We have compiled the most frequently asked questions we receive from everyone.
We will answer your questions about NIPT (New Non-invasive Prenatal Testing) so that you can take the test with ease.

For those who are considering the test

Can anyone take the NIPT(Non-invasive Prenatal Testing)?

There is no age restriction for testing at Hiro Clinic NIPT.

  • Anyone who is 10 weeks pregnant or later may take the test, but it is recommended that the test be taken on your 14th week if you plan to take an amniotic fluid test in case your result turns.
  • Pregnant women with twins are also eligible for this test.
    Please consult with us if you have Vanishing Twin Syndrome.

However, the testing may not be accurate in the following cases:

  • If you yourself have trisomy, monosomy, etc.
  • If the mother has a genetic abnormality
  • If your fetus has triploidy or tetraploidy
  • Those who have undergone stem cell therapy
  • Those who have undergone immunotherapy
  • Those who have received an organ transplant
  • Those who have had a blood transfusion in the past 12 months

At which clinics is the NIPT test available?

NIPT testing is available at all Hiro clinics nationwide in the Kanto, Hokkaido, Kansai, Chubu, and Kyushu regions.
Please check Clinic Information for clinics that can perform the NIPT test.

How long does a consultation take?

Approximately 45 minutes. Please note that it may take more than 1 hour during busy periods.

Please allocate enough time for your visit, as there may be a waiting time depending on the situation.

Can I go alone when I go for an appointment?

Yes, expectant mothers may come alone.

I am considering to have a child at an older age. Are there any age restrictions for testing?

There are no age restrictions.

Is this test covered by medical insurance?

This test is not covered by medical insurance.

Do I need a referral letter from an obstetrician/gynecologist for the testing?

No referral letter is required.

Can I claim a deduction for medical expenses?

Medical Expense Deduction is not applicable.

Where is the Testing Laboratory?

Second Tokyo Clinical Laboratory

Do you offer remote medical services?

If you have any questions concerning your results when you receive them, we will be happy to answer them. Please let the receptionist know your request at the time of your first visit.

How are the specimens sent?

From clinics outside the Tokyo metropolitan area, specimens can be transported quickly by both motorcycle and air mail.
The test is performed domestically and results are reported by e-mail, which is the fastest and most accurate way to receive the results anywhere.

How do I prepare to receive my test results by email?

The test results, and confirmation email you will get after completing the medical questionnaire will be sent from the domain '@nipt-result.com'.
If you have set your iPhone, smart phone, or cell phone to reject e-mails from this domain, you will not be able to receive e-mails
from '@nipt-result.com'. Please make sure to set your e-mail address to be able to receive e-mails from '@nipt-result.com'.

What is the difference between Minimum Plan (O) and Light Plan (A)? Is it just to gender identification?

Minimum Plan (O) is the same as that of a university hospitals and only tests for chromosomes 13, 18, and 21.
Light Plan (A) tests chromosomes 13, 18, and 21 and identify the number of sex chromosomes.
--------------------------------------
The most common abnormal findings observed in testing the number of sex chromosomes are Klinefelter's syndrome (XXY, XXXY, XY/XXY), Turner's syndrome (X), and Superwoman's syndrome (XXX).
The reason why university hospitals do not perform this gender test is because they discourage gender preselection and because gender chromosome abnormalities have relatively mild symptoms.
More information on the relatively frequently occurring chromosomal abnormality is explained here.

Is it possible to undergo NIPT even if I am on heparin injections?

Use of low-molecular-weight heparin is known to alter DNA in the serum, resulting in a high frequency of errors when using heparin injections.
The estimated half-life of heparin is 4~6 hours, so it is advisable to stop using heparin for more than 48 hours ( at least 12 hours) before blood is drawn for NIPT if possible, or before starting to use it.

I am taking Bayaspirin, can I still do the NIPT test?

We request that you discontinue taking this medication as it may affect the test.
When taken TWICE a day - For night and morning doses, take the night before and stop taking the morning of the day.
When taken ONCE a day - Please discontinue taking it at night or in the morning.

Prior to taking the test

Can the test plan be decided the same as the testing day?

The test plan can be changed on the same day.
Please consult with the doctor regarding which plan is best for you.

What is the name of the parking lot in front of the Nagoya clinic?

The parking lot is the Mitsui Repark Nagoya Tsubaki-cho No. 3 Parking Lot.

I heard that twins cannot be tested.

Hiro Clinic NIPT can also test for twins.

I have been diagnosed with vanishing twins, can I do the NIPT test?

The test can be performed starting at 10 weeks of pregnancy.
However, false positives, false negatives, and gender inconsistencies are more likely to occur than usual.

Is there anything I need to prepare for the testing?

You will need to prepare a mother-child handbook with the number of weeks and an ultrasound photograph.

I have severe morning sickness and often struggle, will it affect the collection of blood?

Blood collection will not be affected.

Are there any dietary restrictions on the day of the test?

There is none.

How and when should I contact you for cancellation?

It is possible even on the same day.
Please contact us by phone or through the contact form on the site.

My morning sickness is so bad that I can't seem to make it to the clinic on the day of the appointment.

If you have difficulty coming to the clinic due to illness or other reasons, make sure to call us.
Please note that a cancellation fee will be charged for same-day no-shows.

Can triploids be detected?

It is not detectable by the Veriseq NIPT V2 system at the Second Tokyo Clinical Laboratory.

Triploids and tetraploids are explained in the Human Investor Columns.

(2) Triploid and Tetraploid
Normal somatic cells are diploid (2n). Triploidy and tetraploidy are seen during fetal life. In triploidy, the number of chromosomes (3n) makes it impossible for the child to live long with 69 chromosomes, but it is possible for the child to be born alive.
Triploidy is most often the result of two-sperm fertilization, and triploidy can also occur when diploid oocytes or spermatozoa are formed. Triploidy from the father results in an abnormal placenta.
In addition, triploidy from the mother results in spontaneous abortion in early pregnancy. Tetraploidy results in 92 chromosomes due to the number of chromosomes (4n). When this division occurs in the sex chromosomes, there are no sex chromosomes, XXXY or XYYY.

About the Testing

What does 7 million bases mean?

7 million bases is the size of the gene that serves as a standard for discriminating whole autosomal whole region partial deletion/duplication diseases.

In Hiro Clinic NIPT, an abnormality in which a part of a chromosome is duplicated or missing is detected based on 7 million bases as a whole autosomal whole region partial deletion or duplication disease.
It is not an abnormality in the number of chromosomes like monosomy or trisomy.

Is there a possibility that partial deletions or duplications will be detected in us as well?

The possibilities are not zero.
Anything smaller than 7 million bases is likely to be detected.

What is the sensitivity of the test accuracy?

Sensitivity is one of the criteria for measuring the accuracy of a test.

In NIPT, Sensitivity is the probability that the test is positive among those who had a positive result after delivery. The higher this number is, the higher the accuracy.

What is the specificity of test accuracy?

Specificity is one of the criteria used to measure the accuracy of a test.

Specificity is the probability of a negative test result among those who tested negative after delivery. The higher this number is, the higher the accuracy.
Both sensitivity and specificity are values that indicate the accuracy of a test and are characteristic values of the test.
This value is determined by the testing system. Therefore, it is not measured by Hiro Clinic, but by Illumina, the company that developed the system.

Is partial deletion uncommon?

In NIPT studies around the world, it is known that genetic disorders have ethnic and regional origins.
However, despite the availability of various research data, mainly from Europe and the U.S. but also from Asia, there have been no reports of genetic disease data limited to pregnant women in Japan.
This is also the first data reported for all autosomal whole region partial deletions and duplications diseases.

In Hiro Clinic NIPT, about 1 in 270 of the positive patients tested positive for all autosomal whole region partial deletion diseases.
This calculation is based on data from more than 10,000 pregnant women examined by our clinic.

What is Exon Region?

There are two alternating regions in a gene: the exon region, which carries genetic information, and the intron region, which does not.
Inborn information inherited from parent to child is mainly contained in the exon region.

IntronExon
(with genetic information)
IntronExon
(with genetic information)
IntronExon
(with genetic information)
Intron

Is it possible that a partial deletion or partial duplication does not cause disability to the baby?

Depending on the chromosome site, some parts of the chromosome may not have any genes present. However, it is unlikely that there are no exon regions at all within 7 million bases. Exon regions are usually present in about 2% of the chromosomes.

Is it possible to die immediately from an all autosomal whole region partial deletion/duplication disease?

It is thought to depend on the amount of genes.
We believe that with a duplication of approximately 7 million bases, the number of cases of fetal death is low.
On a side note, there are 48.12 million bases of chromosome 21 involved in Down's syndrome.
It is considered that the severity of symptoms is generally more severe for deletions than for duplications, and depends on the amount of increase or decrease in the base changed.

What specific disorders will occur?

The type of disability is determined by the site and extent of the disorder.
We provide the extent of the disorder area in the results report so that we can find out as much as we can about it.
However, we can only speculate from what has been so far reported.

When counseling a patient who is positive, we will examine the type of gene present at the site of the disorder and previous cases in advance, and speculate on possible symptoms.

Can an all autosomal whole region partial deletion/duplication keep a child alive?

Although there are varying degrees of success, many cases of survival have been reported, so it is considered possible.

It is said to be related to changes in the amount of genes and the extent of the disorder.
The increase or decrease will occur in one part of the chromosome rather than the entire chromosome. It is possible that the symptoms may be milder than in a normal trisomy.

What symptoms can you recognize when a partial deletion or duplication is diagnosed?

As far as we have been able to determine, 54 named diseases or syndromes have been reported worldwide, ranging from chromosomes 1 to 22.
Symptoms range from relatively mild to severe.
Chromosomes from chromosome 1 to 22 vary in size from 250 million bases for the most common to 48 million bases for the least common, and the number of genes varies from 2,610 for the most common to 337 for the least common.

There are also unnamed diseases that are not included in the 54 types, and it is reasonable to assume that there are still others that have not been discovered.

You say there are 49 different cases with partial deletions and duplications, but are there any other cases?

There are also unnamed cases reported in NIPT studies around the world that are not included in the 49 type of cases published on the Hiro Clinic NIPT website.

The Second Tokyo Clinical Laboratory, which is the testing our laboratory, uses testing equipment that measures all autosomal regions, so it is possible to detect all autosomal partial deletion diseases.
However, there are still some diseases and cases that cannot be detected even with the testing equipment of Second Tokyo Clinical Laboratory. It is important to be aware that these cases are not small in number.

What can we do if we test positive for a whole autosomal partial deletion?

First, you should do an amniotic fluid test and then perform a microarray test. The usual G-band (G staining method) may not be able to detect the disease.

How long does it take to complete the test?

It takes about one hour from orientation to consultation, including blood collection.

How many weeks into the pregnancy can I take the test?

The earlier the better, taking into account amniotic fluid testing and other factors. There is no limit to the number of weeks before the test.

However, in rare cases, blood samples may need to be re-collected due to insufficient DNA. If you are really worried about it, you can take the test from the 11th week.

Why do many medical facilities require that you be over 35 years of age to be tested?

This is due to recommendations in Japan by the Japanese Society of Obstetrics and Gynecology.
In general, it is scientifically accepted that it is better for older pregnant women to take this test. This is because even if the sensitivity and specificity are close to 99%, the positive predictive value of the test is lower in cases with a low incidence.

If a test has a sensitivity of 96.5% and a specificity of 99%, but the incidence of disease is 0.1%, only one in two people will get the test correct, even if the test is positive. The positive predictive rate drops even further when the disease incidence rate is even lower, and the Society does not like the idea of NIPT testing for everyone because of the anxiety-provoking consequences (positive NIPT results).

However, the above discussion is probabilistic and statistical. Hiro Clinic NIPT allows testing without age limit for those who wish to be tested.
At Hiro Clinic NIPT, we believe that it is acceptable to leave it up to the patient's decision as to whether or not to test.

Are there any positive cases among people under 35 years of age?

There are some positive cases among those under 35 years of age.

I'm on my 26th week, can I still get tested? Until when can I have an abortion?

At Hiro Clinic NIPT, you can take the test as long as the baby is still in your womb.
It is not a definitive test, as only blood samples are taken.

Hiro Clinic NIPT cannot provide answers about abortion, but abortion procedures are considered to be performed up to 21 weeks and 6 days.

Does the basic test include gender identification? Is there an additional fee?

The basic test (A: Light Plan) includes gender identification and is included in the test results. No additional fee is required.
Please be aware that this will be indicated on the test result report. The (O: Minimum Plan) does not include gender identification.

Test Plan List

 Chromosome
21, 18, & 13
Aneuploidy
Sex chromosomes
Aneuploidy
Autosomal
Aneuploidy
Partial deletion or duplication of Chromosomes
1~5, 7, 8, 10, 15, 18, 20~22
All autosomal whole region partial deletions and duplications
Full Set Plan
(F)
Recommended Plan
(R)
×
Junior Plan
(G)
x×
Over35 Plan
(B)
××
Light Plan
(A)
×××
Minimum Plan
(O)
x×××

※Trisomy and monosomy are included in aneuploidy
Twins can be tested. Prices vary for testing with twins. Please see the Test Plans page for more details.

Why are there so many trisomies on chromosomes 21, 18, and 13?

The autosomes (chromosomes 1~22) are numbered in order of chromosome length. However, the number of genes on each chromosome is lower for 21, 18, and 13, in that order. This is why these three types of trisomies are thought to occur more frequently.

Is NIPT not a definitive test?

The NIPT used at Hiro Clinic NIPT is highly accurate, but it is not definitive.
It is a screening test (not definitive).

Should NIPT basically be regarded as a screening test?

We believe so. Basically, testing is done based on the percentage of risk from the test and the information obtained from the test.

The NIPT test is an absolutely low-risk test, requiring only a blood sample from the mother. We believe that the information obtained from this test will provide important information for childbirth.
Both sensitivity and specificity are close to 99%, and we believe that this test is sufficient as a screening test.

Are there any disadvantages when you changed from Verinata to Second Tokyo Clinical Laboratory?

There are no disadvantages.
The elimination of overseas transportation of specimens has made it possible to obtain results in a shorter period of time.
In addition, we no longer have to deal with the possibility of specimens being damaged during overseas transportation.

How much blood is collected?

10 ml.

I was told that my NT is thick. Which test do you recommend I undergo?

The relatively common diseases with thick NT are trisomy 21, 18, and 13. We recommend the our Plan O or greater.
A thick NT does not immediately mean that there is an abnormality.
There are many cases where it is normal. We recommend that you start with a non-invasive test such as NIPT.

Can I have a medical consultation?

Yes, a consultation with a doctor is available on the day of the NIPT test and is included in the cost of the test.

If you wish to see a doctor on a different day, you will be charged an additional consultation fee.
(20 minutes: ¥4,000 (¥4,400 incl. tax))

If you wish for a consultation, please make a request through My Page at least 2 days prior to the consultation.
If you wish to see a doctor the day before or on the same day, please call us. Depending on the schedule of the doctor in charge, we will accept your appointment if possible.

Call us for an appointment request for the day before or on the day of your visit.
0120-169-629

Available for appointments: 10:00 - 18:00
※Calls can be made only within Japan

Do you offer counseling with a genetic counselor?

Hiro Clinic NIPT has certified genetic counselors in house.

If you wish to have genetic counseling after the NIPT test, a certified genetic counselor shall be available to counsel you with your doctor.
Genetic counseling by a certified genetic counselor is possible with a doctor's presence. (20 minutes: ¥4,000 (¥4,400 incl. tax))

Please call us for more information.
0120-169-629
Available for appointments: 10:00 - 18:00
※Calls can be made only within Japan

Can I join the Mutual Aid Society at a later date?

You can join the Mutual Aid Society only during your appointment date. It is not possible to join at a later date.

After undergoing the test

I would like to have the original results in English as well, is it possible to get it?

Currently, we do not issue test results in English.

What methods of payment are available?

You can pay on the day of the examination by cash or credit card.

Do you provide receipts for mutual aid?

We only issue acknowledgement receipt.

How can I receive the test results?

The results will be sent to you via the Internet.

Results are usually available within 2 to 5 days (usually within 3 to 6 days for some branches and partner facilities) after the blood sample is taken, and the test result report can be viewed on 'My Page'.

Express delivery option is available at all Hiro Clinic NIPT clinics except the partner facilities (delivery within 2~3 days after blood collection).
After logging in to My Page, click the 'Download' button under 'Result PDF File'.

Result Example

If you prefer, you can also receive your results in person at the clinic.
※We currently do not send out the test results in paper form.
※Result reports can be viewed for 3 months after the result report is released.

How long does it take to get the test results back after the blood sample is taken?

Test results are usually returned within 2-5 days (usually within 3-6 days for some branches and partner facilities) after the blood sample is taken.
Express delivery option is available at all Hiro Clinic NIPT clinics except the partner facilities (delivery within 2~3 days after blood collection).

If the laboratory determines that the case is subject to re-inspection, it may delay the release of the results by up to 3 days.
※When results are reported online

If the test result is positive, should I take an amniotic fluid test?

We recommend that you take an amniotic fluid test, depending on what you are considering.

Do you perform amniotic fluid testing?

Hiro Clinic NIPT does not offer amniotic fluid testing, but we do offer a mutual aid society sponsored by affiliated laboratories.
For patients with a positive test result, we offer a subsidy of up to ¥200,000 for the cost of the amniotic fluid test.
Please note that there are certain criteria for amniotic fluid test subsidies.
For details, please refer to Amniotic Fluid Test and Mutual Aid Society.

In addition, the Second Tokyo Clinical Laboratory, with which Hiro Clinic NIPT is affiliated, offers genetic testing of amniotic fluid for those who have been positive for the test at affiliated facilities, including Hiro Clinic NIPT. The cost of the genetic testing of amniotic fluid will be covered by Hiro Clinic NIPT.

Are there any subsidies for the cost of amniotic fluid testing?

Hiro Clinic NIPT offers a mutual aid society sponsored by affiliated laboratories. The membership fee is ¥3,000 (tax free).
By joining, patients with a positive test result can receive up to ¥200,000 (tax included) in subsidies for the cost of an amniotic fluid test.
This is a one-time payment and can only be paid in cash.

In addition, we have established criteria for subsidizing the cost of amniotic fluid testing.
① If all autosomes and sex chromosomes are positive for aneuploidy, G-band and qf-PCR tests will be subsidized.
② If you test positive for partial deletion or duplication of all autosomes, G-band, qf-PCR, microarray, and FISH tests will be subsidized.

For more information about the mutual aid, please refer to Optional Services for Test Plans and Amniotic Fluid Test for further information about the amniotic fluid test.

If it comes back positive, will you refer me for an amniotic fluid test? Also, even if I find a testing place on my own, will they cover the cost if I join a mutual aid society?

Only patients with positive test results will be referred to the nearest medical facility that performs amniotic fluid testing.

The Mutual Aid Society will cover the cost of the amniotic fluid test at any medical facility that Hiro Clinic NIPT refers you to or at any medical facility that you find on your own.
For more information, please refer to Amniotic Fluid Test or contact the clinic reception.

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