Harmony Test vs standard NHS

[Blue2014]

Hi,
I'm 8 weeks with an IVF baby, very very anxious it will all go wrong.

I'm considering paying for the Harmony test (bloody test to check for downs, Edwards etc) but am not sure what comes as standard in the NHS and am not due to book in with midwife for another 2 weeks.

Any advice?

It depends where you live
Some NHS hospitals are now offering a SAFE test (similar to IONA/Harmony) but it is only free to those who get a high risk result from the nuchal test

I have booked for the Harmony test as I am 36 and with my two previous pregnancies my risk from the NHS tests was much higher than those my friends of the same age had. So I am assuming I will be likely to get a high risk result this time and I would rather have a clear answer much earlier on (Harmony can be done from 10 weeks and I have been told I will get the results on about a week).

The NHS tests vary slightly from area to arrea. Where I live, you get a scan to look at the nuchal fold at about 10-12 weeks (may be later than that, not 100% sure but the window is quite small) and a blood test. The results are combined to give you a 1 in xx risk. Last time aged 33 I got something like 1 in 500. They offer diagnostic testing if your risk is greater than 1 in 100. I am not sure how far along you need to be for the amnio or CVS procedures to be done, or how long results take but I would prefer a non-invasive (Harmony is a blood test) test that gives a more accurate picture. My understanding is that you get either a high risk result (meaning there is almost certainly something wrong) or a low risk result (almost certainly nothing wrong - chromasome wise anyway). The test is apparently over 99% accurate. It is costing me 475 including a viability and dating scan (they need to know the exact gestation for the test to make sure you are over 10 weeks).

I would pay for Harmony. The NHS combined nuchal and bloods twice gave me awful risk factors which caused huge anxiety. Harmony showed they were wrong both times without the risk of an invasive test. It's much more accurate and less likely to give you needless fear.

The Professor who helped develop both the nuchal test and the Harmony test told me that Harmony is much more than 99% accurate for Downs. He said its basically 100% but they can't yet market it as such.

You can get Harmony test done from 10 weeks. I can definitely recommend it if you can afford it and are prone to anxiety. It will give you a practically certain answer re trisomies, also a much more detailed 12 week scan than you'll get on the NHS. You might get it on the NHS in some trusts but as a previous poster says only if you are high risk anyway - I wanted to be sure my baby was clear without having to worry about stats like 1:250 1:300 etc. from the triple test, which are 'low risk' but not THAT low.

I just had Harmony and private nuchal at the Fetal Medicine Centre in Harley St - they were excellent. If you can get there it would be worth considering. There is a £400 package if you book in between 10-11 weeks for 1) a viability scan plus bloods at 10 weeks and 2) harmony test results and private nuchal at 12 weeks. This was the best value I found.

On the NHS you will not get Harmony as standard. Certain areas may offer it if high risk is determined (unsure of this)? Even the private nuchal scan at the FMC was much more comprehensive - they looked at more markers than the NHS and so the adjusted risk based on the scan alone should be more accurate. The FMC also looked at the organs in more detail than NHS scans, so this time round I feel less anxious about the anomaly 20 week scan.

Weirdly the test seems to be cheaper in London than here (north west). I think the cost is worth it though for the earliest and most accurate information.

I had the Harmony at the FMC as well, and was really happy with the experience. You have a lovely, detailed scan, and you can also find out the sex of your baby as well as the essential health information.

I did both due to a combination of my age 39, IVF and twins I wanted the extra reassurance , my nt results came back low risk. But I still went ahead with the harmony, it cost 595£ ( 100£ premium for twins). And my risk level went down to 1:10000 for all 3 trisomies.

If you feel like you need extra reassurance I would definitely go ahead and book it in. As others have said it's possible from 10 weeks onwards.

Another vote for FMC on Harley St, although when I had it done the research project was still going so we only had to pay £160. If I was having another child, I would pay the £400 without a doubt.

The cost differences of the Harmony test are really odd. I'm in US and elected to pay for the Harmony test (not covered by insurance) but it only cost $100/160GBP?

Another one here who had the Harmony test at FMC and would recommend it! In London the NHS do a blood test on the day of the 12 week scan and you get results back the same day - but crucially - this is a screening not a diagnostic test, ie it gives you a risk factor not a true diagnosis. As other posters have said you would then be offered (invasive) diagnostic testing in case of a high risk result, but by this time the pregnancy will be more advanced. Also as a pp said, the harmony test is also a screening in theory, but in reality is 99% accurate whereas the NHS test is 80% accurate. I'd say whether to go for it or not depends on what you would do in the case of any issues being found - if you know you would go ahead with a pregnancy regardless then the NHS do screen, but if your feeling is that you would probably not then it's better to know earlier on rather than later IMO.

Ps congratulations on your pregnancy!! And the anxiety is totally normal and understandable. You can probably check what tests are offered by searching for your your local hospital trust's website too.

I'd def go for harmony. I'm 18 weeks with my first baby and I'm 28 years old. Nhs nuchal screening gave me risk factor of 1 in 8 for Down's syndrome.

Our world was turned upside down and I can honestly say it was the worst time of my life with all the worry. We chose to have a cvs as we wanted a diagnostic test to tell us yes or no. Thankfully baby is fine and has no chromosomal abnormalties, but the procedure has a risk of miscarriage so it's not ideal.

If you got a high risk result from nuchal I would imagine you would next go for harmony as invasive testing puts your much wanted baby at risk. So I would skip the nuchal altogether and go straight for harmony.

If I have more children that's what we are going to do. The harmony test is something like 99.5% accurate which is loads more accurate than the nhs one.

Xx

Thank you everyone, that's so helpful - Harmony test it is then

Interesting comments about harmony being 100% accurate. I can categorically confirm it is not as personally know of a recent case where Nuchal and combined bloods said high risk and harmony said all normal.. Baby had Trisomy 18.
It is a very good test but will never be 100%

My standard NHS blood test back back with a high 'risk' (1 in 3) of Down's syndrome/Trisomy 21. I declined the amnio and my consultant managed to arrange for me to have the Harmony test (an equivalent anyway) on the NHS. It took two days to arrange an appointment and then a week later I got the results which confirmed a diagnosis of T21.

As an aside my beautiful daughter was born 4 months ago; because we already knew that she us Down's Syndrome we were able to prepare mentally and practically for her arrival and she is THRIVING!

Congrats on your daughters birth Nightfall

After having a high risk (1 in 20) for Downs and then a horrendous 2 week wait for the Harmony test results to come back I would say if you're on a position to go straight for the Harmony then I would do it.

I think the Harmony test is slight less accurate for T18 mummyme87 I think it is Downs that they say is 100%

How do they feed your results back to you? Post, phone call or face to face?

Congratulations on your pregnancy :)

After suffering a mc during my first pregnancy, I am almost obsessively anxious about every thing that could go wrong so I had decided to do the Harmony test and nuchal at FMC too. When I discussed with the doctor who did my viability scan, she advised me to wait for the NHS nuchal as I am being seen at a hospital where all the doctors are trained by FMC so the nuchal is just as comprehensive. She said the hospital will offer Harmony if my risk is greater than 1:150 and if it is lower than 1:150 but I still want it, her advice would be to come back at that point. I really appreciated her honesty on the matter and did not go for it in the end as my risk is v v low.

My advice would be do what is best for you, if you are really anxious then have it done. Also, some NHS trusts are better than others, so consider that. If I was in a high risk age group, I would get it done but thats my opinion. If you do go ahead, I second all the opinions on FMC, they are absolutely fantastic and I would recommend them over and over again.

I guess my worry is that my first booking in appointment isn't for another 2 weeks but then I move house and thus NHS trusts and fear I'll get a little lost in the system. I am very anxious and if the NHS tests aren't as conclusive I'll fixate on that so it's probably worth it for me

If it will put your mind at rest and the money is not an issue then I would advise having the test.

Are you moving really far from your current house? Could you have all your antenatal care at the new NHS trust instead of starting off at your current local? I would consider that if it is possible. In my case, they gave me the hospital antenatal folder together with a lot of trust specific information on the booking appointment which won't be too helpful if you are moving your care to elsewhere.

If you decide to, it shouldn't be too late to refer yourself to the new hospital - I didn't see a GP or make a referral until I was 9 weeks. I had my booking after 10 weeks and scan at 12 - they just sent me both appointments together by post.

Mummyme87 - Trusomy 18 is Edwards Stndrome right? When I said the apron at FMC told me that Harmony is 100% that is for Downs. He was very clear that it is less accurate for Edwards. I would hope your friend's doc made that clear when using it to test for Edwards.

Yup, agree with PP - if you've got the money go for it. I would have done it, but we didn't have the spare cash.