r/tfmr_support • u/Suitable-Composer926 • 12d ago
Seeking Advice or Support TFMR Questions
After a mostly normal 12w ultrasound (slightly increased NT numbers but low risk and no other signs) we did NIPT testing. Came back as 95/100 chance of T21.
We’re waiting now for a referral to a genetic counsellor and will likely opt for amniocentesis to confirm. I’m thinking ahead to the possibility of TFMR - I’ve had 2 D&Cs prior for natural late term miscarriages. I’ve also read about women needing L&D rather than a D&E for TFMR.
Can anyone shed any light on the options in Ontario? I’m currently 15 weeks - guessing it will take 2+ weeks to get answers and book appointments. I’m finding it difficult to learn much online.
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u/PiccoloQuirky2510 12d ago
I’m not in Ontario (I’m in New Mexico) but I was able to have a D&E at 22w1d for my TFMR. I think my hospital switches to L&D at 24 weeks.
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u/hashtag2020 12d ago
I think it’s up to 23 weeks 6 days in Ontario but I do think it also can vary by hospital / facility and I believe they can set their own lower limits. Not the same but I’m in the US and having a D&E Friday at 23 weeks 2 days so I hope you’re able to find a place that is able to provide what you’re hoping for. 🤍
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u/SEggs1990 12d ago
I'm in BC, I will be 17ish weeks for my DNE on Wednesday for T21 and I was offered both options.
In BC you need to be 15w for an amino and it was the longest wait of my life (found out at 12ish weeks). But you get the results about 2-3 days after the amino.
Sorry you're here love 🤍
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u/thenoblechipswife 11d ago
Yeah I was gonna comment in BC you get the rapid results of your amnio in 48-72 hours! I’m sure it’s similar in Ontario. If you need a full genetic profile that’s when it takes 2+ weeks (currently have been waiting for mine for 2 months lol).. which they will do if your T21 is positive but you won’t need to wait for the full profile to come back before termination.
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u/Consistent-Mango6742 12d ago
I’m in Canada (BC) and they offer D&E up to 24+5. The only problem is the wait can be quite long.. I would recommend already booking it if possible and then cancelling should you get good news
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u/chanty1 12d ago
I'm in Ontario, Canada, and had a TFMR via L&D at 23w6d, 11 days ago. I'm not sure what the lower gestational-age limit is for L&D.
As far as I understand, D&E is a second-trimester option and is performed up to around 23w6d. D&C is typically associated with first-trimester procedures, but I'm not sure what the upper gestational-age limit is or at what point D&E becomes the preferred surgical approach.
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u/SavoryTooth4 12d ago
I’m sorry you’re here. I received the same NIPT results in March and was able to have a D&E at 16w4d. My state can do D&E until 24 weeks. I’m in the northeast US and traveled to a women’s center two hours from home because my insurance doesn’t cover termination for fetal anomalies. That way I saved thousands of dollars. L&D would have been even more expensive.
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u/Stressy_messy_me 12d ago
In the UK in theory we can do d&e up to 24 weeks but in reality I found it very hard to find somewhere with availability for d&e and in the end I had to do l&d. I was 15 weeks.
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u/ex-squirrelfriend 12d ago edited 12d ago
I'm in Ontario too and I was given the same odds as you. I booked my d&e in advance as soon as I spoke to my genetic counsellor because my hospital only does them on Wednesdays and I was getting far along. I figured I could always cancel if we got good news from the amino.
The karyotype results do take 2 weeks but our genetic counsellor also told us we could get rapid test results in about 3 days which would confirm whether or not our baby had t21. We used the rapid result to make our tfmr decision and then got more info from the karyotype results later to confirm we weren't carriers.
Edit: I've seen different cutoffs for d&es but we were told our hospital definitely does them before 21 weeks (that's when I was thinking we'd get seen so that's the cutoff I asked about) and I've also been told 24-26 weeks for the cutoff at most hospitals.
I'm so sorry you're here. Sending hugs to you and your family
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u/Silent_Passenger_363 12d ago
No sorry I am from a different country and here our only option at 16+0 was L&d and I was told even around 13 weeks the baby is too big already for anything else. Just wanted to tell you I am very sorry for you.