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" I am writing this while quite literally lying flat on my back; so I am going to try to write this very quickly before my head goes numb. WHAT: Chorionic villi sampling (or CVS) is the procedure by which a small sample of chorionic villi (a sort of pre-placenta I think) is taken and the genetic make-up of the sample is assessed after culture. Like the amniotic fluid that becomes more abundant later in pregnancy, the little chorionic threads contain the same cells as the fetus and can be sampled at the end of the first trimester. If the chorionic villi are genetically normal than (with this 1-in-100 case exception that I am not going to go into right now - see: brevity) the fetus is normal as well.  CVS is done either transvaginally or transabdominally. In the transvag approach (as best as I can tell from the angle at which I have always been during CVS; a position remarkably similar to my current arrangement although right now my ladylike knees are touching each other and there is not a medical student around for miles) they take a catheter, thread it through the cervix, carefully skirt the amniotic sac and its occupant, and then they somehow get a pair of weensey embroidery scissors up there and snip! some tissue. This is the method by which I have always had CVS done and I can tell you without hesitation: it&amp;#039;s uncomfortable. In fact, if you are reading this prior to having some transvaginal sampling done yourself I am so glad I caught you before you left. Are you listening? TAKE SOME TYLENOL BEFORE YOU GO.  Transabdominal CVS uses a large needle to puncture the abdominal wall, pierce the uterus until it hits the chorionic villi; whereupon repeated jabbing (similar to a plunger motion, now that I think about it) is used to hack some tissue into the syringe. You know, I suppose I could google this for accuracy but surely first-hand accounts are good for something, actual medical knowledge notwithstanding? All I know is that I had my first transabdominal CVS done today and if my description is technically inaccurate it is at least a faithful account of how it appeared to me. What with the seven inch needle in my stomach and all the stabbing he was doing. Between the two, transvag and transab, I would have to say the transabdominal approach is less unpleasant. Unless, of course, it is a dichorionic-diamniotic twin pregnancy and you have asked for a sample on both. In that case they try to avoid multiple insertion sites into the uterus (and you honor them for it, as each insertion increases the risk of miscarriage) by first doing the needle, wall, pierce, jab jab jab thing and then\u2026 they do not fully withdraw the needle which has stretched a full six inches through your stomach muscles. No. They merely withdraw it partway and then redirect the needle in the opposite direction and repeat the process. This hurts. It hurts a lot. It hurts at the time and it hurts eight hours later such that one is unable to sit up without help. So, again, my helpful hint for the day: TYLENOL.  WHERE: Downtown Rochester, MN on a Sunday evening is a rather surreal place. Well, all downtown areas without a strong residential presence are always weird on weekends, but Rochester was doubly so. First, Rochester is a stark blend of very modern steel-and-glass buildings and hotels that have not been touched at all since the 1950s. It was sort of funky and sort of quaint and sort of creepy. Second, almost everything was closed but people were wandering around anyway. We rejected the first restaurant we found on the grounds that I was not completely in the mood for Italian. We then staggered around for another forty-five minutes before we realized that the Italian place had the distinct advantage of at least being open.  By Monday morning at 7 am, however, it was a completely different city. People in scrubs, people in lab coats, pharmaceutical reps, sick people\u2026 well, that was pretty much it but there were a lot of them and most of the restaurants were serving already. I never believe that hotel alarm clocks will actually function so I had woken up in a panic all night long, convinced that I had overslept. I finally gave up at 6 in the morning and allowed myself a ridiculous 50 minutes to walk three blocks to Mayo. Mayo is like every other hospital in which I have ever been, only a thousand times more efficient. I was registered, tagged, insuranced and sitting in the Perinatology waiting room with almost an hour to spare. This was unfortunate because I was so nervous at this point I needed to throw up or get it over with already.  WHEN: Yesterday, as noted. First round of results back today, as we opted to have FISH done on the samples. FISH gives a quickie glance at the most frequently troubled chromosomes: 21, 18, 13, and the sex chromosomes X and sometimes Y. The full karyotype with the all-important (to us) first and fourth chromosomes will not be available for another week to ten days.  Great! More waiting!  WHO: Me, mostly, and the fetii 13a and 13b who had cameos once I was taken into the ultrasound room. I had a nurse who stayed with me all morning and then a second one who appeared for the CVS. There was an ultrasound tech who was very reassuring and her student who did not say a word but smiled a lot. When the needles started going in the nurses rubbed my feet and arm and told me how great I was while the ultrasound techs clucked at me in a soothing way. Although I like men as much as the next girl (rather more, perhaps; men being something of a weakness of mine, back in the day) give me a bunch of women when I am feeling poorly. They were great.  WHY: By the time I got to Mayo I had pretty much decided to go ahead and do CVS, provided the perinatologist thought he could get it done without killing anybody (I don&amp;#039;t often get to write that phrase without facetiousness). Unless the doctor had taken a look at the fetuses (b, particularly) and said he saw absolutely nothing whatsoever to warrant CVS as he had never in twenty-five years of practice seen such genetically perfect beings, adding that he is also a well-known psychic; I was fairly certain that I wanted to get the testing done.  What the ultrasound tech (who promptly rearranged the screen to let me see everything, bless her) found and the perinatologist confirmed was this: A looks great. B has a nuchal translucency that is on the high-end of their cut-off for normal (they took tons of measurements getting 1.7mm, 1.8mm with the largest single measurement being 2.1mm) but it IS within the range of normal. However, 13b also has a two-vessel cord. I had to ask what this meant and they told me that a two-vessel as opposed to a three-vessel cord is another soft marker for chromosomal problems.  So I weighed our options and told them to go ahead with the stabbening.  HOW it went: Very well. The procedure hurt like the blazes and I am still bed-ridden due to muscle soreness but I am glad we are finally going to get a clear picture of what is going on with these babies. The ultrasound tech said that without our history she would not have given either the NT or the cord a second glance and that she has a good feeling about these two.  As the perinatologist tidied up he said, &amp;quot;My money is on their both being normal.&amp;quot;  I said, &amp;quot;REALLY?&amp;quot; with such shocked incredulity that I startled him.  &amp;quot;Uh, yes.&amp;quot;  &amp;quot;It&amp;#039;s just that no one has ever said that to me before. They usually say &amp;#039;I&amp;#039;m sorry but\u2026&amp;#039; and things go downhill from there.&amp;quot;  He patted my knee and left.  Now we wait. "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.redbookmag.com/body/pregnancy-fertility/a1829/cvs-update/>