Confused about testing done during pregnancy

[lm3898]

Hi ladies, hoping you can help...

I'm supposed to have my nuchal translucency first trimester screen on Dec 4th. I went through all of these tests/options with my doctor and he said after that we have the NT, we have the option of the CVS and/or the amnio exams but both are invasive & both of those have slight risks.

My girlfriend said she is having the maternTi/harmony test which I'm reading has a much better accuracy rate than the nuchal with no risks at all to the mother or fetus...

I'm confused why my doctor never mentioned this test...do only some people qualify for it? Does anyone know what else it would test for?

Thanks for any help...

 

[confuzion]

Usually doctors will recommend it to women over the age of 35 as they have a higher risk of chromosomal abnormalities. It also depends on where you live and your doctor's office whether these tests are even available.

At my midwife's office I was given the choice between doing the NT scan or having the panorama blood test done (which is basically the same as harmony and materniT21). I chose the blood test even though my midwife said at my age (24) she doesn't see a need for it. But I'm more comfortable with the accuracy, and I'd also like to find out the gender .

I would maybe ask your doctor if this is something they offer next time you go in (or you can phone in) if this is something you'd prefer to do.

 

[ItsAWonder]

I just got off the phone with the geneticist about this.

The main thing is insurance coverage and who is insured.

I am getting the NT First trimester scan and a finger stick (not sure what the stick is for). These have been covered by insurance since 2009, but you should still check with your insurance company if you are not either under 20 or over 35.

The MaterniT21 is a brand name for the Maternal Fetal DNA test. (It's like Kleenex vs. tissue paper.) The lab my doctor uses is one of only a few that do this test and are certified to do the test. This was news to me. Many labs are not yet certified and their results are not as accurate. Insurance companies also will not work with non-certified labs. Google bought a number of the labs recently and due to Google not being certified those labs can no longer accept insurance.

To be eligible for this test through insurance you have to be high risk - age 35 or older, age 20 or younger, 2 or more spontaneous miscarriages, family history of genetic disorders etc.

The cost of the test can be anywhere from $0.00 to $2,800.00. The lab we will be using has a policy that they charge women who qualify based on being high risk a maximum of $200.00. So, even though my insurance may not cover the full amount, I will only pay $200.00 or less.

If you were to request it and not be high risk, you would be charged the full $2800.00 (again, this depends upon the lab not your doctor). Most doctors will make you call the lab before you show for your appointment so you know what fees you will be charged. Call your doc before your scan and request information about if they do this test and what lab they use, then call the lab.

Another thing to note is that not all labs run the same tests. Sequenom lab currently has the technology to screen for the most abnormalities.

The good thing about this test is, rather than get ratios of possible issues, you are given a positive or negative result. The results are anywhere from 93%-99% accurate.

If one or some of the screens come back positive then the doctor recommends Amnio.

The other insurance issue is that, if you have the Maternal Fetal DNA test than your insurance may not cover the follow-up Amnio. They may say that one test is all you get.

If this is too much info, or confusing, let me know and I can clarify.

 

[lm3898]

Thank you both so much.

ItsAWonder - are you saying that one is sort of the "brand" but you can pay for a cheaper test? The Maternal Fetal DNA test? Could I hope to pay a lesser amount out of pocket for that?

I am not considered high risk but I can't imagine why they wouldn't let everyone get this test rather than one that can potentially harm the mother/fetus [cvs/amnio]...it seems so unfair.

 

[PandaMao]

Lm3898, cvs/amnio is invasive, but the nt scan it's not. It's just an ultrasound and they specifically look at the Nuchal fold on the back of the baby's neck. They also take a little but of blood from you (they poke your finger with a needle similar to what a diabetic does to test blood sugar) so it's not even much blood. That's it. They take the number from the Nuchal measurement and results from your blood to determine your risk factor for baby having certain genetic abnormalities. If baby is high risk that's usually when you are offered amnio testing. The amnio testing it's not required. If my results had come back high risk I would have declined further testing, but my risk was low. I think pretty much all insurance covers nt scan, but not the maternal fetal DNA test (harmony, maternit21, I'm sure there are other names for this test) unless your risk I'd high from age or other factors. The DNA test is quite expensive with no insurance though so most opt not to do it.

 

[lm3898]

Thank you -Panda. What you wrote about maternit21 is pretty much my issue...I understand about nuchal, cvs and amnio but I can't understand why harmony/maternit21 isn't offered to everyone since there are no risks to the fetus/mother unlike the cvs and amnio....it just doesn't seem fair. I'm trying to find out how much the test would be without insurance but it seems to vary greatly.

Lm3898, cvs/amnio is invasive, but the nt scan it's not. It's just an ultrasound and they specifically look at the Nuchal fold on the back of the baby's neck. They also take a little but of blood from you (they poke your finger with a needle similar to what a diabetic does to test blood sugar) so it's not even much blood. That's it. They take the number from the Nuchal measurement and results from your blood to determine your risk factor for baby having certain genetic abnormalities. If baby is high risk that's usually when you are offered amnio testing. The amnio testing it's not required. If my results had come back high risk I would have declined further testing, but my risk was low. I think pretty much all insurance covers nt scan, but not the maternal fetal DNA test (harmony, maternit21, I'm sure there are other names for this test) unless your risk I'd high from age or other factors. The DNA test is quite expensive with no insurance though so most opt not to do it.