Should I have NIPT if I'm over 35 or can I wait for the NHS dating scan?

Many women over 35 wonder whether they should pay for private non-invasive prenatal testing (NIPT) straight away or wait for the NHS dating scan and combined test. The short answer: your age alone doesn’t determine your screening pathway - the NHS offers the combined test to everyone, and private NIPT is a personal choice based on timing, scope, and what you want to know earlier in pregnancy.

What the NHS offers at every age

The NHS provides free screening for Down’s syndrome (trisomy 21), Edwards’ syndrome (trisomy 18), and Patau’s syndrome (trisomy 13) to all pregnant women, regardless of age. This is called the combined test, and it happens between 11 and 14 weeks of pregnancy.

The combined test includes:

• An ultrasound scan to measure the fluid at the back of the baby’s neck (nuchal translucency)
• A blood test that checks two pregnancy hormones in your blood
• Your age as one factor in the risk calculation

The test gives you a risk score - for example, 1 in 150 or 1 in 2,000 - rather than a yes-or-no answer. If your result shows a higher chance (typically 1 in 150 or greater), you’ll be offered diagnostic testing such as amniocentesis or chorionic villus sampling (CVS) to know for certain.

Your age is factored into the combined test calculation because the chance of chromosomal conditions does increase with maternal age. However, the NHS combined test is offered universally - it’s not restricted to or reserved for older mothers.

When private NIPT might make sense

NIPT analyses cell-free DNA from the placenta that circulates in your blood. It screens for the same three common trisomies as the NHS combined test - and depending on the panel you choose, it can also screen for rarer chromosomal conditions and microdeletions such as 22q11.2 deletion syndrome.

Key differences between NIPT and the NHS combined test:

• Timing. NIPT can be done from 9 or 10 weeks of pregnancy (depending on the test), which is earlier than the combined test window of 11-14 weeks. If you want reassurance sooner, private NIPT allows that.
• Detection rate. NIPT has a higher detection rate for Down’s syndrome - more than 99% - and a lower false-positive rate compared with the combined test. This means fewer people are told they have a higher chance when the baby does not actually have a condition.
• Scope. Some NIPT panels screen for additional conditions beyond the three common trisomies. The NHS combined test covers only trisomies 21, 18, and 13.
• No diagnostic procedure needed. Because NIPT is more accurate, fewer people go on to need amniocentesis or CVS. However, NIPT is still a screening test, not a diagnostic one - a high-chance result would still need confirmation with a diagnostic test before any decisions are made.

What maternal age really means for screening

Maternal age is one risk factor for chromosomal conditions, but it doesn’t work like a threshold where you suddenly need different tests at 35. The chance of trisomy 21 increases gradually with age - it’s not a step-change at any particular birthday.

Because the NHS combined test already takes your age into account when calculating your individual risk, being over 35 doesn’t automatically mean you should skip it and go straight to private testing. Many women over 35 have a low-chance combined test result and don’t need further testing.

That said, some women over 35 prefer the earlier timing and higher accuracy of NIPT. It’s a personal decision based on:

• How early you want information
• Whether you want to screen for conditions beyond the three common trisomies
• Your family history or any other factors that might make additional screening relevant
• Your own preference for certainty versus waiting

Can you do both?

Yes. Some women have private NIPT early (from 9 or 10 weeks) and still attend the NHS dating scan at around 12 weeks. The dating scan checks the baby’s development, confirms how many weeks pregnant you are, and looks for structural features - it’s not just about screening for trisomies. You can’t “replace” the dating scan with NIPT, because NIPT only analyses DNA for chromosomal conditions; it doesn’t give you an ultrasound picture of the baby’s anatomy or growth.

If you’ve already had a low-chance NIPT result, you may decide you don’t need the NHS combined test blood sample - though some women still choose to have the combined test as a second data point. Speak to your midwife about what makes sense for your situation.

The waiting question

If you wait for the NHS combined test, you’ll have your dating scan and blood test between 11 and 14 weeks, with results typically back within a few days. If the result shows a higher chance, you’ll be offered diagnostic testing, which gives a definitive answer but carries a small risk of miscarriage (less than 1 in 100 for amniocentesis, slightly higher for CVS).

If you have private NIPT at 9 or 10 weeks, you’ll usually have results within a week or two - so you may have information by the time you’d otherwise be attending the NHS dating scan. For some women, that earlier reassurance is valuable. For others, waiting a few more weeks for the free NHS pathway is the right choice.

Neither approach is “better” in a medical sense - it depends on what matters most to you.

What you can do at Jeen

Jeen offers several NIPT options that can be done earlier than the NHS combined test, with results typically back within a few working days of your sample reaching the laboratory. All include a free midwife consultation before you take the test, so you can discuss which panel is right for you.

If you want the earliest possible screening with a focused panel, PrenatalSafe 3 UK screens for the three most common trisomies from 10 weeks, with results in 2-4 working days of your sample reaching the laboratory - our fastest turnaround. You’ll also receive a free midwife consultation, and if your result shows a higher chance, a specialist will follow up with you.

For standard NIPT coverage from 9 weeks, Panorama NIPT includes a 9-condition panel (the three common trisomies plus sex chromosome conditions and triploidy) with optional fetal sex reporting. If you want to screen for rarer microdeletions - including 22q11.2 deletion syndrome, which occurs in around 1 in 4,000 births and is not covered by the NHS combined test - Panorama Microdeletions extends the panel to 13 conditions, also from 9 weeks.

For a mid-range option, Niptify NIPT offers a 30-condition panel from 10 weeks, covering the standard trisomies plus additional chromosomal and microdeletion conditions. If you prefer a test analysed in the UK, VeriSeq v2 NIPT uses Illumina’s platform at TDL Genetics in the UK, with a 3-4 working day turnaround from when your sample reaches the laboratory, and optional fetal sex reporting.

All of these tests have a detection rate above 99% for Down’s syndrome. The NHS combined test covers a small, fixed set of three trisomies; the NIPT panels we offer can screen for many more conditions, depending on which test you choose. You’ll have a free midwife consultation to help you decide what’s right for your pregnancy.