromosomal abnormality caused by maternal origin. One had Trisomy 15 and the other had Trisomy 16. My other miscarriages we did not test. At first he and I were leaning towards not doing the test for my most recent loss this September, because we assumed it would be the same exact scenario of a Trisomy due to maternal origin. We believed it would have been a waste of time and money. But my doctor had a good reason to try to talk us into doing the test again.

Now that we have recently found out I have the MTHFR gene mutation, my doctor wanted to determine whether this embryo had a chromosomal abnormality. He said, “If the embryo does not have a chromosomal abnormality we might have you try Lovenox.” Lovenox is a medication used to help during pregnancy for women who have a MTHFR gene mutation. He said that he would talk to my out-of-state doctor as far as the next steps after the Anora results.

When my doctor called me several days later with the results he said, “It was a triploidy of paternal origin.” This was the first time my egg quality had nothing to do with the chromosomal abnormality. But unfortunately, now we also have a chromosomal abnormality issue from my husband’s side (paternal origin). So I’m unsure whether I will still need to take Lovenox or not as a precaution with my next pregnancy. That’s one of the questions I need to ask him. He explained there were two YY chromosomes in this embryo, in other words two sperm had entered one egg. I remembered that the clinic I went to just prior to my current doctor believed this pregnancy was either one of two things; 1) pregnancy with multiple embryos, or 2) a molar pregnancy.

But he confirmed this was not a pregnancy with multiples, and that it could be a partial molar pregnancy. A molar pregnancy is bad for several reasons. I was feeling very overwhelmed because I had done prior research and understood that molar pregnancies could cause some serious complications. Even with the D&C surgery, it is possible the partial molar pregnancy could have already triggered issues in my body.

A partial molar pregnancy, from what I understand, is when the cells of the baby can mutate within the mother’s womb and cause tumors within the uterus. The worst case scenarios for a molar pregnancy is permanent infertility and/or cancer. Even as I am writing this now I paused my typing for a few moments and I feel a sense of dread. Two terrible possible outcomes. So why does my doctor think it might be a partial molar pregnancy? He said one of the possible complications of a triploidy of paternal origin (the results of my Anora test on the embryo) is a molar pregnancy. And one of the possible complications of a molar pregnancy can lead to something called Persistent Trophoblastic Disease (PTD), which is caused when tissue from a molar pregnancy isn’t completely removed.

Genetic-events-occurring-in-normal-conceptions-and-complete-and-partial-molar-pregnancies

Image of normal conception compared to complete mole and partial mole. Partial mole shows two paternal sets of genes resulting in in non-viable fetus.

PTD can lead to Gestational Trophoblastic Disease (GTD) and this can lead to Choriocarcinoma which is a fast-spreading cancer that starts in the uterus. Needless to say I’m feeling overwhelmed. I asked my doctor how they would know if it was a partial molar pregnancy and he said, “We have to check your blood levels weekly to make sure your hCG levels are dropping back down to zero. If they don’t drop down to zero within a few weeks it could indicate a partial molar pregnancy.”

I did some research about molar pregnancies prior to talking to my current doctor, the reason being that my previous doctor said, “It’s either multiples or a molar pregnancy.” With a molar pregnancy the hCG level rises so dramatically it can be mistaken for a pregnancy of multiples. My first doctor said my hCG level was 81,000 when a normal range at that time would have been around 3,000. Clearly my levels were very high.

So there is a very real possibility that I might have to deal with the after effects of a partial molar pregnancy. It’s already affecting my plans. I was planning to do my Frozen Embryo Transfer (FET) in December 2019. I was going to do the Saline Infusion Sonohysterography (SIS) procedure to make sure my uterus was good to go with no abnormalities and then be jetting off to my procedure in Seattle. My doctor said, “Unfortunately both [doctor in Seattle] and I think that it would be best to postpone your FET until we rule out a partial molar pregnancy. Two months is just not enough time to figure that out. We will need to do weekly blood draws until your hCG drops down to zero. Once it drops down to zero we will need to monitor your blood levels each month for six months. He and I think that you should wait at least six months before you do the transfer.” Some websites suggested waiting 6-12 months before trying again. The risk of doing it too early is it could trigger the cells to become cancerous. So at the earliest I could do my FET in April 2020.

I have my 2-week post-op doctor appointment here on Thursday. I’ll be doing my first weekly blood draw on that day. My doctor will also be putting me on birth control for a while, I’m assuming until I am ready to start my FET protocol which could be anywhere from 6-12 months from now. My little embryo has been waiting so long already and I hate to think that it has to sit even longer. But like my doctor and I agreed over the phone, “It’s better to be safe than sorry.”

I’ve had so much bad luck over these years I’ve come to expect it. I suppose it has become a defense mechanism of sorts. “Hope for the best but expect the worst.” Part of me feels like if I don’t expect the worst then I won’t be mentally prepared to handle it when it comes. Like with this situation for example, I was already learning what molar pregnancies were before my current doctor said this is what we might be dealing with. Initially I was very overwhelmed after that phone call. But what can you do? You just have to follow the doctors orders and learn what you can online about whatever issue you are dealing with. If there is nothing you can do about the situation in that moment you just have to let it be. Personally, I think it’s better to do research shortly before meeting with your doctor so you can at least be prepared with certain questions. By doing that closer to your appointment you are less likely to sit there stewing on potential negative outcomes. Granted, I am saying this about a diagnosis that has not been confirmed as cancerous. I believe if I was diagnosed with cancer I would probably be researching every corner of the internet to figure out how to get rid of it. But for now, I am trying to guard myself against “worst-case scenario” thinking. The best way I know how to do that is to distract myself.

I’ve been listening to my audio book and watching TV lately as a distraction. Maybe I’ll listen to my audiobook while I clean the house. My house could use a good clutter clean, deep clean, and every other clean in between. I suppose that would help me take my mind off of this too. I think it’s so important to lean on healthy coping skills during the times that we are worried about the future. Beyond distraction comes acceptance, learning, and healing. With each new obstacle that comes my way I choose to remain determined to keep moving forward and do everything I can to create our family. I want to look back on these times and know without a doubt I did absolutely everything I could.

Thank you for reading.

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