Prenatal Genetic Testing with Twins?

[Squishy622]

Did anyone do genetic testing like Maternit21, Harmony, or Verifi with your twins? Once again Google is confusing me. I forgot to ask my doc about this when I was there this week so I'll give a call to ask their thoughts, but I'm curious if anyone here opted for it.

This may be a moot point, my insurance may not cover since they consider it investigational for multiples, even though all of the test company websites say they are valid for twins.

[anakah]

We did not do any genetic testing. Our ob felt like we were not at any risks so we didn't pursue it.

[kels09]

We had PGS done during our IVF process so we didn't need to have the harmony or maternit21 testing done. When discussing our options for genetic testing Oruro RE told us that those tests are often inclonclusive with twins because you don't know which one it applies to.

I would definitely discuss if it's benefical to you with your OB.

[anotherdreamer]

My OB said it would have been accurate, as did the brochure, but we opted against it due to crappy insurance and confusion over coverage.

[elvenqueen]

We had our NT scan and blood draw for a calculated risk. Not sure exactly how it's calculated for twins (ours are di/di), and we were given two identical risk factors for them so I'm assuming it was just one conclusion for both of them. They did have the exact same nuchal fold measurement at the time, though.

[carrotcake]

We just did the NT scan + blood testing. It wasn't super common at the time when we would've done it and I felt good enough about the first tri screening. I was offered a CVS right off the bat due to my age, but I declined since my first tri screening came back with no elevated risk.

I *think* if you have di/di, and a problem is detected, you won't know for which baby.

[blueberries8]

We just did the NT scan. My doctor said the traditional blood testing done with the NT scan would be inaccurate. For the the non-invasive fetal blood sampling there are a couple companies that do it for twins (with accurate results), though some of them use a test that is just designed for singletons. I would have done it if our insurance covered it but they didn't. We figured if the NT results were at all borderline we would pay out of pocket to do it, but the NT results were good, so we decided to skip it.

[Deleted]

Like others, we only did the NT scan and bloodwork. When the results came back we were only told that both babies were "low risk." My doctor never mentioned any of the other tests, likely because I'm 24 and we have no family history to be concerned about.

[ashb62]

Mar 14, 2015 12:53:59 GMT -5 carrotcake said:

We just did the NT scan + blood testing. It wasn't super common at the time when we would've done it and I felt good enough about the first tri screening. I was offered a CVS right off the bat due to my age, but I declined since my first tri screening came back with no elevated risk.

I *think* if you have di/di, and a problem is detected, you won't know for which baby.

This was my understanding as well.

We didn't do any extra testing.

[sugar4bri]

Originally we weren't going to because insurance wouldn't cover it. However, when we had our AS we found baby b had a couple of calcium deposits on her heart, so because of that, the Harmony test would now be covered. Thankfully everything came back a-ok!

[rayray007]

We didn't do maternal serum screening bc we wouldn't know which LO we were looking at.

[Squishy622]

Thanks all! Will definitely see what my doc says but after reading your answers I'm leaning toward sticking with the basic NT scan/ state blood work I had been planning on.

[lupineaura]

I had the Harmony test done. My understanding is similar to that of the other ladies- if they uncover a problem they don't know for which twin it applies. However, a "negative" test is considered accurate. Ours was negative, but we still saw a genetic counselor later on in the pregnancy for other reasons. The genetic counselor said she met with some people from the test company (NOT the sales people) and after their discussion she feels fairly confident in the accuracy for twins. So that was good piece of mind for us.

[Deleted]

We did exactly zero testing. Amniocentesis scared me because of the (extremely slighty) miscarriage risk. And the blood based ones my OB recommended that I skip because she said they aren't as accurate for twins - for example, one chromosomally normal child could "cover up" a chromosomal abnormality in the other child. We didn't even do the NT scan. It seemed pointless as we never would have terminated either one of the kids. And we figured that *if* we found something worrying at the anatomy scan, then we could start trying to prepare ourselves. In the meantime, the blood tests seemed like a bigger source of stress than not having them.

[bluebonnet22]

The blood tests related to the NT scan are NOT accurate for twins, and thus the detection rate for Downs Syndrome is only 70-80% for twins if you go the NT scan route. This was unacceptable for DH and I, so we opted for the maternit21 test which is 99+% accurate for twins (if screen is negative). If there is a positive, you're correct that you wouldn't know which twin, but in that case you could get NT testing or get an amnio depending on how important accurate results were. I did the Maternit21 early at 10 weeks so it felt great by 11 weeks to know we were 99% in the clear for all chromosomal abnormalities (vs only 75% clear with an NT scan). Although my insurance doesn't cover Maternit21, they only charge $200 MAX for those that aren't covered - this is more than worth it for the peace of mind! I got my final bill last week for my test and was happy to pay the $200.

[julie216]

Mar 16, 2015 9:38:37 GMT -5 bluebonnet22 said:

The blood tests related to the NT scan are NOT accurate for twins, and thus the detection rate for Downs Syndrome is only 70-80% for twins if you go the NT scan route. This was unacceptable for DH and I, so we opted for the maternit21 test which is 99+% accurate for twins (if screen is negative). If there is a positive, you're correct that you wouldn't know which twin, but in that case you could get NT testing or get an amnio depending on how important accurate results were. I did the Maternit21 early at 10 weeks so it felt great by 11 weeks to know we were 99% in the clear for all chromosomal abnormalities (vs only 75% clear with an NT scan). Although my insurance doesn't cover Maternit21, they only charge $200 MAX for those that aren't covered - this is more than worth it for the peace of mind! I got my final bill last week for my test and was happy to pay the $200.

This!  Although I didn't get the Maternit21 till I was 13 weeks.  They didn't do the NT scan bloodwork when I had that done..had the M21 done a week later.  Such a relief that it came back that we too were 99% in the clear for all chromosomal abnormalities!

[richzep]

I did the NT scan which came out clear and then did maternity21 as well. Right after I did it, I was told that if there was an issue we wouldn't know which baby. ?
So essentially I did it for no reason. But the results came back good so in the end I'm actually glad I ended up doing it.

[Squishy622]

bluebonnet22 that's great info, thanks. Do you mind if I ask if you were in one of the categories that Maternit21 classifies as high risk (AMA, family history, etc.)? I'm curious if that $200 max charge applies if I'm not high-risk.

[bluebonnet22]

Mar 16, 2015 12:52:10 GMT -5 Squishy622 said:

bluebonnet22 that's great info, thanks. Do you mind if I ask if you were in one of the categories that Maternit21 classifies as high risk (AMA, family history, etc.)? I'm curious if that $200 max charge applies if I'm not high-risk.

I was worried I wouldn't be in the $200 category because I'm not AMA or family history, etc. My OB did have a flyer about Maternit21 that said it would be $200 for "everyone" that wasn't covered by insurance, but I'm not going to lie - I held onto the flyer and I was prepared to have to fight them just in case! I was relieved when the bill came in for only $200 and said final bill on it. FWIW, my OB felt the NT scan blood results shouldn't be used for twins and maternit21 was my best bet. 

Also for anyone that's interested, you can't tell the sex from any of these tests when you are having twins unless it's 2 girls. I'm having b/g twins and was just told "at least one boy". 

[Squishy622]

Thanks bluebonnet22, that's helpful! While I wait for a call back from my doc I put an email out to the MaterniT21 folks so we'll see what they say. Just want to explore all my options. Mine are identical- so wouldn't we be able to tell based on the presence or absence of the male chromosome in that case?

[bluebonnet22]

Mar 16, 2015 16:07:03 GMT -5 Squishy622 said:

Thanks bluebonnet22, that's helpful! While I wait for a call back from my doc I put an email out to the MaterniT21 folks so we'll see what they say. Just want to explore all my options. Mine are identical- so wouldn't we be able to tell based on the presence or absence of the male chromosome in that case?

You are completely right about the sex,  I always forget about identical twins ! When I had called Maternit21 originally they told me they wouldn't give me the $200 price, but then back when I called I didn't know about multiples - so I'm not sure if technically that's why they gave me that pricing? My doctor did check on the maternit21 lab form "high risk pregnancy" (or whatever the wording is)  and then wrote twins next to it. 

[Squishy622]

Just in case anyone is debating doing this and is curious. My doc did recommend the Maternit21 for me if I choose to do it, he feels it's been validated in twins just as the company claims. The great thing about M21 specifically vs their competitors, as bluebonnet22 mentioned, is that they will cap your OOP cost at $200 if they're not contracted with your insurance provider.

I'm going to talk it over with my husband tonight. The possible peace of mind if everything looks good is a huge pro for me, but I am also wary of the uncertainty regarding not knowing which twin if something does come back abnormal. And now that I think about it, if they're identical, wouldn't there be a chance that the abnormality was in both of them? Still learning about the nuances of twins over here. Decisions, decisions!

Thanks again everyone.

[cml112]

We did the Harmony test, the genetic counselor seemed to favor this one. During our IVF I produced not exactly the best quality of eggs and had a loss due to chromosome abnormalities. So it is weighing heavily on my mind. I just want either the peace of mind or the ability to plan for something if we do find out the results are not negative. It seemed to be the most accurate (without doing something invasive like amino) for Downs or other genetic disorders. Better to get it over with now than to get further along and wish that we had done it and got it over with. So now we wait....

[Squishy622]

Good luck cml112, I will be thinking good thoughts for you. We are waiting too, should hear the results this week.

[cml112]

Mar 24, 2015 21:18:03 GMT -5 Squishy622 said:

Good luck cml112, I will be thinking good thoughts for you. We are waiting too, should hear the results this week.

The genetic counselor said she should hear back either the end of this week or the beginning of next week. I feel like I'm growing more anxious with each passing day, I hope to not have to go through the weekend too!! FX for good news for the both of us

[robertjane33]

We got a funky NT scan result so went forward with Mat21 testing. We talked to a genetic counselor who seemed much more up to date than our OB and who explained that the tests were 99% for twins, but as others have said, if there were a problem, you wouldn't know which twin. We felt we needed the information and went forward with the test, and it came back as all clear. Also, we found out early that we were having "at least one boy" - turned out to be one of each!

ETA: Because K was AMA, it was covered by our insurance.

[Squishy622]

cml112 Any news?

We got our results, 2 girls and everything came back normal. So relieved and glad we chose to do this.

[cml112]

Mar 27, 2015 20:15:51 GMT -5 Squishy622 said:

cml112 Any news?

We got our results, 2 girls and everything came back normal. So relieved and glad we chose to do this.

We got our test results back too....everything is normal! I feel like we overcame a big hurdle today. The smallest bummer was that this lab doesn't test gender with the test! But we are just so relieved that we have 2 healthy LOs!

Congrats on your healthy little girls!!! That's so awesome!

[Squishy622]

Hooray, huge congrats cml112!

[bluebonnet22]

Congrats on all the good test results ladies!