For Twins and More Than Two Babies

If You are Pregnant with Twins

If you are carrying a twin pregnancy, you can have OHIP-funded Non-Invasive Prenatal Testing (NIPT), regardless of your age. This testing can be arranged by the doctor or nurse practitioner who is looking after your pregnancy.

It is recommended that you also consider having a 11-14 week ultrasound, which may include the measurement of the Nuchal Translucency (NT), if available in your area.

Select which statement is true for you to see which lab you can choose for NIPT:

I did not have In Vitro Fertilization (IVF) for this pregnancy

If you did not have this pregnancy through IVF, NIPT can be done through either LifeLabs or Dynacare. NIPT through LifeLabs will be able to screen whether the twins are identical or fraternal.

I had In Vitro Fertilization (IVF) for this pregnancy

If you had this pregnancy through IVF, NIPT can usually be arranged through either laboratory. However, there are two situations when NIPT should only be ordered through Dynacare:

a twin pregnancy where a donor egg was used.
a twin pregnancy where a gestational carrier (surrogate) is involved.

If You are Pregnant with More than Two Babies

If you are having triplets, quadruplets, or more, your option for screening the pregnancy for chromosome differences is limited to Nuchal translucency (NT) ultrasound only.

If You are Pregnant with One Baby but Had a "Vanishing Twin"

A "vanishing twin" pregnancy is a pregnancy that started as twins, but one twin was lost (miscarried). If you had a "vanishing" twin, select the situation that applies to you to see your options for screening:

I am in the first trimester of pregnancy (about 2 or 3 months pregnant) and I am able to have a Nuchal Translucency (NT) ultrasound.

You can have Nuchal Translucency (NT) and Second Trimester Screening (STS) organized by your health-care provider. The following steps can be followed:

Get a nuchal translucency (NT) ultrasound in the first trimester of pregnancy (when you are about 3 months pregnant). There should be no prenatal screening blood work done on the day of this ultrasound for you. The "Multiple Marker Screening" requisition form will be filled out at the time of the ultrasound. It is important that you keep this requisition in a safe place because it will be needed for blood work later in the pregnancy.
Go for Second Trimester Screening (STS) blood work in the second trimester (when you are about 4 or 5 months pregnant). The blood draw must be done at least 8 weeks after the miscarriage of the twin.

I am in the first trimester of pregnancy (about 2 or 3 months pregnant) but I am not able to have a Nuchal Translucency (NT) ultrasound.

If you cannot have a nuchal translucency ultrasound, you can have Second Trimester Screening (STS) blood work on its own in the second trimester (between 14 weeks and 20 weeks 6 days of pregnancy). The blood draw must be done at least 8 weeks after the miscarriage of the twin. This testing can be organized by your health-care provider.

I am in the second trimester of pregnancy (about 4 or 5 months pregnant) and have not had a Nuchal Translucency (NT) ultrasound.

If you are in the second trimester of pregnancy, you can have Second Trimester Screening (STS) blood work on its own (between 14 weeks and 20 weeks 6 days of pregnancy). The blood draw must be done at least 8 weeks after the miscarriage of the twin.

If you had a "vanishing twin" pregnancy, Non-Invasive Prenatal Testing (NIPT) and enhanced First Trimester Screening (eFTS) cannot be done. This is because there can be genetic material (DNA) or hormones (proteins) in your blood from the twin that miscarried, and this can make this testing less accurate.

For Health-Care Providers

Step-by-step guide for how to order screening in "vanishing twin" / co-twin demise scenarios

Requisitions and How to Order