An innovative genetic test has been developed by investigators from Massachusetts General Hospital (MGH), Brigham and Women's Hospital (BWH), and the Broad Institute of MIT and Harvard. The non-invasive test uses a blood sample from pregnant individuals to check all genes for fetal DNA sequence variants. This groundbreaking research suggests it is now possible to comprehensively screen the majority of genes across the fetal genome via blood test rather than the invasive practice of amniocentesis. Pioneering Change in Prenatal Diagnosis The lead of this innovative research, Michael E. Talkowski, PhD, senior director of MGH's Center for Genomic Medicine shed some light on this novel test. He explained, "Our study suggests that it is feasible to screen most genes across the fetal genome using a blood test rather than requiring an invasive procedure such as amniocentesis." This revolutionary approach could change the landscape of prenatal diagnosis globally, providing patients with a safer, non-invasive option. Previous Limitations of Non-Invasive Prenatal Testing Current non-invasive prenatal testing (NIPT), also known as prenatal-cell-free DNA-screening, examines very large changes in fetal chromosomes such as Down syndrome (an extra copy of chromosome 21), entire chromosome gain or loss, the number of X and Y sex chromosomes (indicating the sex), and variants relevant for some fetal conditions. However, for many prenatal genetic diagnoses, it is necessary to determine individual nucleotide changes across the protein coding sequence of the genome, known as the 'exome'. Previously, exome screening required an invasive procedure, but the newfound technique utilizes circulating DNA in the mother's blood. How Non-Invasive Fetal Sequencing (NIFS) Exists and Functions The group of scientists coined this novel technique as Non-Invasive Fetal Sequencing (NIFS). The researchers developed NIFS to offer a reliable method to discover and interpret variants across the fetus exome through DNA circulating in mothers blood. The method doesn't require any additional genetic test on the mother or father. This innovative approach can effectively survey the exome, discover sequence changes, and distinguish potentially pathogenic variants from likely benign ones inherited from the mother. Testing Results So Far The NIFS method was tested on 51 pregnancies that spanned all three trimesters and were representative of the pregnant population receiving care at MGH and BWH. The method showed a high sensitivity for discovering single-base DNA changes and small insertions and deletions in the fetal genome, irrespective of the amount of fetal DNA. In 14 pregnancies, NIFS detected all clinically relevant variants that were reported from invasive testing in the same individuals. The Potential Impact on Future Prenatal Care Identifying fetal sequence variants from cell-free fetal DNA has been part of the standard care but it previously required an invasive procedure. However, the NIFS method suggests that non-invasive sequencing can obtain the same genetic information from a blood test alone. This is particularly significant for pregnancies where a fetal anomaly is suspected from ultrasound and where an invasive test is indicated. While this test needs further study to optimize and refine the methods, the emergence of NIFS has already indicated a promising future for prenatal diagnostics.