Combined test/harmony/quad

[Summersun12]

Feeling confused and frustrated.

Long story short. I was scanned and baby was lying face down so they were unable to give me a date and complete the screening test for down syndrome/edwards syndrome and platau. The next scan i could get was in 3 weeks time when i will be 16.4.

I raised concern that i really wanted the screening done at this stage with the neck fluid being measured along with bloods (combined) i was told this cant happen and ill be invited back for bloods.

Ive tried asking but feel im not being listened to. The bloods at 16 weeks, are these any less accurate screening than the combined? So they test for all three downs, edwards, platau?

Im considering harmony but its quite costly. Has anyone done this?

Im nearing 38 so want to be extra cautious.

Could you ask your hospital if they do a harmony like test? It’s usually cheaper through them if they offer it, usually £200-250 rather than £400-500.

@Summersun12 my situation isn’t exactly the same, but I am 38 and was really anxious about getting screening of some sort done.

I was told that based on my age alone my background risk score would be 1:112 so high risk.

I then had the date through for my ‘12 week’ scan and it was when I’d be 14 weeks so I knew it would be pushing it to be done in time.

In the end after discussing at length with my midwife I decided to book a private SAFE nipt test at the birth company in London.

If I’d have gone to the scan at 14 weeks and then had to wait for screening results and THEN got the call to say I’m high risk, and THEN book a nipt, I’d have been waiting ages.

Instead I skipped most of the anxious wait and instead had the SAFE nipt done at 13+4. The scan they did was incredible. Far more thorough than any nhs scan I’ve ever had done. They were able to get an nt measurement and do all the necessary checks. Nothing was rushed. Immediately after the scan they gave me my adjusted risk score based on my age combined with the scan findings, and that changed my risk to 1:539. Then they took the blood which would give me the accurate score.

I got the results a week later. 1:100,000 for all trisomies.

I’m so glad I went for that scan. By the time I had my nhs scan at 14 weeks they couldn’t get the nt measurement. I declined their combined screening because I knew the nipt results would override it anyway as they’re more accurate and my midwife had advised that.

The private test and scan was pricey at £500 but for me, well worth it.

Good luck xx

The bloods alone are not quite as accurate but I remember this being the only thing on offer with some of my previous. The harmony test is pricey but has high accuracy so if you are worried after your NHS tests that could be a good option.

I got the combined, I'm 36 and got DS 1 in over 17k chance. E&P 1 in 100k chance. So pretty good for my age, no concerns at the anomaly scan either. Not much different chance wise to our twins at 30yr.

Thanks so much for your reply.

Fairly similar concern as i knew my scan was nearing 14 weeks so was worried whats happened would happen that i would miss out on combined test.

I think ill look into private.

Ultrasound direct do private NT combined test too.

Thank @Chelyanne do you know what week they can do harmoney until?

Won’t you get an nhs screening test at 20 weeks?

I had the harmony test recently. Yes it’s costly but it’s a drop in the ocean in the context of having a baby!

I think it's any time during pregnancy after 10wk.

@dinohat they have me back in at 16 weeks for blood test but not the neck measurement/blood. Ive been trying to get information if the bloods from 16 weeks is any less accurate and if it still test for all 3 syndromes. Nhs website says it only test for downs.

www.qmul.ac.uk/wolfson/services/antenatal-screening/screening-tests/ some good info here

The harmony/nipt tests can be done at any point in pregnancy after 10 weeks.

I had the blood test at 13.6 because they couldn't get the nt measurement and I came back high risk so ended up paying for the harmony. It was £400 done there and then at the hospital. I wish I had just done the harmony to begin with. The NHS blood test really isn't that accurate and is based on statistics so your age will increase the risk figure they give you so you're already more likely to come back high risk.

If you can afford it I would definitely go for a nipt and cut the waiting around for other test results.

I had Harmony at just over 10 weeks to avoid the Combined test as I was over 40 and it would automatically be higher risk due to age.
I found it very reassuring. But it is still not 100%.
It cost £400 I think.

Thanks everyone for youre replies. From what im reading harmony is more accurate but wondering by how much?

Ive enquired hospital dont do private but there is a clinic that will do for £500.

Is NICP test same as harmony?

Sorry that this had happened. I can't believe they arent fitting you in sooner for a repeat scan! I thought the NT can only be done until 14 weeks. Have you spoken to you midwife?

My experience is not indiciative of your experience or what will happen. I got pregnant for the 1st time age 38 and paid for the NIPT at 10+5 weeks due to my age. Unfortunately, it showed patau syndrome. They did a detailed scan and there were obvious deformaties and problems. I was glad that I had a choice so early on. I don't know how I would have coped if I'd have had to wait until 16+ weeks.

If you do have the NIPT, shop around. Harmony, SAFE, panorama, Vantis are all just brand names of the same test. Check if the blood tests are analysed in the UK, or shipped to the USA- which will take longer. Some clinics include add ons like an extra scan, so do check what exactly is included.

Also check how you will be informed of the results and what the next steps would be. I've heard of some clinics giving the results (bad news also!) via text or email, then telling them to follow up themselves for further treatment!

I'd certainly be pushing for another scan asap, or ask whether your hospital/clinic do the NIPT at a reduce rate. Best of luck x

@Elouera thanks so much for replying and i am so sorry you had to go through what you did. I think thats why im anxious i would like accurate information early on.

I felt midwife was dismissive because she said she doesnt see why im concerned as im getting bloods at 16weeks but i still wasnt given an answer to the diffrence between neck fluid measurementbegore 14 weeks plus bloods and the blood only test at 16 weeks.

I think ill call hospital on monday and see if they do a reduced rate although i cant see anything on line. Otherwise ill look to see if we can afford to go private x

I was under the impression that if the screening isn’t / cannot be carried out before 14 weeks then the quad test only checks for Down syndrome?

I recently had a NIPT (harmony) as I didn’t even bother with the NHS screening as I was pretty sure my age (36) would result in a high risk result.
If you can afford it I would highly recommend a private NIPT test. X

@HayB i spoke to midwife yesterday who said the 16week blood only tests for all i.e downs, edwards and platau but i dont think thats correct. What ive read online and in the screening booklet i was given irs downs test only.

@HayB did you find harmony test reassuring?

@Summersun12
Yes that was my understanding that they can now only test for Down’s syndrome if not done on the 12 week scan 🤔

I definitely found the harmony reassuring. I didn’t see the point in the nhs one at my age and didn’t want to waste time for nhs and then further tests back if a difficult decision had to be considered if some of the screening results were high risk.

X

Thanks again for everyone responding.

I managed to get some accurate information today.

They only need to scan once up to 14 weeks for the combined test (bloods + NT ultrasound) if like me baby is in wrong position for measurement they wont scan again. This tests for downs, edwards and patau's.

If this screening cant be done like in my case you will be offered a 16week blood test that will ONLY screen for downs.

Its taken me speaking to 4 different midwifes to get accurate information.

I explained i felt anxious because of my age and really wanted screened for all 3. I was told my only option is to go private.

@Summersun12 there are other options for NIPT. Usually labs do them directly without the scan for much cheaper and much quicker turnaround. I've just enquired with a lab and although I'd need a referral (gp will be able to do this) it would be £295 for the test + £45 for the blood draw, I'd get the results in 3-5 working days.

@nocalledID

Thanks for this

Would you mind sharing the name of lab? I couldnr find anything online and in scotland the midwife only had name of one provider for harmony test. No hospital offers private.

Going to lab direct might be good option.

@Summersun12 I know that ultrasound direct offer it in Scotland (I've actually been on the phone to the Scottish last last week as she deals with their social media). However they send their bloods to TDL in Manchester/London - which is where I've enquired with. The lady from UD mentioned sending the blood via Royal Mail as a next day delivery, but TDL have said I'd have to go to London directly. Might be worth enquiring with Manchester though?