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The risk of defects is more salient and does indeed cliff. Risk of having a child with Down Syndrome: At age 20, 1 in 1,441 At age 25, 1 in 1,383 At age 30,

The risk of defects is more salient and does indeed cliff. Risk of having a child with Down Syndrome: At age 20, 1 in 1,441 At age 25, 1 in 1,383 At age 30, 1 in 959 At age 35, 1 in 338 At age 40, 1 in 84 At age 45, 1 in 32 At age 50, 1 in 44 http://en.wikipedia.org/wiki/Advanced_maternal_age#Risk_of_birth_defects http://en.wikipedia.org/wiki/Advanced_maternal_age#Risk_of_b...

cjbprime 12y ago
It's a different kind of risk, though. In the last few years "cell-free DNA tests" -- sequencing fetal cells that are circulating in the mother's bloodstream -- have become common (and paid for by health insurance), and they detect chromosomal abnormality as early as 8 weeks into the pregnancy. If you aren't ethically opposed to abortion, the risk of Down's can be the "well, damn, guess we'll try again in a few months" sort of risk.
- differentView 12y ago
  >If you aren't ethically opposed to abortion, the risk of Down's can be the "well, damn, guess we'll try again in a few months" sort of risk. You say that as if there is no emotional, psychological, and physical costs to an abortion. The costs is often to both partners and marriage/relationship.
  - kabouseng 12y ago
    GP also states it very non-challantly as a go-no go decision. Usually you get a result stating the child have a 1 in 200 chance of down syndrome considered a high risk. But in 199 cases you will have a normal healthy baby. Do you now abort or not? Also you might have taken a while to get pregnant, lets say 5 or 6 months, so aborting means you get to wait another 5 months before getting pregnant again.
    - jpatokal 12y ago
      If ultrasound shows a high risk of Down syndrome, many women opt for amniocentesis, which can give a definite diagnosis. This does run a (small) risk of inducing a miscarriage though.
      - cjbprime 12y ago
        I think this knowledge is out of date; the cell-free DNA test I talked about is both more reliable (it sequences the genome, and Down's is an easily-detectable chromosomal disorder) and is available earlier than an ultrasound or amnio.
    - cjbprime 12y ago
      As with the poster below, you're not understanding the advancement of the cell-free DNA test I described. It is >98% accurate at detecting Down's in the first 10 weeks, is non-invasive, and is now commonly used.
      - Domenic_S 12y ago
        Some misconception here. Medical tests are either screening tests or definitive tests. Screening tests return the odds that what you're screening for is found, and at some indicative threshold the more invasive definitive test is performed. Cell-Free Fetal DNA Testing is a screening test. It's a fantastic advancement, no doubt, and interestingly the false-negative rate is almost 0. However, amniocentesis is still the gold standard for definitive DNA testing (i.e., if the cell-free screen came back as 'elevated risk', the mother would still have an amnio). Further, insurance coverage for the cell-free screen is not at great levels. The screen is not yet standard-of-care. Even with high-quality Silicon Valley big-tech-company insurance, our out of pocket was several hundred dollars. Worth it imo, but again not standard-of-care. Moreover, cell-free screens are not available to women carrying multiples or who used egg donors, both situations that are much more common in the advanced maternal age/IVF segment. It's a truly revolutionary technology, but we still have a way to go.
Maakuth 12y ago
I wonder if the Down probability is connected to the age of eggs or the womb? I mean, does using frozen eggs make the effective risk comparable to the age when the eggs were harvested?
- cjbprime 12y ago
  It's believed to be tied to the age of the eggs, so frozen eggs would indeed have a lower risk, but I'm skeptical that we've gathered enough data to know either way.

cjbprime 12y ago

It's a different kind of risk, though. In the last few years "cell-free DNA tests" -- sequencing fetal cells that are circulating in the mother's bloodstream -- have become common (and paid for by health insurance), and they detect chromosomal abnormality as early as 8 weeks into the pregnancy. If you aren't ethically opposed to abortion, the risk of Down's can be the "well, damn, guess we'll try again in a few months" sort of risk.

differentView 12y ago
>If you aren't ethically opposed to abortion, the risk of Down's can be the "well, damn, guess we'll try again in a few months" sort of risk. You say that as if there is no emotional, psychological, and physical costs to an abortion. The costs is often to both partners and marriage/relationship.
- kabouseng 12y ago
  GP also states it very non-challantly as a go-no go decision. Usually you get a result stating the child have a 1 in 200 chance of down syndrome considered a high risk. But in 199 cases you will have a normal healthy baby. Do you now abort or not? Also you might have taken a while to get pregnant, lets say 5 or 6 months, so aborting means you get to wait another 5 months before getting pregnant again.
  - jpatokal 12y ago
    If ultrasound shows a high risk of Down syndrome, many women opt for amniocentesis, which can give a definite diagnosis. This does run a (small) risk of inducing a miscarriage though.
    - cjbprime 12y ago
      I think this knowledge is out of date; the cell-free DNA test I talked about is both more reliable (it sequences the genome, and Down's is an easily-detectable chromosomal disorder) and is available earlier than an ultrasound or amnio.
  - cjbprime 12y ago
    As with the poster below, you're not understanding the advancement of the cell-free DNA test I described. It is >98% accurate at detecting Down's in the first 10 weeks, is non-invasive, and is now commonly used.
    - Domenic_S 12y ago
      Some misconception here. Medical tests are either screening tests or definitive tests. Screening tests return the odds that what you're screening for is found, and at some indicative threshold the more invasive definitive test is performed. Cell-Free Fetal DNA Testing is a screening test. It's a fantastic advancement, no doubt, and interestingly the false-negative rate is almost 0. However, amniocentesis is still the gold standard for definitive DNA testing (i.e., if the cell-free screen came back as 'elevated risk', the mother would still have an amnio). Further, insurance coverage for the cell-free screen is not at great levels. The screen is not yet standard-of-care. Even with high-quality Silicon Valley big-tech-company insurance, our out of pocket was several hundred dollars. Worth it imo, but again not standard-of-care. Moreover, cell-free screens are not available to women carrying multiples or who used egg donors, both situations that are much more common in the advanced maternal age/IVF segment. It's a truly revolutionary technology, but we still have a way to go.

Maakuth 12y ago

I wonder if the Down probability is connected to the age of eggs or the womb? I mean, does using frozen eggs make the effective risk comparable to the age when the eggs were harvested?

cjbprime 12y ago
It's believed to be tied to the age of the eggs, so frozen eggs would indeed have a lower risk, but I'm skeptical that we've gathered enough data to know either way.