Non-Invasive Prenatal Testing (NIPT) Guide

Non-Invasive Prenatal Testing (NIPT) is a prenatal genetic screening test consisting of blood work after 9 or 10 weeks gestation. This test is offered to individuals as either an OHIP-funded or private-pay test depending on the situation.

Download NIPT Leaflet

NIPT does not routinely come with an ultrasound. If a pregnant individual decides to have NIPT from the start, they do not need another screening test (such as eFTS). A 11-14 week (nuchal translucency) ultrasound on its own is recommended to get more information about the health of the baby.

Step-by-step instructions are outlined below, to provide guidance to health-care providers for how to order this test in Ontario.

Step 1

Determine if Pregnant Individual is Eligible for OHIP-funded NIPT

NIPT should be offered to all pregnant individuals prior to initiating prenatal genetic screening along with other available options.
The funding for NIPT varies and will depend on the reason for testing.
If individuals do not meet any of the criteria for OHIP-funded NIPT, they can choose private-pay NIPT.

Step 2

Determine the Appropriate NIPT Lab for Pregnant Individual

Select OHIP-funded NIPT or private-pay NIPT to learn about available options.

OHIP-Funded NIPT

OHIP-funded NIPT is currently offered through two provincial labs: Dynacare and LifeLabs.
For most pregnancies, NIPT can be ordered through either LifeLabs or Dynacare.
There are two types of IVF twin pregnancies that can only have NIPT through Dynacare: donor egg was used or a surrogate is involved.

Singleton Pregnancies - Questions to Consider when Selecting a Lab
Pregnancy Type	Questions to Consider	Harmony® Prenatal Test \| Dynacare	PanoramaTM NIPT \| LifeLabs
non-IVF singleton pregnancy	Can NIPT be done?	Yes	Yes
IVF singleton pregnancy	Can NIPT be done when a pregnant individual's own oocytes are used?	Yes	Yes
IVF singleton pregnancy	Can NIPT be done when a gestational carrier (surrogate) is involved?	Yes	Yes
IVF singleton pregnancy	Can NIPT be done when donor eggs (not self) are used?	Yes	Yes
Any singleton pregnancy	Can NIPT screen for sex chromosome aneuploidies?¹	Yes, and is optional (opt-in for monosomy X, sex chromosome aneuploidies)	Yes, and is not optional (screening for sex chromosome aneuploidies is part of standard testing - cannot opt out)
Any singleton pregnancy	Can NIPT be done in a "vanishing" twin / co-twin demise scenario?²	No	No

¹ - Twin pregnancies generally cannot be screened for sex chromosome aneuploidies. However, PanoramaTM can screen for sex chromosome aneuploidies in monozygotic twin pregnancies only.

² - "Vanishing" twin pregnancy is a pregnancy that started as a twin pregnancy with subsequent loss of fetal heart activity or loss of the embryo in one of the pregnancy sacs.

Multiple Gestation Pregnancies (Twins or More) - Questions to Consider when Selecting a Lab
Pregnancy Type	Questions to Consider	Harmony® Prenatal Test \| Dynacare	PanoramaTM NIPT \| LifeLabs
non-IVF twin pregnancy	Can NIPT be done?	Yes	Yes Zygosity testing is included (which means it can can tell you if the twins are identical or fraternal)¹
IVF twin pregnancy	Can NIPT be done when a pregnant individual's own oocytes are used?	Yes	Yes Zygosity testing is included
IVF twin pregnancy	Can NIPT be done when a gestational carrier (surrogate) is involved?	Yes	No (only singletons)
IVF twin pregnancy	Can NIPT be done when donor eggs (not self) are used?	Yes	No (only singletons)
Any pregnancy	Can NIPT be done for higher order multiples?	No	No

¹ - Chorionicity, rather than zygosity, has an impact on the outcome of twin pregnancies. Zygosity testing can complement, but not replace, ultrasound evaluation of chorionicity in some clinical scenarios. For example, evaluating zygosity through NIPT may impact pregnancy surveillance when chronicity assignment is uncertain, and can help interpret “high risk” aneuploidy results.

Private-Pay NIPT

Private-pay NIPT is available through the Ontario-based laboratories (LifeLabs or Dynacare), as well as through other laboratories based outside of Canada. Prenatal Screening Ontario is unable to endorse any specific private-pay test or laboratory. We encourage you to read about what factors you and the pregnant individuals in your care may choose to consider.

Step 3

Provide the Completed NIPT Requisition to Pregnant Individual

Dynacare | Harmony Prenatal Test

Download Requisition

Download MOH Checklist

LifeLabs | Panorama NIPT

Download Requisition and MOH Checklist

Please note that Dynacare and LifeLabs have separate requisitions for private-pay NIPT, and these can be found on their websites.

Step 5

Communicate Results and Next Steps

Results will be reported to you by the lab generally within 7-10 business days.
Communicate results back to the pregnant individual once report is received.
Ensure continuity of care: forward the report to any other providers involved in the care of the pregnant individual.

Point of Care Tool - How to Discuss NIPT Results