Molar Pregnancy

This post is to attempt to explain what a molar pregnancy is to those people who don't know. If you already know this or don't care to know feel free to skip this post.

What is a Molar Pregnancy?
First of all, there are two different types of molar pregnancy (MP), complete and partial. I will refer to complete as CMP and partial as PMP. I had a CMP. Both are rare ~1/1,000 odds due to a genetic error during fertilizations. The odds of a second MP are somewhere around 1/100, but this varies and I believe the odds are less if you had a PMP. This is caused when there is no genetic information in the egg, but a sperm still fertilizes what is there. A CMP can not develop into a fetus, but still produces HCG and your body thinks it is pregnant. A PMP is when two sperm somehow fertilize the same egg or it could be a two-headed sperm. This results in a triploidy fetus such as XXX, XXY or XYY. Although this does produce a fetus it cannot live normally even if the baby makes it to term. To be clear not all babies that have triploidy are molar. Molar pregnancy has an added component of these cells that replicate and form fluid filled sacs in the placenta.

What is the procedure for treating a non-complicated MP?
Although a MP is not viable your body thinks it is pregnant and continues to produce HCG, which spreads the growth of the cystic areas. Due to this a D&C procedure is pretty much always needed to remove the tissue (I have heard of some instances where this was not the case, but it is required 99.99% of the time from what I have seen). The D&C will hopefully make your body think you have miscarried and your HCG will start going down. It is generally recommended that you get weekly HCG tests until you get three negatives, followed by bloodwork monthly until you have three monthly negatives. The American College of Gynecology recommends a wait time from negative of six months to a year, but there is some research indicating that shorter wait times may be okay if you drop quickly without other intervention. **Disclaimer**: I am not a Dr. and do not know your specific story, please talk to your Dr. if you want to try sooner than they have recommended.

Why is HCG monitoring important?
The basic answer to this is that the HCG level drops tell your Dr. whether the tissue growth could be spreading or not. What happens is as the tissue grows it continues to produce HCG (pregnancy hormone). If you get pregnant before your monitoring is over the Dr. will not know if the rise is from a new pregnancy or a cancer like condition.

Did you say cancer?
The truth is what is scary about a MP is that it can cause cancer called Choriocarcinoma. is very rare (the statistics I've seen are like 1-3%, but I haven't seen anything too reliable) but is largely cureable especially with good medical care. More common is something called gestational trohoblastic disease (GTD), which is when tissue continues to grow following D&C but remains isolated to the uterus. GTD is more common in CMP with occurring in approximately 20% of cases compared to 5% of cases in PMP. GTD and Choriocarcinoma are treated with various chemotherapy drugs including methotrexate, Act-D or EMACO depending on severity. GTD may also be treated by repeat D&C if your Dr. feels there is enough tissue leftover to warrant this. Dr.'s may also use chest x-rays to monitor whether you have spreading to your lungs. Longer wait times are typical for those who require chemo.

I hope I didn't overwhelm you with information, but if you have questions please feel free to ask. Also if you are newly diagnosed with a MP please try to take it one day at a time because the reality is 80-95% of those diagnosed will not need further treatment after an initial D&C.