@AMCsquared ugh I was so confused after my first appointment too and then I went back over all my paperwork! Here's what I'm having - see if it sounds like your plan too, but it might be called something different:
Ultrascreen (aka First Timester Screen) = NT scan + finger prick. The finger prick looks at levels of free Beta hcg (this is different from the betas to confirm pregnancy you probably got earlier) and PAPP-A in *your* blood. These two blood markers (low PAPP-A and high free beta Hcg) can indicate a chance of carrying a baby with chromosomal abnormalities. I think a lot of insurances cover this. This is also more accurate than the second trimester screen or "quad screen".
NIPT (could be MaterniT21, Harmony, etc) - blood draw that looks for *the baby's DNA* in your blood, looks for trisomies and baby's sex, and takes up to a few weeks to get back, because only a few specific labs process them. I have to go to my obgyn's office for them to do this draw and they send it to Sequenom, instead of my regular outpatient lab where I get normal labs like iron, thyroid, etc. So it can cost more if your doctor doesn't consider you high risk and your insurance only covers it for high risk.
Technically the finger prick is a type of NIPT/NIPS, but I think for the most part "NIPT" has become a shorthand for the MaterniT21 type tests.
ETA - as we get into this testing it's important to remember these are just screens, not a diagnosis. So any abnormal value should just be a jumping off point for more conversations about further screening or diagnostic procedures (and whether you even want to do them!)
Me: 36 | DH 35, Married 2007
TTC #1 June 2015 April 2016 - AMH, FSH, Progesterone normal June 2016 - HSG clear *TW* BFP - Aug16, demise confirmed Sep16, incomplete m/c, D&C Nov16 BFP 3/27/17, edd 12/7/17 DS - 12/9/17 TTC #2 December 2018 BFP 2/22/19, edd 11/4/19 DD - 11/1/19 My Chart
@AMCsquared I think it's strange you'd do the nipt test twice? NIPT isn't considered diagnostic, so like @whiska said, it's a starting point. Depending on the results, I believe the most common next step is a CVS (or I guess amnio but I'm not sure). The CVS and amnio are diagnostic and lets them get a better look at the DNA.
** December BMB Siggy Challenge - Animals in Pools **
Me: 31+ H: 32 TTC Since 11/2015 #1 - MMC 6.5 weeks (2/16); #2 - MC due to cystic hygroma at 20 weeks (10/16); #3 CP (2/17); #4 - Due 12.16.17
When I was pregnant with DS1 we tested positive with the NIPT for neural tube defects. The doctor refered us to a genetic counselor where they took extensive family history, went over all the tests, and did another, more in depth ultrasound. After a few weeks we met again and the genetic counselor said that likely it wasnt a true neural tube defect or spina bifida, but the elevated levels in my blood could be indicators of other things later in pregnancy so I was just monitored more closely with twice weekly non stress tests in the third tri (concerns were pre term labor or potentially low amniotic fluid). Had the additional tests come back more concerning next step would have been an amniocentesis, but our dr didn't think it was necessary. Just sharing in case anyone gets any concerning test result or are curious.
Ladies I'm so confused and I just can't get the testing cleared up in my brain no matter what I read. Helppp lol. My gyno wrote down that at 10 weeks I am doing an at home finger prick blood test called non invasive prenatal first trimester instant risk assessment. She wrote that it tests for DS, T18, T13. Then I have the corresponding US at 12 weeks.
She wrote if those tests bring back questionable results, then the next step is the NIPT test which includes the gender. Is that the harmony test? I'm confused bc I'm seeing that the harmony test includes DS and t13/18 and gender. So NIPT is a totally different test? Or not
the finger prick goes with the US at 12 weeks - the combo is your nuchal translucency screen. they do the prick in advance so you get "all" the results the day of your US. or, you can get the prick done the day of the US and hear back about the blood prick results two weeks later (for those of you that don't have an at-home option and are trying to cut down on the number of appointments). this is usually the first step. if your results indicate further testing is indicated, then a NIPT such as harmony can be ordered and will be covered by insurance due to the results of the NT scan. previously your follow-on options were invasive such as CVS or amniocentesis. make sense?
Has anyone tried the SneakPeek test? It's a blood DNA test, I found it on Amazon for $60, the test kit and results are included in the price. It got surprisingly good reviews. Most at home sex predictor kits are crap.
@anewadventure - fyi some doctors skip the nipt test if something shows wonky on the NT because nipt aren't considered "diagnostic". While they are considered to be very accurate, they actually only tell you the likelihood of something being wrong. The only way to confirm is through the more invasive options (amnio and cvs).
** December BMB Siggy Challenge - Animals in Pools **
Me: 31+ H: 32 TTC Since 11/2015 #1 - MMC 6.5 weeks (2/16); #2 - MC due to cystic hygroma at 20 weeks (10/16); #3 CP (2/17); #4 - Due 12.16.17
@AMCsquared Not really loving how your doctor explained it. Sounds totally confusing and not really what I've come to understand. The finger stick and the NT scan are used in conjunction with each other. NIPT blood tests like Harmony and MaterniT21 are optional, NOT the next step. It's actually the invasive stuff like amnio and CVS that comes next, from my understanding.
We sat down with a genetic counselor on Monday and she explained things way more clearly than my OB did. Basically, the NIPT first trimester blood draw is used with the NT scan to screen for chromosomal abnormalities. Just the NT scan alone has only a 60% accuracy rate, whereas the combination of the scan and the finger stick/blood draw bumps it up to around 90% accuracy. I should also note that the NT scan is just a normal ultrasound where they measure the baby from rump to crown, measure the fluid behind the neck, and check out the heart for any potential defects like holes. You can also opt for NIPT like Harmony or MaterniT21 which has a 99% accuracy rate. According to the counselor, as of last August most major insurance companies now cover MaterniT21, high risk or not. We called to double check (we have Anthem Blue Cross) and they do cover MaterniT21, even though I'm not AMA and we don't have a family history. Also, they tell you it takes 7-10 days, but everyone I've talked to about it has gotten their results in less than a week.
We did have to get some further testing done because my husbands father is Jewish and there are a slew of conditions they screen for because of that. This one didn't have a particular name, but the lab it goes through just screens for something like 18-36 conditions prevalent in the Jewish community. Both my husband and I were drawn for this.
As for us, we opted for all the genetic testing... The Jew stuff, MaterniT21, and the NT scan (which will be in a couple more weeks for me).
Adding some information that I've learned about Harmony pricing in the last week. Apparently if your insurance covers the Harmony testing, you will pay the out of pocket rate (if any) that your insurance company has negotiated with Harmony (aka Ariosa Diagnostics). In my case, my insurance probably won't cover the Harmony test because I am not high risk. However, the rep and billing department at Ariosa have told me that if my insurance rejects the claim, they will only charge me $199 for the test. This actually happens to be a lower price than the price that my insurance has negotiated with Ariosa ($450), so I really do hope that they reject the claim!
Yes, that's another thing the genetic counselor mentioned. Like @blueskies17 said, out of pocket is going to be way less. For MaterniT21, if insurance rejects the claim, the lab has to bill you $1300 (otherwise they'd be charged with insurance fraud), but they'll only hold you accountable for $200. It'll even say on the bill to call them so they can adjust it.
Thanks for all the info, ladies! I'm 10w6d and just had the NIPT blood draw today. They said it takes 14 business days to get the results back. The NT ultrasound scan is scheduled for Tuesday. Praying for no big surprises!
Just popping in to let you ladies know, my Harmony results were covered 100% and $0 out of pocket but probably due to AMA and other issues. I did get my results in 5 business days.
@acgonzalez22 that is so good to hear! I called my insurance company and mine is covered 100 percent! So glad everything came back good for you. I go for mine in one week. Every insurance is different so I definitely doesn't hurt to ask.
I contacted my insurance hoping harmony might be covered bc my insurance is generally pretty amazing. But they said no only tests deemed medically necessary by the doctor are covered
Me: 31 DH: 32 DH since 12.2009 Married 08.2013 EDD 12.2017
@lin24-2 I believe it's a simple blood test. Then you sign into the website to get the results. Someone else might be able to give more details, but that's how I understand how it works.
While I believe it officially says it takes 7-10 days to get the results, I've heard most people get them back quicker.
** December BMB Siggy Challenge - Animals in Pools **
Me: 31+ H: 32 TTC Since 11/2015 #1 - MMC 6.5 weeks (2/16); #2 - MC due to cystic hygroma at 20 weeks (10/16); #3 CP (2/17); #4 - Due 12.16.17
@lin24-2 I had Harmony done and it was just a lab draw. My OB called me with the results. They had told me the results would take 7 to 10 business days but it was 5 business days. Again, I don't know if Panorma is any different but I believe it is also just a blood draw. The actual company mailed me results after my Dr gave them to me. GL!
I had the Harmony test and my blood draw was last Monday the 15th. They called me this morning with the results. We have low probability for any of the conditions it tests for. Also, found out we are having a girl! I was so nervous when she asked if I wanted to know. This will make one of each for us.
Are any of these screening/diagnostic testing required? I have my 12 week US on June 8th and I don't mind waiting until later to find out the gender and I'm afraid of any unnecessary procedures. I'm 33 and this will be my first baby.
@lin24-2. Here in America the Harmony doesn't have an ultrasound. But you might be thinking of the NT scan, which includes a blood test and an ultrasound. They are different tests and while there are some overlaps in conditions they scan for, they are considered two different tests.
@isabelbustamante1023 - both the Harmony and the NT scan are optional, but they are very low risk to the fetus. I believe the NT is usually covered by insurance. I know someone here posted that more insurances are starting to cover the Harmony test, but I haven't seen that in my experience. I know for myself and for my friends who are or were very recently pregnant, it was only covered if there was a reason (previous experience with a chromosonal disorder or advanced maternal age are two common reasons it would be covered). But if you're interested, I'd talk to your doctor and your insurance, perhaps it's covered.
ETA - While not a required test, I am very pro NT scan. It's so low risk to the baby (especially if you're already doing an u/s during that visit) and identify serious problems with the fetus incredibly early. I know some women chose to not to have this test, and I respect their decision. But I think knowledge is powerful, and this test can give you so much knowledge.
** December BMB Siggy Challenge - Animals in Pools **
Me: 31+ H: 32 TTC Since 11/2015 #1 - MMC 6.5 weeks (2/16); #2 - MC due to cystic hygroma at 20 weeks (10/16); #3 CP (2/17); #4 - Due 12.16.17
@blairbecky78 Congratulations!! I hope I get my results back as quickly as you did- I had my Harmony blood draw done on Wednesday and they told me it would take 2 weeks.
@isabelbustamante1023 The tests people are discussing are non-invasive and just include a blood draw from you and possibly an extra ultrasound (basically zero risk). They are not required, but often recommended depending on your age and history. Basically, they can tell a lot by looking at baby's cells that have reached your blood stream. If they suspect something is wrong based on the blood tests, then they ask to do invasive tests like an amniocentesis in order to properly diagnose the baby. The amnio does carry some risk, but can be declined.
Anyone have the Counsyl version of the test? Was wondering how long it took you to get the results. They told me I would receive an email in 7-10 days detailing what ins will pay and what's OOP and once I approve it results will be sent. I'm hoping ins pays since im AMA.
@Marley629 The testing my husband and I both had to do because of his Jewish background is through Counsyl. We haven't gotten the results back yet (today is the 7th day), but we did get emails on day 3 saying they received our samples and letting us know how much we'd have to pay out of pocket (which was only $20 and I'm not AMA).
@Marley629@vvitchhazel Our NIPT is through Counsyl. (informed pregnancy screen) I got our expected OOP estimate in 2-3 days. They've got a status tracker on the website that shows up once the lab begins processing your sample. I can see that our results are in Clinical Review right now (next step is released to our Dr). Understandably they were at this step all weekend while the lab was, presumably, closed.
I'm using Counsyl also. I used them twice last year and both times I had the testing done on a Monday and the results came in the next Wednesday.
I'm a little stressed now because I received the email last Tuesday that the sample was received but when I just checked online it said "date invalid" where it listed the date received. No idea what that means.
Man, this waiting is hard.
Me: 38 l DH: 41 Gavin - 8/27/10 *TW* Gabriel - 2nd tri loss 5/17/16 Trisomy 18 & 21 Hope - 2nd tri loss 12/7/16 complications from pneumonia
Is anyone else not doing NIPT? I'm low risk, insurance doesn't cover it, and if it only tells probability, not results, I feel it may cause more worry than it is worth... I am torn.
@Knottie1468511252 i'm not doing it -- my doctor said I don't need to since I'm low risk, and like you, my insurance doesn't cover it for low-risk, under 35 pregnant women. I looked up the out-of-pocket cost and it would be around $625 for me -- DH and I decided just to do the covered NT scan, and decided against the NIPT/panorama test.
Me: 33 DH: 34 Married: Oct 2015 TTC #1: Sept 2016 BFP: 10/19/16 ~ blighted ovum ~ D&C 11/23/16 BFP: 3/24/17 DD1 born 12/2/17 TTC #2: July 2018 BFP: 8/26/18 DD2 born 5/16/19
So panaroma test is done now :-) First I had detailed ultrasound, checked hearth beat, got also two normal pictures and three 3D. I was so amazed with everything, my boyfried could make video by phone. Then they took 2 blood samples, will go to US California, Natera. The cost here is €500, not paid by insurance in any age, results should come within 7-10 working days.
I got my MaterniT21 results today. It took 8 days. The genetic counselor said that the Counsyl results could take another week, but those are different tests--not the trisomies and early sex detection.
Thanks @Tennis11785. Our test results came back negative for all the trisomies. Just waiting on the other tests, but I'm confident that those will be negative as well. My husband is half Jewish and I'm not Jewish at all, so the risk wasn't very high to begin with.
Thanks @Tennis11785 ! We got only good news today. Feeling very happy and relieved. DH and I are checking the gender results together tonight (but I may have already peeked).
Re: Harmony Test/Early Gender Detection Experiences
Ultrascreen (aka First Timester Screen) = NT scan + finger prick. The finger prick looks at levels of free Beta hcg (this is different from the betas to confirm pregnancy you probably got earlier) and PAPP-A in *your* blood. These two blood markers (low PAPP-A and high free beta Hcg) can indicate a chance of carrying a baby with chromosomal abnormalities. I think a lot of insurances cover this. This is also more accurate than the second trimester screen or "quad screen".
NIPT (could be MaterniT21, Harmony, etc) - blood draw that looks for *the baby's DNA* in your blood, looks for trisomies and baby's sex, and takes up to a few weeks to get back, because only a few specific labs process them. I have to go to my obgyn's office for them to do this draw and they send it to Sequenom, instead of my regular outpatient lab where I get normal labs like iron, thyroid, etc. So it can cost more if your doctor doesn't consider you high risk and your insurance only covers it for high risk.
Technically the finger prick is a type of NIPT/NIPS, but I think for the most part "NIPT" has become a shorthand for the MaterniT21 type tests.
ETA - as we get into this testing it's important to remember these are just screens, not a diagnosis. So any abnormal value should just be a jumping off point for more conversations about further screening or diagnostic procedures (and whether you even want to do them!)
April 2016 - AMH, FSH, Progesterone normal
June 2016 - HSG clear
*TW* BFP - Aug16, demise confirmed Sep16, incomplete m/c, D&C Nov16
BFP 3/27/17, edd 12/7/17
DS - 12/9/17
TTC #2 December 2018
BFP 2/22/19, edd 11/4/19
DD - 11/1/19
My Chart
** December BMB Siggy Challenge - Animals in Pools **
Me: 31+ H: 32
TTC Since 11/2015
#1 - MMC 6.5 weeks (2/16); #2 - MC due to cystic hygroma at 20 weeks (10/16); #3 CP (2/17); #4 - Due 12.16.17
this is usually the first step. if your results indicate further testing is indicated, then a NIPT such as harmony can be ordered and will be covered by insurance due to the results of the NT scan. previously your follow-on options were invasive such as CVS or amniocentesis. make sense?
ETA: words. and @AMCsquared
Met: September 2005 Married: October 2008 DS: 09/2014
It's a blood DNA test, I found it on Amazon for $60, the test kit and results are included in the price. It got surprisingly good reviews. Most at home sex predictor kits are crap.
** December BMB Siggy Challenge - Animals in Pools **
Me: 31+ H: 32
TTC Since 11/2015
#1 - MMC 6.5 weeks (2/16); #2 - MC due to cystic hygroma at 20 weeks (10/16); #3 CP (2/17); #4 - Due 12.16.17
We sat down with a genetic counselor on Monday and she explained things way more clearly than my OB did. Basically, the NIPT first trimester blood draw is used with the NT scan to screen for chromosomal abnormalities. Just the NT scan alone has only a 60% accuracy rate, whereas the combination of the scan and the finger stick/blood draw bumps it up to around 90% accuracy. I should also note that the NT scan is just a normal ultrasound where they measure the baby from rump to crown, measure the fluid behind the neck, and check out the heart for any potential defects like holes. You can also opt for NIPT like Harmony or MaterniT21 which has a 99% accuracy rate. According to the counselor, as of last August most major insurance companies now cover MaterniT21, high risk or not. We called to double check (we have Anthem Blue Cross) and they do cover MaterniT21, even though I'm not AMA and we don't have a family history. Also, they tell you it takes 7-10 days, but everyone I've talked to about it has gotten their results in less than a week.
We did have to get some further testing done because my husbands father is Jewish and there are a slew of conditions they screen for because of that. This one didn't have a particular name, but the lab it goes through just screens for something like 18-36 conditions prevalent in the Jewish community. Both my husband and I were drawn for this.
As for us, we opted for all the genetic testing... The Jew stuff, MaterniT21, and the NT scan (which will be in a couple more weeks for me).
Edited: wording
I contacted my insurance hoping harmony might be covered bc my insurance is generally pretty amazing. But they said no only tests deemed medically necessary by the doctor are covered
While I believe it officially says it takes 7-10 days to get the results, I've heard most people get them back quicker.
** December BMB Siggy Challenge - Animals in Pools **
Me: 31+ H: 32
TTC Since 11/2015
#1 - MMC 6.5 weeks (2/16); #2 - MC due to cystic hygroma at 20 weeks (10/16); #3 CP (2/17); #4 - Due 12.16.17
@isabelbustamante1023 - both the Harmony and the NT scan are optional, but they are very low risk to the fetus. I believe the NT is usually covered by insurance. I know someone here posted that more insurances are starting to cover the Harmony test, but I haven't seen that in my experience. I know for myself and for my friends who are or were very recently pregnant, it was only covered if there was a reason (previous experience with a chromosonal disorder or advanced maternal age are two common reasons it would be covered). But if you're interested, I'd talk to your doctor and your insurance, perhaps it's covered.
ETA - While not a required test, I am very pro NT scan. It's so low risk to the baby (especially if you're already doing an u/s during that visit) and identify serious problems with the fetus incredibly early. I know some women chose to not to have this test, and I respect their decision. But I think knowledge is powerful, and this test can give you so much knowledge.
** December BMB Siggy Challenge - Animals in Pools **
Me: 31+ H: 32
TTC Since 11/2015
#1 - MMC 6.5 weeks (2/16); #2 - MC due to cystic hygroma at 20 weeks (10/16); #3 CP (2/17); #4 - Due 12.16.17
DX Diminished Ovarian Reserve, Factor V Leiden Mutation, Secondary Infertility
MFI (SA #1Count 11mill, Motility: 18%, Morphology: 1%)
AMH .328 | FSH 13.2
DX Diminished Ovarian Reserve, Factor V Leiden Mutation, Secondary Infertility
MFI (SA #1Count 11mill, Motility: 18%, Morphology: 1%)
AMH .328 | FSH 13.2
I'm a little stressed now because I received the email last Tuesday that the sample was received but when I just checked online it said "date invalid" where it listed the date received. No idea what that means.
Man, this waiting is hard.
Gavin - 8/27/10
*TW*
Gabriel - 2nd tri loss 5/17/16 Trisomy 18 & 21
Hope - 2nd tri loss 12/7/16 complications from pneumonia
Married: Oct 2015
TTC #1: Sept 2016
BFP: 10/19/16 ~ blighted ovum ~ D&C 11/23/16
BFP: 3/24/17
TTC #2: July 2018
BFP: 8/26/18
First I had detailed ultrasound, checked hearth beat, got also two normal pictures and three 3D.
I was so amazed with everything, my boyfried could make video by phone.
Then they took 2 blood samples, will go to US California, Natera. The cost here is €500, not paid by insurance in any age, results should come within 7-10 working days.
** December BMB Siggy Challenge - Animals in Pools **
Me: 31+ H: 32
TTC Since 11/2015
#1 - MMC 6.5 weeks (2/16); #2 - MC due to cystic hygroma at 20 weeks (10/16); #3 CP (2/17); #4 - Due 12.16.17