# Harmony blood test v nuchal fold combined test



## Babydustneeded

Hi Everyone

I'm 13 weeks pregnant with identical twins. Am in a quandry as I had the Harmony blood test privately to test for Downs and a few other genetic diseases, it came back as low risk, 1 in 10,000. I've also just had the usual Nuchal fold scan and blood test which has come back as high risk at 1 in 97. The consultants never tell you what to do or give you much of an opinion but I can tell they are pointing me towards amniocentesis and say the Harmony test isn't definitive. I thought the Harmony was marketed as this great new test that meant you no longer had to have the invasive amnio and risk the miscarriage chance. I'm now not sure whether to trust the Harmony result or not...

Anyone been through this or got a view on it? 

Many thanks
Baby dust


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## Thursdayschild

Hi Babydust,
Hmm, I'm sorry I don't know the answer but I'd be very interested if someone else does. Did you have the Harmony test done at FMC in London? You could call them up and see what they say As I understand it, the Harmony test gives 99% accuracy for Downs, 98% for Trisomy 18 and 90% for Trisomy 13. I thought, only when it is inconclusive do they advise an amnio/cvs...
I suppose if it's 99% accurate, in 1% of cases the Harmony test can be wrong, and you have a roughly 1% chance of having Downs according to their blood test + nuchal, so if you definitely don't want to have a Downs baby (twins) then they are advising the amnio to tell you one way or another for certain. What a horrid, and difficult, situation to find yourself in. Do you know if the accuracy %s for the Harmony test are affected by having twins? I read somewhere on here (FF) someone had said that you could ask for the success rate of each consultant who might perform the amnio/CVS - because the standard statistic is 1% miscarriage risk, but that's a national average for all  procedures and some consultants may have a 100% so-far-so-good record over several years ... You could maybe pick someone who is really brilliant at doing amnios and has a high tech scanner etc so they can really guide the needle accurately etc. Just a thought. I hope you get resolution for this, and of course I hope that you end up finding out there are two very healthy twins in there!
I'm 9w5d and have been wondering whether to have the Harmony test. My IVF consultant said, why not have the NHS nuchal at 12w and if that comes back high risk *then* have the Harmony test - so that would seem to suggest that he thinks the Harmony is quite accurate.... Seems odd that your Harmony result was SO low risk - 1 in 10,000 sounds unlikely to me that it could be just wrong. But I don't know...  
Good luck, best wishes & lots and lots of babydust xxx


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## Cornishrex

I'm 8 weeks, and planning on going to have the new NIFTY test at 10 weeks (it hit the uk in October: like harmony but cheaper and slightly higher certainties I think, but not much!). I cannot understand the advice you have been given. As I understand it, from two separate midwives, the standard testing process will automatically categorise us as high risk because of our age, so there is no point in relying on, or doing the standard Nhs free test, you might as well jump straight to harmony or nifty. They will give a 99 per cent likelihood one way or the other. It's only if you get a result from that which suggests that you are 99 per cent likely to have a Down's syndrome problem etc, where you need to decide whether you then want back up confirmation from the invasive tests on the Nhs, before deciding whether or not to terminate. When I have my nifty, if it gives me the all clear, I will rely on that .....


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## Cornishrex

Ps, to be clear, both midwives recommended that I jump straight to nifty / harmony and not bother with the basic nuchal thing at all. So at my booking in appt today, my midwife has not even booked me in for the nuchal scan thing.


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## Babydustneeded

Hi everyone

Thanks for the replies, I had the harmony test done at The Birth Company, same building as the FMC. In fact I've just been to the FMC and paid to have my nucal fold done again by Professor Nicolaides who is supposed to be the best. My result came out worse - 1 in 34 - but he said looking at the babies they do not have downs, they have normal neck measurements, bones in the nose, correct blood flow, organs look fine and he is also a fan of the harmony test so that was additional confirmation.  He said I just have high hcg and that is skewing the results off the scale - just like age does. I'd like to believe him, and I do, but I'm still half thinking about amnio because of the high hcg which is a common downs indicator - in such a quandry! I'd rely on the harmony test but the NHS was a bit dismissive about it. Am seeing another consultant at the NHS hospital tomorrow...the agony continues!


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## Cornishrex

Well for gods sake keep us updated. I'm going for my nifty blood test on 5 jan .....


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## Thursdayschild

Babydust! ooh, I'm sure I'd also be panicking and thinking like you are, and maybe even considering a more invasive test - BUT, why would Doc Nicolaides give you false hope and tell you not to worry if there really was a problem in his opinion? Having twins would make your hcg high anyway, and maybe some women make more hcg than others (they certainly seem to given the massively wide ranges of "normal" for each day/week etc) so he could be right too, that it is just skewing your result. 
By the way, in case it's of interest to you or cornish or anyone else reading: when I had my first harmony scan yesterday (not the nuchal one), I asked the sonographer how you could get a false positive - ie, how could there be any % of chromosomally odd dna in a woman's blood stream if the baby did not have a chromosomal problem. She said it was when the placenta itself is the source of the odd chromosomes. (ie in "mosaicism" - but where the bit that became the baby is fine but the bit that became the placenta is not 100% chromosomally normal, though she said it still would function as a normal placenta). 
Please keep us updated, like Cornishrex says. And don't worry too much - see what the other NHS consultant says  xxx


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## Babydustneeded

Hi Everyone

Thanks for the comments. Just a quick update. I saw the other NHS consultant. He was fairly similar to the others in that he just said here are the facts it is up to you what you do next. He was less dismissive about the Harmony test, he said that early indications point to it being a good test but it is early days and it is still a screening test and not diagnostic. He also said high HCG levels can be a good thing - the total opposite to his NHS colleagues! 

My boyfriend and I are really 'need to know' kind of people and the NHS has left us with enough doubt to make us totally miserable and we're finding it difficult to move on from it. I'm 14 weeks now and haven't told that many people yet - I should be jumping for joy and telling the world. As it is twins I'm also quite clearly showing! The people we have told in the same breath we've said but we are worried blah, blah blah and then had a lengthy discussion about tests, stats and downs. It shouldn't be like this. I think we are going to have the amnio test as it will be another 5 months of misery and worry if we don't.


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## Cornishrex

Well good luck. Let us know how goes.


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## Mum of 1 at last!

Hi, could someone give me a bit more info on the Harmony & Nifty tests please?

I have looked into the Harmony and mentioned it at the hospital when I was being scanned but the nurse just looked at me blankly!

Does it have to be done at a certain stage?

I have never heard of the Nifty test so ant relevant information would be much appreciated

Thanks!

Sarah (14+5)


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## jules40:)x

Hi I know this is a bit late but did anyone tell you that blood tests with twins are always skewed? xx


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## DarlingGirl

LincsSarah said:


> Hi, could someone give me a bit more info on the Harmony & Nifty tests please?
> 
> I have looked into the Harmony and mentioned it at the hospital when I was being scanned but the nurse just looked at me blankly!
> 
> Does it have to be done at a certain stage?
> 
> I have never heard of the Nifty test so ant relevant information would be much appreciated
> 
> Thanks!
> 
> Sarah (14+5)


Here is a link Sarah that has info on both tests.

http://www.thisismy.co.uk/non-invasive-prenatal-testing-nipt/

I think it needs to be done between 11-13weeks though?

I had the Harmony last week and anxiously awaiting my results!

xxxx


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## Babydustneeded

Hi Everyone

A quick update, I went to Kings to have the amniocentesis test. The did a really detailed scan, noted the harmony blood test result and said you really don't need the amnio. Your scan looks fine and you can trust the Harmony test. They are a bit more enlightened about Harmony at Kings than they are where I live in Brighton. So we didn't have the test done. DH who is a real black and white need to know kind of guy was with me and also accepted this so on we go!

Jules40, what do you mean about skewed blood test results with twins? I have high hcg which can be a downs indicator but the consultant said he wasn't worried about it - it can be high with twins which I assume is what you mean?

BTW, have found a really nice consultant at Brighton now thank god. The last guy I saw I almost had a row with he was so unhelpful!

Good luck all!


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## jules40:)x

Great news I hope you can enjoy the rest of your pregnancy - yes I simply meant that levels of all sorts can be higher with twin pregnancies it is quite a specialist area xx


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## Me Myself and I

Cornishrex said:


> I'm 8 weeks, and planning on going to have the new NIFTY test at 10 weeks (it hit the uk in October: like harmony but cheaper and slightly higher certainties I think, but not much!). I cannot understand the advice you have been given. As I understand it, from two separate midwives, the standard testing process will automatically categorise us as high risk because of our age, so there is no point in relying on, or doing the standard Nhs free test, you might as well jump straight to harmony or nifty. They will give a 99 per cent likelihood one way or the other. It's only if you get a result from that which suggests that you are 99 per cent likely to have a Down's syndrome problem etc, where you need to decide whether you then want back up confirmation from the invasive tests on the Nhs, before deciding whether or not to terminate. When I have my nifty, if it gives me the all clear, I will rely on that .....


It is not quite as cut and dried as you have outlined. My age obviously does mean a slightly higher risk, but that is only one element, the blood results and NT measurement. The only reason that I am so 'up' on this is that given my age and NT my risk was low but add in the blood results I am well and truly high risk!

I have had the Harmony, my repeated NT was far more positive and thorough. I was told that Harmony was 99.9% accurate - i.e. one false positive per 1000 results.


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## Cornishtwinkle

I know I'm a bit late posting here but I'm about to have my harmony test at the fmc. I was offered it down here in cornwall by the screening nurse as a private test but I lost a bit of confidence when she suggested not having the nuchal. The fmc seem to strongly recommend the nuchal as well as the harmony. Does anyone know if that is just belt and braces or whether they use it to identify other issues with the baby. I fear that I might have a similar scenario to babydustneeded and would be in the same situation regarding considering the amnio. 

Also when the harmony is said to be 99% positive is the 1% a false positive or is there any cases of a false negative. Me, myself and I you seem to be very knowledgeable.


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## Chickabooo

I got my harmony results and had my scan with fmc a couple of weeks ago.  The scan was very thorough.  They looked at everything including the heart structure, blood flow through through the liver etc as well as nuchal fold and nasal bone. They seemed to examine all structures as well as they could for the 12 week stage.  
Now my triple test risk came back as 1:3.  My Harmony came back as less than 1:10,000.  From what the fmc told me I took it as a given that my baby is healthy and there was absolutely no need for an amnio.  Now reading back through this post I feel a bit less sure


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