Double Marker Reflex to NIPT Test: Booking, Price, and Results
About Double Marker Reflex to NIPT Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | Dual Marker Reflex to NIPT, First Trimester Screening Reflex NIPT, Dual Marker Test with NIPT Reflex, Combined First Trimester Screening with Reflex NIPT, Maternal Serum Screening Reflex NIPT |
| Sample Type | Venous blood (maternal) |
| Fasting Required | No fasting required |
| Report Time | Double Marker results: 2 to 3 days; if NIPT reflex is triggered: an additional 7 to 14 days |
| Recommended For | Pregnant women, typically between 10 and 14 weeks of gestation; especially recommended for women aged 35 or above, those with a family history of chromosomal disorders, or those with a previous affected pregnancy |
| Price | Starting at ₹3,000 |
What Is a Double Marker Reflex to NIPT Test?
The Double Marker Reflex to NIPT Test is a two-stage prenatal screening that combines a biochemical blood test with advanced genetic analysis. It begins with the Double Marker Screening Test, which measures two proteins in the mother's blood. If the initial result shows an elevated risk, the same blood sample is automatically used for an NIPT reflex test, which analyses cell-free foetal DNA. Also called the Dual Marker test with NIPT reflex or first trimester screening reflex NIPT, this test is performed during the first trimester of pregnancy.
What Does a Double Marker Reflex to NIPT Test Measure?
This test works in two stages. The first stage measures biochemical markers in the mother's blood, and the second stage, triggered only when needed, examines foetal genetic material.
| Stage | Parameter | What It Is |
|---|---|---|
| Stage 1: Double Marker | PAPP-A (Pregnancy-Associated Plasma Protein-A) | A protein produced by the placenta; low levels may indicate a higher risk of chromosomal abnormality |
| Stage 1: Double Marker | Free beta-hCG (Human Chorionic Gonadotropin) | A hormone produced by the placenta; abnormal levels may suggest increased chromosomal risk |
| Stage 2: NIPT (if triggered) | Cell-free foetal DNA (cfDNA) | Fragments of foetal DNA circulating in the mother's blood; analysed for chromosomal conditions |
| Stage 2: NIPT (if triggered) | Foetal Fraction | The proportion of foetal DNA in the sample; a minimum of 4% is needed for a reliable result |
If the Double Marker screening test results fall in the high-risk category, the sample is automatically processed for NIPT. Research shows that 92% of high-risk cases identified by the dual marker screen were reclassified as low risk after NIPT, making the reflex approach both efficient and cost-effective.
Why Is a Double Marker Reflex to NIPT Test Done?
This test is a standard part of first-trimester prenatal care and helps assess the risk of certain chromosomal conditions in the developing baby.
Common Symptoms That May Require This Test
Doctors typically recommend this test based on specific risk factors rather than symptoms. The following indications are the most common reasons for ordering it:
- Advanced maternal age (35 years or older)
- A previous pregnancy affected by a chromosomal disorder
- A family history of chromosomal abnormalities
- Abnormal findings on an early ultrasound scan
- Concerns about foetal health, including anxiety about genetic conditions
- Routine first-trimester screening as part of standard antenatal care
Conditions This Test Can Help Detect
The first trimester aneuploidy screening offered by this test can help assess the risk of several conditions:
- Down syndrome (trisomy 21), the most common chromosomal abnormality
- Edwards syndrome (trisomy 18), which affects organ development
- Patau syndrome (trisomy 13), a rare genetic disorder
- Risk of intrauterine growth restriction (IUGR), linked to low PAPP-A levels
- Risk of pre-eclampsia, a pregnancy complication associated with reduced PAPP-A in the first trimester
Double Marker Reflex to NIPT Test During Pregnancy
This test is specifically designed for use during the first trimester of pregnancy. It is usually performed alongside a nuchal translucency ultrasound scan, carried out between 11 and 14 weeks of gestation, to give the most accurate risk assessment possible. The combined approach of blood markers, ultrasound measurement, and maternal age achieves a detection rate of approximately 80% to 87% for Down syndrome at a 5% false-positive rate.
How to Prepare and What to Expect
Preparation for this test is straightforward, and the collection process is the same as for any routine blood test.
Do You Need to Fast?
No fasting is required before this test. You may eat and drink as normal on the day of your appointment. If other tests are being done at the same time, check with your doctor whether any of those require fasting.
Practical Tips Before Your Test
The following steps will help ensure your appointment goes smoothly:
- Schedule your test between 11 and 14 weeks of pregnancy for the most accurate results
- Bring your nuchal translucency (NT) ultrasound report if you have already had it done
- Carry any previous test reports or prescriptions from your doctor
- Inform the phlebotomist if you have diabetes, an IVF pregnancy, or are expecting twins
- Drink adequate water before your appointment to make the blood draw easier
Step-by-Step Procedure
Here is what happens from the moment you arrive for your prenatal screening reflex test:
- You will be seated comfortably, and a trained phlebotomist will clean a small area on your arm.
- A blood sample of approximately 5 to 10 mL is drawn from a vein. You may feel a brief, mild prick; the discomfort passes quickly.
- The sample is sent to the laboratory, where PAPP-A and beta-hCG levels are measured and expressed as MoM (Multiples of Median) values.
- These values are combined with your NT scan measurement and maternal age to calculate a risk score.
- If the risk score falls in the high-risk category, the same stored sample is automatically forwarded for NIPT (cell-free DNA analysis) — no additional blood draw is needed.
- Your doctor receives the final report, which is then shared with you, typically within 2 to 3 days for the Double Marker portion and up to 14 days if NIPT is triggered.
Factors That Can Affect Accuracy
Several factors may influence the reliability of your results:
- Low foetal DNA fraction (below 4%) can lead to an inconclusive NIPT result
- Higher maternal BMI is associated with a lower foetal fraction, as greater maternal blood volume dilutes foetal DNA
- Pre-gestational diabetes may reduce PAPP-A and beta-hCG levels, affecting the screening calculation
- IVF or ICSI pregnancies may alter marker levels and require adjusted interpretation
- Multiple pregnancies (twins or more) can affect both foetal fraction and marker values
Understanding Your Double Marker Reflex to NIPT Test Results
Your results will be shared by your doctor, who will interpret them in the context of your age, medical history, and ultrasound findings. The table below shows the general reference ranges used for this test.
| Parameter | Normal Range | Unit | Notes |
|---|---|---|---|
| PAPP-A | 0.5 to 2.0 MoM | MoM | Values below 0.5 MoM may indicate increased chromosomal risk |
| Free beta-hCG | 0.5 to 2.0 MoM | MoM | Values above 2.0 MoM may indicate increased risk of Down syndrome |
| NIPT Risk Assessment | Low Risk | Categorical | Sensitivity of 99.17% for trisomy 21; specificity of 99.95% |
| Foetal Fraction (NIPT) | 4% or above | Percentage | Results below 4% foetal fraction are considered inconclusive |
Risk categories used in reporting:
- Low Risk: calculated risk below 1 in 1,000
- Intermediate or Moderate Risk: calculated risk between 1 in 100 and 1 in 1,000
- High Risk (Screen Positive): calculated risk of 1 in 100 or higher
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain medical situations can affect how results are read:
- Women with pre-gestational diabetes may have lower PAPP-A and beta-hCG values, which can affect the accuracy of the risk calculation.
- Women with a higher BMI may have a lower foetal fraction in NIPT, increasing the chance of an inconclusive result.
- Kidney transplant recipients may show significantly elevated marker levels, leading to higher false-positive rates for trisomy 21 screening.
- Twin or multiple pregnancies can affect both foetal fraction and marker concentrations, requiring specialist interpretation.
How to Maintain Healthy Levels
While this is a screening test and not directly influenced by lifestyle changes, these general tips support a healthy pregnancy:
- Eat a varied diet with fruits, vegetables, whole grains, and proteins, and take prescribed prenatal vitamins including folic acid, iron, and calcium.
- Attend all recommended antenatal appointments, scans, and follow-up tests as advised by your doctor.
- Avoid smoking and alcohol throughout pregnancy, as these can affect foetal development.
Lupin Diagnostics Double Marker Reflex to NIPT Test Price and Home Collection
The Double Marker Reflex to NIPT test price starts at approximately ₹3,000, with home sample collection available across India.
| City | Approximate Price (₹) |
|---|---|
| Delhi | ₹3,000 |
| Mumbai | ₹3,600 |
| Vijayawada | ₹3,000 |
| Bangalore | ₹3,200 |
| Chennai | ₹3,000 |
| Hyderabad | ₹3,000 |
| Kolkata | ₹2,800 |
| Pune | ₹3,000 to ₹3,600 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred time slot.
- Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Home Collection
A trained phlebotomist will visit your home at your chosen time to collect the blood sample, making it convenient for expectant mothers. All samples are processed in NABL-accredited laboratories, ensuring accuracy and reliability. Your digital report is delivered directly to your email or WhatsApp.
Frequently Asked Questions
The Double Marker test measures hormone and protein levels in the mother's blood to calculate a statistical risk score. NIPT, by contrast, directly analyses fragments of foetal DNA circulating in the mother's bloodstream. The Double Marker test with NIPT reflex combines both: the less expensive biochemical screen is done first, and NIPT is only performed if the initial result indicates elevated risk.
The ideal window is between 11 and 14 weeks of gestation. This timing ensures that PAPP-A and beta-hCG levels are at the right stage for accurate measurement and that the NT ultrasound scan can also be performed. NIPT, if triggered, can be carried out from as early as 10 weeks.
No fasting is needed. You can eat and drink as you normally would before your appointment. There are no dietary restrictions specific to this prenatal screening reflex test.
A high-risk Double Marker result automatically triggers the NIPT stage using the same blood sample. If NIPT also indicates elevated risk, your doctor may recommend a confirmatory diagnostic test such as chorionic villus sampling (CVS) between weeks 10 and 13, or amniocentesis after approximately 16 weeks. Your obstetrician will guide you through the next steps.
NIPT has a sensitivity of 99.17% for trisomy 21 (Down syndrome) and a specificity of 99.95%. Despite this high accuracy, it remains a screening test. A high-risk NIPT result should be confirmed with a diagnostic procedure before any clinical decisions are made.
Yes. A higher maternal BMI is associated with a lower foetal fraction in the blood sample, because greater maternal blood volume dilutes the foetal DNA. Women in the highest BMI category have a significantly higher rate of inconclusive NIPT results compared to those with a normal BMI. Your doctor will factor this in when reviewing your results.
Yes. The Double Marker Reflex to NIPT test involves only a routine blood draw from the mother's arm. It is completely non-invasive and carries no risk of miscarriage or harm to the baby. Both the Double Marker and NIPT components are performed using the same blood sample.
Double Marker Reflex to NIPT Test: Booking, Price, and Results
