Is it possible...or am I asking for too much

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lexi0408

Guest
First let me say I know I am incredibly lucky. I am the proud mother of two healthy boys (3yrs and 17 months). My husband and I are, obviously at least carriers or I wouldn't even be seeking advice here. I found out I was a carrier for CF when I was 10 weeks pregnant with my first son in 2010 I tested positive for delta F508. My husband was subsequently tested and he's also a carrier for a different (and much less common) mutation though I don't remember which. We didn't do any prenatal (amnio,cvs) with our first baby. My pregnancy was difficult and scary as at 29 weeks I had a partial placental abruption and was on bed rest for 3 weeks at 32 weeks I went in to my OB's office and in 45 minutes my blood pressure went from 125/85 to 210/110 less than 20 hours later I was 90 minutes from home and delivering my baby. At 2 weeks he had his newborn heel prick- another week later we learned the best news that the screening was negative for CF our baby isn't even a carrier. Fast forward 19 months almost and my husband and I were pregnant with our second child. This time we opted for an Amnio- the results took a very long two weeks but again we received the news that our baby was indeed a boy and that he was also not a carrier for cf. Now my baby is almost 18 months old and I am feeling the itch for another baby. It's thought consuming. I just don't feel complete I want another child in my family. My insurance doesn't cover IVF/PGD at all and I can't afford it out of pocket. My husband is petrified and I know and understand why. We both know we've poked a sleeping dragon twice now and have been spared. I also know that the chances of having a CF positive child don't change with each pregnancy that it remains 25% and 75% but is there anyone out there that can give me words of hope? I know I won't be complete without another baby but my husband is adamant that he does not want a baby with CF. Please. I've tried googling stories of women that have had 3 non-affected babies naturally with 2 carrier parents but it seems like there's none to be found. I guess I'm looking for hope or words of encouragement that it does and can happen....and it could be me.

Thanks in advance!
 

Aboveallislove

Super Moderator
Dear Lexi,

I am so sorry for you anguish. I can tell you I know of a family with 7 kids and only the last had CF. But as you said the odds are the same--25%. I know after our son's diagnosis my husband and I both struggled with whether to try for a second child. It was almost as if with the CF diagnosis, we received one of infertility too. At different times we were both at different places. We eventually decided that our son (with CF) is perfect and so would a second child--with or without CF, but alas, God had a better idea and we weren't able to have a second baby. My heart aches from that. But God knows best. Different parents make different choices and their is no "right" answer. All I can say is that through it both me and my husband felt we both had to be 100% on the same page of having a second child and that we talked a lot of our desires (not just for each other--but for our son to have a sibling) and fears and always left the discussion with only if you are 100% there with me. I know, though, that given where we ended up, I have some sense of peace because we realized that our son was perfect and that we were open to God's will ...come what may. Even though you are blessed with two healthy children, that doesn't take away the longing. I know your ache. I truly do. And I am so sorry.
 

Melissa75

Administrator
I think Aboveallislove's response was excellent. I only have a little to add and I'm only relevant in that I'm a mom of three and I spend a lot of time on this site because I have bronchiectasis--a type of lung damage caused by CF and by other things.

I definitely agree with Aboveallislove that both parents have to be on the same page about having another child, regardless of genetic risks. It is stressful on a marriage to have children--period. Each additional child means a drop in alone time, a drop in one-on-one time with the other children, and an uptick in chaos and financial load.

You wrote that your husband is adamantly opposed to having a child with CF. This made me wonder if he felt this way when you were pregnant with number two, and how did he handle that? Are you hoping/anticipating he will have the same acceptance of the situation that he might have had during that pregnancy? And are you willing to risk that he doesn't?

With the chance of CF being 25% for each pregnancy--no matter the previous outcomes--if I were you, I would make this decision together as if the child were going to have CF. And then, if you still want three children, think about WHEN you want to get pregnant. For example, if you anticipate lengthy doctors' appointments, do you want one/both of your other children in school already? Also, CF has a financial burden of co-pays and potential lost work-time as well, and does that change how you feel about the cost of PGD/IVF? Do you have extended family emotional and childcare support?

I wish you the best in whatever you choose. I tend to be scientific and logical in my approach, but please know that I feel for your situation.
One thing you might do is postpone the decision. I believe that the need/urge to have another is somewhat associated with the developmental milestones of your youngest baby (walking/weaning etc). Without telling yourself "no," you could tell yourself "I'm going to wait and see how I feel in X months/years."
 
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welshwitch

Guest
Some excellent responses here! As a side note, my parents knew they were carriers AFTER they had me (in 1979) and then rolled the dice by having one more kid in 1983. My brother, lucky boy, did not have CF! But it makes me think, they must have been OK with the idea of another CF kid if they were willing to run the risk! I know of families who had 2 CF kids, and then had one more WITHOUT CF. Such a personal decision. And here I am, 34 years old with CF, trying to decide if I should have kids….so the cycle continues :) Best of luck with your journey!
 

CFParent2

New member
If you are not able to afford IVF might you might not be able to afford the care of a child with CF. Latest and greatest drugs are 30k/month. If you are middle income the opportunities for financial aid are limited in the US.

My wife and I also faced this question after child #1. We were looking into adoption from China or another country. Too many kids in this world that need parents already. If your funds are limited I would consider becoming a foster parent and then adopting. Another option would be to get a sperm donation from your husband's father/brother if they were not a carrier. That child would have nearly the same genetic make-up as a child of your own.

As much as CF toughens and forms our children into the great people that they are today, very few would have wished CF upon themselves.
 
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lexi0408

Guest
The difference between ivf/Pgd and CF is the insurance. My insurance company will cover the medications and treatments needed for a child with CF but they will not cover the process involved in creating healthy children. Seems a bit backwards to me but- I'm not in the insurance business.
 

CFParent2

New member
The difference between ivf/Pgd and CF is the insurance. My insurance company will cover the medications and treatments needed for a child with CF but they will not cover the process involved in creating healthy children. Seems a bit backwards to me but- I'm not in the insurance business.

It is backwards. Insurance exists because bad things happen. If homes never burned we would not carry fire insurance.
 

donin

New member
it already was you...

I appreciate that you are struggling. But, you have two healthy children, you know you are fortunate, you know the odds, and you know that the odds don't change with each pregnancy yet you are looking on a site populated by people who are profoundly affected by CF for reassurance. I don't understand. If you were looking for reassurance/help regarding raising a child with CF I would see it. You are, "looking for hope and words of encouragement that it does and can happen...and it could be me." From my perspective it already was you.
 

triples15

Super Moderator
Hi Lexi,

I have CF, and I am also a mother. I can tell you that I 100% understand you wanting another child. I can also tell you that while my HEART absolutely wants another child, my HEAD says absolutely not. The unfortunate part is that my brain cannot shut off the feelings in my heart, but it is something I have to live with. My situation is quite different than yours in the fact that I have to choose not to have any more for the sake of my own health. You have decide based on what the health status of the baby may be.

I can tell you this. When my husband and first started pursuing having baby many years ago, our first step was to have him carrier tested. Had he been a carrier our plan was NOT to pursue pregnancy without IVF/PGD. I have lived with CF everyday of my life (obviously) and would never, ever knowingly give a child a 1 in 4 chance of having this nasty disease. Yes treatments are improving, and yes, I've lived 33 years and been able to graduate college, get married and have a family. However, the fact remains that people, CHILDREN, still die of this disease every day. It's no walk in the park.

Also wanted to mention that you should talk to the doc that did you and your husbands carrier testing and see if they would be willing to write a letter to your insurance company explaining that you are both CF carriers and have a 1 in 4 chance of having a child with CF, and mention that the cost of cover a child with CF is FAR greater than the IVF/PGD. In our case, this worked to get my husbands carrier testing covered, after the insurance initially denied it. My CF doc wrote a letter explaining the odds and costs of child with CF, and they covered it to the tune of about $1200. I know IVF/PGD will be WAAY more than than that, but it's worth a try. Even if they agreed to partially cover it, it would be a start. Also, many Reproductive Endrocrinologists offer payment plans, so if your insurance helped at all maybe you put the remainder on payments.

Anyway, that's my 2 cents! :)

Take Care,

Autumn 33 w/cf
 

LittleLab4CF

Super Moderator
Your husband has voted, no CF children, but I don't see anything saying he doesn't want another child. In one way or another, from IVF to terminating a pregnancy, all the current tools end up testing an embryo and keeping one or two and destroying those with CF genes. The importance of this is how you and the two of you feel about this topic.

Long ago a friend and his wife were considering a second child. Their first child was born with a rare and horrible genetic disease called Osteogenisis Imperfecta. Every bone in her body was broken during childbirth and just depressing a computer key bent her finger to breaking when she was five. The fear of having another OI child was consuming. In spite of everything, they wanted another child and then magically, his wife was pregnant. Now they were terrified, and he was asking me about having an amniocentesis. This was an established procedure but it wasn't widely used and most weren't well informed on the subject.

After listening to the details of the situation, he asked what I thought about amnio. He and I belonged to the same church and very deliberately, the Synod had no official position on the termination of an embryo/fetus so any religious reasons were theirs. I was about to ask if abortion was the reason he was so fusticated when it struck me, he might not understand what and why he's considering doing.

Rather than explain the mechanics of the procedure, I asked what they planned to do with the results of the test. Suddenly he realized what the endgame of an amniocentesis can be. They couldn't and wouldn't terminate a pregnancy, their beautiful, intelligent daughter was proof that the life of a child is more than the sum of their genes.

My personal belief is to support the individual's choices regarding when and how to have a baby. You and your husband have some issues to negotiate. I doubt there's a CFer who truly wishes they'd never been born. CF is a part of me and it holds both bad and good influence over who I am. I also doubt any parent begrudges their child or children for having CF. And, though no parent should feel responsible for their child having CF, many harbor deep, irrational guilt.

Look into current drug trials for your mutation and your husband's. It's looking so bright, you'll have to wear shades. Genetic medicine, as in a medicine that modifies the action of each cell's nucleus to act as if there were no CFTR mutations are now targeting the most common mutations and some are near to panacea drugs. It's not the strongest argument for having a no-worry kid but it is valid.

One other item has to do with your 1 in 4 odds with each pregnancy. This statistical model assumes the same mutation in mom and dad. The fact that you carry ∆F508, you said you are a carrier, is good and bad news. You may still have CF as complete testing for all ~1900 hasn't been done on everyone involved. For the statistical model to work, hubby should carry ∆F508 as well. Toss out the model if you don't share the same mutation. ∆F508 is responsible for about 66% of all CF patients so it's a known harmful CFTR gene mutation. About a year ago, somebody cited a recent scientific paper hailing another 160 or so CFTR mutations that had been discovered to be CF causing, raising the total to something like 300. What? Only a fraction of the mostly harmless ~1900 CFTR mutations have been thoroughly scrutinized. And the matrix of possible combinations of mutations far exceeds the number of CF patients alive in the world.

What this means in short. His mutation is nothing to be blasé about, if it is known for virulence. Come back with some research on both mutations and ask us if anybody has ∆F508 and ........your husband's mutation. At this point in CF research, anecdotal evidence is as good as you'll get. You can read what is known about his mutation but even technical papers play word games. Note the difference between 'mutation "X" has not been proven to interfere with chloride ion exchange' and 'mutation "X" has been proven to not interfere with chloride ion exchange'.

I'd be generally unconcerned about having a CF baby. It is relatively new information that so many potential combinations of mutations could result in CF or CRMS. In our general population as high as 1 in 25 adults (Ireland) are carriers resulting in a staggering 1 in 1400 births with CF. Admittedly, you're not 1:1400 because you're both carriers and ∆F508 is usually nasty. Until you know more about dad's mutation, it could be as frightening as the standard 1:4, 2:4, 1:4 or more likely a 1:4 chance of some mild CF symptoms. The autosomal recessive bit of this equation works when both mutations are the same. Two different but non working mutations could act just like two identical bad mutations or they could do something that we don't understand in some arcane biochemical process.

Hope that helps.

LL
 

CFParent2

New member
The difference between ivf/Pgd and CF is the insurance. My insurance company will cover the medications and treatments needed for a child with CF but they will not cover the process involved in creating healthy children. Seems a bit backwards to me but- I'm not in the insurance business.

Also, I would not rely on maintaining any level of insurance if your are in the US with the way our health care system is changing.
 

imported_Momto2

New member
We went a different route because I couldnt bear the thought of knowingly passing my suffering along to my children OR shortening my time with them by insisting on self pregnancy. We adopted. Although treatment for CF has come a long way, dont be fooled by the media hype. Folks die from CF every day, yes even children and teens who've had the best of care. IF you have a child with CF, its gonna take 2 very committed parents. If your husband is not on board, that would be a no started for me, plus the guilt of knowingly setting my child up with a terminal genetic disease. To me, it would be like purposely giving my child a long, slow, incurable cancer just to make myself happy. Really??? Be happy with what you have, if you must have a 3rd, either screen or adopt.
 
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