What is the benefit of Harmony test?

[BessMarvin]

I've recently found I'm pregnant again.

With my first there was no NIPT then. Now this is something you can do privately.

Looking into it, it seems to cost about £400 for a scan and the blood test. It's quite expensive so I'm wondering what the pros are for doing it?

OK you find out the sex earlier than the 20 week scan, but that just seems like a bonus.
You get a scan to see if everything looks OK so far, but just paying for an early scan is much cheaper.

So it must be about the tests. So what is the advantage of this rather than what the NHS will do as a matter of course?

Thanks for any advice!

I was told it was an alternative to amniocentesis if you get a high risk result on the nuchal test at 12 weeks for downs, Edwards, or patau syndrome. Amnio has risk of miscarriage, Harmony tests don't.

Sorry, to be clear, on the NHS I could have only had amnio as a further test.

So in that case you'd have it after the NHS scan so the private scan wouldn't be early. Or you'd have it before the NHS scan, anticipating you'd get a high risk result.

It tells you with 99% (maybe even higher) certainty whether your baby has Downs and the other trisomys. I much preferred that to the ‘risk’ which the combined testing comes out with, which for me was quite scary and a bit confusing.

I think if I ever do get pregnant again I would get this test done rather than an early scan and not even bother with the nhs screening. If I have the money that is!!

I am definitely leaning that way, it's just the price tag that is making me reluctant.

For my twin pregnancy, the combined blood tests weren't accurate for risk factors (they generally aren't for multiple births), and an amnio was risky because there was then a chance of miscarrying both babies.

The NIPT test was fairly quick and very accurate, and no amnio was needed. In my case, it was £400 very well spent

I liked the idea of finding out the sex early but our local Harmony test now don’t offer that (presumably some terminate based on that info).

If the nhs 12 week test results came back as high risk I’d do it then.

I had it done for both of my pregnancies at 12 weeks. I'd have terminated my pregnancy if the baby had Edwards or Pataus as they are incompatible with life so I wanted an answer ASAP as I wanted to avoid the trauma of a later termination.

It is the least invasive way to get a very good indicator of trisomy risk. Tiny margin of error. We felt it was excellent value for peace of mind. If you're looking at the Fetal medicine centre I can't recommend them enough.

Thanks to everyone who's replied.

It seems like it's most useful if you have twins or the 12 week results are high. But I imagine if the results are high, the wait between that and getting the NIPT result is really difficult.

Still not sure what we'll do. Probably see if we feel we can afford it.

Exactly the same as the poster above, I was 35 in my last pregnancy and 37 for this so already somewhat higher risk and I just wanted to know as early and accurately as possible. Finding out the gender was a bonus as the NHS don’t tell you here so you’d have to get a private scan anyway.

NIPT takes fetal DNA that has crossed the placental barrier and is circulating in the mother's blood and looks for chromosomal abnormalities. Harmony test looks for downs, patau, Edwards and some sex chromosomes anomalies, but my understanding is that if you paid enough they could look for a whole lot more, or at least will be able to in the near future. An ok result tends to be given as a 1 in 10000 risk, ie they won't ever say baby is definitely ok.

NHS Michel translucency screening, takes a measurement from ultrasound scan (fairly subjective), and factors in your age, plus some blood results (hormone levels I think) and comes up with a probability score for whether or not your baby "might" have a chromosomal abnormality. Anything higher than 1 in 150 (I think) is considered high risk, even though at that point you are still 149 in 150 chance of no problem! NHS will then offer amnio or CVS, which both carry risks of miscarriage or premature labour.

NIPT can be carried out at 10 weeks with results in 5 working days, nuchal translucency is 12-13 weeks then wait for results, then maybe have a NIPT or straight to amnio then wait.... Then potentially make life changing decisions based on those results.

I was 36 (so higher risk for downs) when I conceived my DD, DH and I had decided prior to ttc that we would abort i there was chromosomal syndrome. I would have been devastated of it had come to this but would have wanted to get it done as early as possible. I felt like the NIPT was the best way to do that. I also wouldn't have wanted a amnio based on a probability (friend had an extreme premie following amnio), and I suffer from anxiety, so new that the probability type result from the nt would have messed with my head at a vulnerable time. DD was fine and is 5 months old now, I don't regret spending £400 on the test!!

Nuchel not Michel!!

I had NIPT as I am an older mum (37) therefore the risk of chromosomal abnormality is higher. It’s more accurate than the NHS screening so it gave me more peace of mind. I also wanted to avoid amnio/CVS if at all possible.

OP the short answer is that the Harmony (and other NIPT tests) is a screening test, as is the nuchal fold test, so it can only give you the odds of having a problem, not a definitive yes/no diagnosis. But NIPT tests are quite a bit more accurate than the standard 12 week testing. If you do get high odds of a trisomy condition, you still need a diagnostic test (amnio or CVS) to confirm.

I had the 12 week NHS screening which came back as high risk. I was offered Harmony on the NHS because of my result, which then came back as low risk. The NHS Harmony test does not tell you the sex of the baby.

The combined test gives a result in terms of the odds of there being a problem with your baby, maternal age is used to calculate this therefore the older you are the more likely you are to get a 'high risk' result. Which would then lead to amino or cvs (with associated miscarriage risk) and not finding out what's going on til around 14 weeks.

For me, the fact you could do the harmony test and get the result by 11 weeks was a big factor in going for it. Last pregnancy my nhs 12 week scan was very late at 13+5. If there was high risk found at that scan, it would be very late to be making difficult decisions. The harmony test is also more accurate than the NHS screening. I had quite a bit of anxiety this pregnancy so for me it was worth the money for the 2+ weeks of extra peace of mind. Finding out the sex and an extra scan (which was much better than the nhs scan) was a bonus!

In the event my nhs scan was a bit earlier than last time but I'd probably still go for it. It doesn't replace an amnio though - because it still gives a risk not a diagnosis, to get a definite diagnosis with a high risk result you'd need the amnio.

If the time frame doesn't bother you It may be worth checking whether your hospital go straight to amnio/CVS or offer Harmony based on a high risk nuchal screening result - my local hospital offers Harmony but I think it varies by hospital.

@ChromeWaves I knew the combined test on the NHS would come out as high risk for me purely because of my age and regardless of all other markers.

Not true as you found out.

My trust doesn't offer NIPT, so when I became pregnant at 44yo I paid for the Harmony test. The alternative was to wait until my 20 week scan and possibly have to have an amniocentesis test for trisomy.

It certainly eased my mind.

Thank you for all the comments and advice.

I think we are going to go for it, especially as I'm in my late 30s.

I’m 41 and pregnant and my NHS combined test came out as 1:55000 so I think factors other than age (hormone levels, nuchal fold, etc) can wipe out the age effect.