Harmony test - is it worth it?

[tacosplease]

Is a Harmony test just a blood test or does it involve a scan as well? Is there any advantage to having a Harmony test done compared with going through the usual process with the NHS?

I know the Harmony test can tell you the sex of the baby as early as 11 or 12 weeks (so that’s definitely one advantage if you’re keen to find out!) Can it show whether you have toxoplasmosis as well?

Also, what’s the best time to have it - and do you still need a 12-week scan on the NHS if you have a Harmony test?

They do a scan prior to the actual blood test.

I understand you should have the 12 week scan anyway but the hospital recommended we not do the Downs screening test as the Harmony/NIPT tests are more accurate.

I had the harmony test done - just a blood test completed. We had it done with the first scan as we were in the hospital anyway. I'm not sure if it's worth the money but it was to me and I would have it again.

Sorry, just seen your question about timings. They can do it from ten weeks, I think. My view was that I wanted to know about any abnormalities as soon as possible, as I would not have wanted to be making difficult decisions about whether to proceed with a pregnancy later on. But it depends on what you would do if an abnormality was detected, I guess - I’m not sure if the reliability is different depending on the stage of the pregnancy.

I’ve had three losses in the past and am 39.

I knew I’d get a high-risk NHS result based on my age alone and I’d worry excessively.

We paid £400 for NIPT at 10 weeks, had a very detailed scan where we saw him waving, I cried absolute buckets, and a few days later got a phone call telling me he was a healthy boy.

I absolutely recommend it.

The NHS tests would've taken too long for me and then possibly an amnio at 16-18 weeks if non conclusive. No thanks.
I had NIPT at 10 weeks so I would know if anything was wrong before I went to 12 week scan as I would've wanted any difficult decisions made by then.

Worth every penny to me. Scan then blood taken. Had email with results within a week.

We did the Harmony test. It was £400 and worth it for us but we were fortunate to have the money to spend on it. Some might disagree that it's worth what you get for it.

Yes it is considerably more accurate than the NHS tests for screening for Down's, Edward's, and Patau's. It is also a lot more accurate than the NHS scans at telling you the sex because it tests the baby's DNA rather than judging from looking at the scan.

As pp have said, we wanted to know as soon as possible whether there were any difficult decisions to be made.

You get a scan. They do not test for toxoplasmosis although I'm sure there are other private tests for that. My midwife had my booking bloods tested for toxoplasmosis without any push back at all.

I didn't think a scan was standard with harmony tests, if you've had the harmony/NIPT then the NHS 12 week will be dating only as you wouldn't need the screening.

Re toxoplasmosis, I don't know if it would show up as I've only ever seen the harmony/NIPT tests refer to fetal tests (chromosomal abnormalities etc) but you can contract it anytime if exposed and it can take 2-3 weeks to be detectable after infection so I wouldn't rely on one blood test if you think there's a risk you've been exposed. And it's only a risk to the baby if you get it for the first time during pregnancy.

Thanks for the advice.

So just to double check - if I go for the Harmony at 10 weeks, presumably I should still get the 12 week scan from the NHS as it will be two weeks later?

Also, is Harmony/NIPT the same thing?

I think it varies by location / health board - I'm in Scotland and the Harmony is only available privately.
I paid for it and was very glad to have it but it's a personal choice.
I had the 12 week scan (at around 14 wks) on the NHS but the neck measurement that forms part of the downs screening (which I opted into) couldnt be got because of the babies position. As a result I was told to come back for a blood test at 16 weeks.
I did that, but half expected to get a high risk result anyway due to age and other factors so I couldnt settle in my mind, knowing a more detailed test was available.
I spoke to my husband and agreed that even if just to help settle my mind it was worth doing, so we had an evening appt, they took the bloods and performed another scan, this seemed routine and was just a nice opportunity to see baby again and get some more pics.
I actually got the harmony result back before the NHS blood result (which incidentally was low risk in the end anyway!) Bonus being that the harmony report did detail the sex of the baby too which was nice.
Overall, for me it was the right decision but very much a personal choice.
Good luck whatever you decide.

You wouldn't necessarily get a high risk result based on your age livid, I'm also 39 and didn't get a high risk NHS result.

I had the harmony test privately, it involved a scan and a blood test and was worth it in my opinion but mine was covered under health insurance so I didn't pay. I didn't find out the sex, you can choose not to.

I have had the Harmony test 3 times. You have to have a scan to confirm the number of babies and the gestation. I would only go to a provider that includes a scan in the package.

It tests for the three major trisomies (with high accuracy, it's very close to diagnostic) and can tell you the sex with high accuracy. You can have it any time from 10 weeks, I would have it as soon as possible as some places do it cheaper if this early, and also because if you would terminate a pregnancy affected by a trisomy (I would have done) then presumably you would want to do this as early as possible.

I went ahead and had the NHS 12 week scan too as that's the one they'll use for dating. But there's no point having the combined screening if you already have a clear Harmony result. The dating measurements are more accurate at 12 weeks than 10 and the baby has developed massively in those 2 weeks so it give them a chance to check for other developmental concerns.

Thanks! So it sounds like Harmony followed by a dating (but not combined) scan at 12 weeks with the NHS is the way to go.

Is it better to have the Harmony at 10 weeks or 11 weeks? I know it’s more costly at 11 weeks, but at 11 it includes the nuchal test according to the FMC website - so should I go for that option?

I currently have an NHS 12 week scan booked for 12+6.

I would have it at 10. The nuchal test is not so good at detecting problems as the harmony test, so if you have the latter you've really got that covered. There have been a few instances of false negatives with the Harmony I think but it's very rare.

FMC is the best choice of provider I think if convenient - I've had it twice there and once elsewhere and they are definitely more informative and professional at the FMC.

I had it at 11 weeks but that was because when I booked it the secretary would only take LMP date from me rather than the ovulation date that I knew (the scan agreed with my ovulation date in the end!). The consultant measured nuchal too as it's still worth measuring as it can pick up other issues. I had mine at an NHS hospital but privately - suspect that was similar to the experience at the FMC rather than some of the standalone clinics offering the tests. The ARC website has some good information about things to consider and questions to ask when picking a location to have the test.

Harmony is one brand of test. NIPT is the type of test (bit like a Hoover being a brand of vacuum cleaner iyswim).

False positive rate does increase with age for the combined test (the NHS standard screening) - stats quoted in Expecting Better.

The consultant measured nuchal too as it's still worth measuring as it can pick up other issues.

@Weathergirl1 so do you think it is better to go for the harmony/nuchal combined at 11 weeks rather than just the harmony at 10 weeks (followed by a dating scan on the NHS at 12 weeks)?

Sorry, really struggling to get my head round this for some reason!

NIPT stands for Non-invasive Prenatal Testing. Harmony is one type, as is Panorama. We went to The Birth Company as we liked the look of the Panorama test better (I think it cost a little more but screened for more things). We were very happy with the service, both at the clinic and in terms of speed of results.

They will measure the nuchal at your NHS 12 week scan even if you decline the screening.

I had harmony in both my pregnancies and declined the NHS screening in both following discussions with the midwives/sonographers. They still checked the nuchal at my 12 week scans as a high nuchal can indicate things like heart problems that are unrelated to the three trisomies tested for by the harmony.

@tacosplease as it'll get measured regardless at the 12 week NHS scan then it's probably not worth worrying about them measuring it or not in conjunction with NIPT. I hadn't realised until this thread that they wouldn't measure it if you were just 10 weeks. We wanted NIPT results prior to the '12 week' scan so we had it as early as possible, especially since we knew that that was actually happening at 13 weeks by my dates. The only issue I see with booking in slap bang on 10 weeks is if you're going off LMP to work that out and you ovulated slightly later as you'd then not be quite 10 weeks at the appointment. I reckon it's probably best to speak to someone at the FMC and ask them for advice on timing.

I had harmony in both my pregnancies and declined the NHS screening in both following discussions with the midwives/sonographers.

@Sunshinegirl82 thanks! By screening do you mean the NHS blood test at the 12 week scan? Does the NHS test look for exactly the same thing as the Harmony test (Down’s, Patau and Edwards), meaning there’s no point in having it if you’ve already had a Harmony test done?

I would do it again in a heartbeat. DS came back 1:26 risk of downs syndrome I needed to know for preparing myself and the waiting was killing me but I did not want to risk the amnio. The scan was so much more detailed and I had plenty of time to watch him moving and wiggling. They can also tell you the gender by it if you wish to know. I'll never forget my DH calling me up and saying "he's ok" best phone call of my life! Still get the NHS scan because there are other things they will be looking for but it was worth every penny for setting my mind at ease.

@Weathergirl1 that’s helpful, thank you. I had an early scan at the FMC yesterday that dated me at eight weeks exactly, so I guess I should be safe to book the Harmony for two weeks’ time, although I will ask their advice just in case. I will then have my 12-week scan and nuchal with the NHS but decline the blood test.

I could have the nuchal at the FMC for £100 more, but there doesn’t seem much point in spending the extra money if the NHS offer it anyway at 12 weeks - would you agree?

@tacosplease that would sound reasonable to me. You should have the Harmony results back by the time you go for the NHS scan & nuchal measurement is straight away so you'll know it there and then without having to wait any longer for a result 👍

@tacosplease yes the Harmony and the NHS screening are testing for the same trisomies. I declined the NHS blood test screening so I never received a high/low risk result after my 12 week scan although the nuchal was measured.

The NHS screening works by taking a number of factors (the nuchal measurement, the results of the blood tests, your age etc) and running them through a computer program. It then provides a probability of the trisomies being present based on that information. If the probability is higher than 1 in 150 for any of the trisomies you are deemed high risk and offered further testing.

The NIPT/harmony extracts the baby's DNA from the mothers blood and looks for the trisomies that way. It's therefore much more accurate. If you receive a high risk result with the NHS screening one option for further testing would be the Harmony. There really isn't any point therefore in having the NHS screening if you have had a low risk harmony result as it would actually be a step backwards in terms of accuracy.

The NHS blood test is looking at the levels of certain hormones in the blood for the benefit of the computer program, it doesn't look at the DNA at all.

Great, thanks. It’s all a lot more clear now!