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 publicly-funded or private-pay test depending on the situation.

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 practitioners for how to order this test in Ontario.

Step 1

Determine if Pregnant Individual is Eligible for Publicly-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 publicly-funded NIPT, they can choose private-pay NIPT.

Step 2

Determine the Appropriate NIPT Lab for Pregnant Individual

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

Publicly-Funded NIPT

Publicly-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 oocytes (eggs) were used or a gestational carrier (surrogate) is involved.

Singleton Pregnancies - Questions to Consider when Selecting a Lab
Questions to Consider for Singleton Pregnancies	Harmony^TM Prenatal Test \| Dynacare®	Panorama^TM NIPT \| LifeLabs®
Can NIPT be done when a pregnant individual's own oocytes are used?¹	Yes (trisomies 21/18/13 and can choose to opt in for sex chromosome aneuploidies screening)	Yes (trisomies 21/18/13 and can opt out of screening for sex chromosome aneuploidies)
Can NIPT be done when donor oocytes (not self) are used?	Yes (trisomies 21/18/13 and can choose to opt in for sex chromosome aneuploidies screening)	Yes (trisomies 21/18/13; not eligible for sex chromosome aneuploidies screening)
Can NIPT be done when a gestational carrier (surrogate) is involved?	Yes (trisomies 21/18/13 and can choose to opt in for sex chromosome aneuploidies screening)	Yes (trisomies 21/18/13; not eligible for sex chromosome aneuploidies screening)
Can NIPT be done in a "vanishing" twin / co-twin demise scenario?²	No	No

¹ - Pregnancy may be conceived either naturally or through assisted reproductive technology.

² - A "vanishing" twin scenario occurs when one of the gestational sacs or fetuses in a set of twins disappears or gets reabsorbed, leading to a singleton pregnancy.

Multiple Gestation Pregnancies (Twins or More) - Questions to Consider when Selecting a Lab
Questions to Consider for Multiple Gestation Pregnancies	Harmony^TM Prenatal Test \| Dynacare®	Panorama^TM NIPT \| LifeLabs®
Can NIPT be done for a twin pregnancy when an individual's own oocytes are used?¹	Yes (trisomies 21/18/13)²	Yes (trisomies 21/18/13) Identifies whether twins are likely monozygotic (identical) or dizygotic (fraternal)^{3, 4}
Can NIPT be done for a twin pregnancy when donor oocytes (not self) are used?	Yes	No (only for singletons)
Can NIPT be done for a twin pregnancy when a gestational carrier (surrogate) is involved?	Yes	No (only for singletons)
Can NIPT be done for higher order multiples (triplets etc)	No	No

¹ - Pregnancy may be conceived either naturally or through assisted reproductive technology.

²- Twins are not eligible for sex chromosome aneuploidy screening with the Harmony^TM Prenatal Test.

³ - Only monozygotic twins can be screened for sex chromosome aneuploidies with Panorama^TM NIPT.

⁴ - 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 Publicly-funded Requisition

LifeLabs | Panorama NIPT

Download Publicly-funded Requisition

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 practitioners involved in the care of the pregnant individual.

Point of Care Tool - How to Discuss NIPT Results