Question on Combined Screening + Harmony test - particularly for mothers 35+

[Millimama]

Hello! Hope everyone is doing well. Really interested in feedback: I had the combined screening test at 12 weeks on NHS, which resulted in a very high risk rating for my birth. I ended up doing the harmony test privately and was rated very low risk. I'm really interested in other mothers experiences with these tests - particularly if you are over 38 -I'm 42. Happy to DM if you prefer. Really looking forward to hearing your stories, thanks in advance and keep very well!

I didn't have the combined test as I went straight to Harmony, however the midwives said that an older age increases your results on the combined as they consider it a risk factor. They also said the Harmony is far more accurate because it is your actual DNA being tested, so if you got low risk Harmony you can trust that.

I'm 38 (39 EDD) and I was given a high risk result for my combined screening (1:110). This was based on a higher hcg level and my age (NT and Papp a were all ok). I was really anxious about it but had the harmony test and got low risk 1:10,000 result. I did try and have the harmony test before my combined screening but the consultant was away so I had to wait. It's a shame because it caused me lots of anxiety getting the call to say the combined screening came back high risk. Wish I could have avoided it but at least I got good news in the end.

I was 38 and had NIPT which came back low risk. Didn’t bother with the NHS screening after that.

I was 41, and had the combined test.
If it had been high risk, I would have then had the Harmony test (would have paid for it).

I would definitely worry even with a low risk from the NHS test as it's not very accurate. You could get a low risk and still have to face a baby with abnormalities either at the 20 week scan when it was picked up which is very late, or not until far longer down the line.

I just think the NHS should be using the npt test was standard

*as standard

I had a very high risk combined due to age (40 at EDD), high hcg and low papp a. I went on to have NIPT and this came back 'highly unlikely'. I wish I'd had NIPT first. The only thing the combined did do was to pick up the low papp a which means I'm now on aspirin.

I'm 37 and both results came low

Hi I know this post is a couple of months old but I’m interested in others thoughts , I’m 42 just had combined test back whilst I’m not high risk I wouldn’t say I’m confident with the figures and thinking I should may go private for nipt. Tris 21 was 1/982 and Tris 13/18 was 1/228 that’s worrying me more. My husband thinks wait till 20 week scan but I’ll be 21 weeks at that point and 15 now , not sure I can stand not knowing more. Am I being over the top my background risk was better odds before adjusted in tris 13/18 so going to guess something else pushed that out pap looks lower than my previous pregnancy. This process of limbo is awful

Hi Wishful2021,
Congrats on your pregnancy!
I would say the NIPT is worth the investment if your prime concern is Trisomies 21, 13, 18 being identified - in that realm NIPT is highly reliable. NIPT can also detect other genetic anomalies but is less reliable in those cases. For true, exhaustive and definitive information on genetic anomalies being ruled in or out, an amnio with full array is the best option. I know this is scary for some women. I did one, I was in good hands and am glad I did it, the results were clear. I will say your combined screen results are definitely encouraging, you're in a good range. It may be elevated compared to prior screens you've done because the age factor definitely influences the result. Personally I find the age skew a bit bullshit, it's statistical and can feel worrying without actual genetic material backing it's arithmetic. The limbo sucks, and to that I say find out more and early, waiting and worrying is no good and if hard decisions need to be made, earlier is better. And if all is well, sit back and enjoy the pregnancy well informed. Good luck. Do let me know what happens if you like.

I am 37 and got low risk from the nhs combined screening test so decided not to get the NIPT

My harmony test (at 10 weeks) came back v low risk but the combined screening put me at 1:3 of DS. Also had raised NT so had the full array CVS. It picked up a rare genetic abnormality that shows up as high risk for downs but isn't. If we hadn't already had the harmony (and almost ruled out downs) they would just have done CVS for 3 trisomies and our baby's genetic condition would have gone undetected. Resulted in TFMR 😞

Hi Millimama I’ve booked the NIPT I need a clearer answer x

Dear Amymone. I am so very sorry.
I just got back from hospital after tfmr from an anomaly that wasn't identified until other issues emerged in the pregnancy. it's the hardest experience I've ever been through.
I wish you all the best.

Dear Wishful2021. I'm wishing you the very best possible outcome.

Lots of love to you ladies.