The Complete Egg

The before, during and after of a molar pregnancy, with a side of chemo and a 12 month wait before ttc. And most recently: experience of a healthy pregnancy.

Saturday, September 09, 2006

How long to wait before trying? 3 months? 6 months? 12 months? Oh, the big debate. It's been interesting to read the forum at mymolarpregnancy.com and watch the opinions fly. The differences seem to depend on whether you have a partial or complete molar pregnancy, whether your numbers come down on their own or you need chemo, and most importantly (well, that depends on who you talk to) what your doctor thinks.

The wait time is coupled with blood tests to test the beta-hcg. The only way that doctors can tell if the trophoblastic (placental) cells are persisting (continuing to grow) is by monitoring the beta-hcg. If the cells persist and beta-hcg levels increase then you need chemotherapy (a mild chemo) to kill the cells. If you get pregnant, there is no clear way to see if a disease (persisting trophoblastic cells) has developed because the new placenta from the pregnancy will produce beta-hcg. It would take a few weeks to be able to ultrasound and determine that in fact there is an inter-uterine pregnancy. There is still a risk that the other abnormal placental cells have metastisized (spread to other parts of the body) and no one would be able to track this or treat it until after you deliver. You could get quite sick during your pregnancy.

Usually, for molar pregnancies that quickly resolve on their own to zero, there is almost no chance of recurrence. That is, beta-hcg levels will not likely increase after you reach zero.

This is what I've heard on the forum buzz and from reading research:

Partial Molars(this will depend on your individual case and your doctor's opinion):
- if you have lower levels pre-d&c (like under 200,000) and d&c is done in first trimester and levels go down to zero in a short period of time (5-6 weeks), then there are some doctors (not the conservative ones) that will say 3 months wait from when levels are zero.
- it is more common to have a 6 month wait from when levels fall on their own to zero
- if you need chemo to bring your levels to zero then usually the wait time is 12 months

Complete Molars
- if levels resolve on their own quickly to zero, then some doctors will give a 6 month wait (from when levels reach zero)
- the more conservative wait time is 12 months
- if you need chemo, then most doctors will give a 12 month wait time from when levels are zero (or from the last chemo treatment) but some doctors say 6 months. See this research for evidence supporting a wait time of at least 6 months.

I went hunting for some research and came up with this article on the web. I think I read this fairly soon after my d&c and I shouldn't have. It was way too much information and some sad stories. I would have been better off waiting longer (maybe 3 months or 6 months or 12 months) to read it. So the big wig specialists seem to agree on 12 months for someone like me who has to be treated with chemo to bring my levels down. As hard as that was to accept, I think it's probably the best idea. One of my oncologists, Dr.H, said 6 months and my other oncologist, Dr.P (associate to previous doctor) said "it's not 6 months like Dr. H said, you'll need to wait 12 months." They had a case where the GTN came back after 11 months. I imagine that for most it won't come back after 6 months but there's the risk. I'm going to ask her why she thinks 12 months instead of 6 (view other post for answer). There was some talk in that article about how the chemo may damage the mature eggs and it would be better to give some time and let them flush out of the system (my words, not theirs).

The 12 month wait feels to me like a slap in the face after being punched in the stomach. Insult to injury. Rubbing my face in the pain. Kicked when you're down. But a part of me knows that the wait will probably be good for my mental health. It's time for me! I can stop the obsessing about babymaking. I never thought that I would go there. Of course, I guess I always believed that I would have a healthy first pregnancy and child (even though I knew the stats about miscarriage). I don't think anyone really, truly believes that miscarriage is going to happen to them.

But the good news is:
- there is treatment
- I will not die from this
- my fertility remains intact

That's great news, in fact.

8 Comments:

Anonymous Anonymous said...

Enjoy your blog. I got started much the same way, just putting up pages about my baby and my experiences.

3:07 PM  
Blogger Chantelle said...

Thanks for reading. I can't wait to blog about my baby. Check back in a couple of years I guess. It's a process, it's a process...that's my mantra.

4:32 PM  
Blogger Rebecca said...

Thank you for writing about your experience. I have just learned that I had a complete molar pregnancy and am trying to find the positives in it all. My doctor suggested a year before trying to concieve. Let the wait begin!

7:50 PM  
Blogger sweetipie said...

I recently suffered a partial molar and then continued bleeding for the next two months. My levels have not gone down to zero and I am scheduled to start chemo within the next week. I like you have searched for several answers and I obsess over baby making. I even have had trouble being around other pregnant women and babies because it makes me very sad. I wish you luck and I will be trying for pregnancy as soon as they give me the ok!

12:38 PM  
Blogger McVee said...

Thank you for your blog. I had a complete molar pregnancy and am now going through chemo. I am especially interested in looking at other women's levels who have gone through the same thing. There is very little information out there specific to this. I only wish when people posted here it gave the date instead of the time. I don't know where you are now in the process, but I hope you are well. Thank you again for this valuable resource.

8:51 AM  
Blogger McVee said...

Thank you for this blog. I had a complete molar pregnancy and am now going through chemo. I am most interested in seeing the levels of others that have gone through this same thing. There is very little information online about this specific topic, therefore this page is a valuable resource. I only wish that it would post the date of the women's posts rather than the time of day. I hope you have had great success in your journey Chantelle. 9/21/11

8:56 AM  
Anonymous Anonymous said...

I have found ur blog very interesting reading... I am recovering frm Partial mole pregnancy and lime a lot of others, concerned + hoping my hcg keeps lowering and returns to normal quickly. I have been advised to wait 3 mths b4 trying again providing my hcg reaches 0. My PMP was caught very early thankfully but it has been a scary experience which has been tougher emotionally rather than physically. I feel ive lost a baby even though it wad established there was no actual foetus removed. I just hope recovery goes well and await the lab results. Thankyou for your blog. I send love to others who are going thru this. Xxxx

8:56 AM  
Anonymous Anonymous said...

Thank you for your story. I found it helpful. I also had a molar Pregnany. Ive been told to wait 6 months. Im at the 4 month mark and I am having the hardest time in the world waiting. Im almost to the point where Im done waiting. Ive had moments where Im ok with everything and then moments where I just cry my eyes out. The hardest thing for me is that everyone I know and see everyday are all pregant. Seeing everyone elses joy when I have to wait so long is very rough on me. Thank you for your story!

5:38 PM  

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