What is the Triple Screening Test Turkey?
The triple screening test Turkey is a non-invasive method that measures free alpha-fetoprotein (AFP), total hCG and free estriol levels in the blood of the expectant mother between the 15th and 20th weeks of pregnancy to screen for possible risks of the fetus such as Down syndrome, Edwards syndrome and neural tube defects. The three biochemical markers are evaluated in a statistical model together with demographic parameters such as the mother’s age, gestational week and body mass. In this way, the screening test helps to identify high-risk pregnancies in the early stages and reduces the rate of unnecessary invasive procedures.
When is the Triple Screening Test Performed?
The triple screening test is performed between the 15th and 20th weeks, when fetal plasma proteins and hormone levels reach their most reliable reference ranges in the middle of pregnancy. The 16th to 18th weeks in particular is the period when the correlation of AFP, hCG and estriol values with gestational age is most clearly seen. Earlier or later testing is not recommended, as it may increase false positive or negative rates.
What Values Are Measured in the Triple Screening Test? (AFP, HCG, Estriol)
AFP is a plasma protein that passes from the liver of the fetus to the placenta and can be elevated in cases of neural tube defects and abdominal wall openings. Total hCG is a hormone secreted by the placenta and is abnormally elevated in pregnancies with Down syndrome. Free estriol is an estrogen derivative synthesized in the kidneys of the fetus and passed into the maternal circulation; it usually decreases in cases of aneuploidy. Risk assessment is performed by calculating the MoM (multiple of median) values of these three parameters.
What Risks Does the Triple Screen Test Identify?
The test specifically screens for Trisomy 21 (Down syndrome), Trisomy 18 (Edwards syndrome) and neural tube defects (anencephaly, spina bifida). An increase in AFP levels may also indicate low-closed abdominal defects or non-aneuploidy causes. Imbalances between hCG and estriol may indicate placental dysfunction in addition to chromosomal abnormalities. In cases where high risk is detected, detailed ultrasonography and, if necessary, referral to diagnostic tests such as amniocentesis are made.
What is the Difference Between Double and Triple Screening Test?
While only β-hCG and PAPP-A are measured in the double screening test, AFP, total hCG and free estriol values are taken into account in the triple test instead of these two parameters. Double screening is a method applied in the early period (11–14 weeks), while triple screening is performed in the middle trimester. While the risk of Down and Edwards syndrome is determined with the double test, the triple test also allows for screening for neural tube defects.
How is the Triple Screening Test Performed?
Approximately 5–10 ml of blood is taken from the expectant mother’s arm during the appropriate week of pregnancy. After the serum is separated, AFP, total hCG and estriol levels are measured quantitatively using immunoassay methods. The measured values are converted to MoM form by correcting factors such as the patient’s gestational week, weight, age and smoking. The risk calculation software evaluates these three parameters and demographic data to create a risk ratio in the 1/X format for each risk type.
How to Evaluate Results?
Test results are reported separately for trisomy 21 and 18 and neural tube defects as 1/X. For example, a risk of 1/250 indicates that one in 250 pregnancies may have the relevant anomaly. Clinical cut-off values are usually chosen between 1/250 and 1/300; cases above this threshold are considered “high risk” and invasive diagnostic amniocentesis or detailed fetal anatomic ultrasound is recommended. Results below the cut-off value are considered “low risk”, but no screening method provides a definitive diagnosis, so the patient is guided by ultrasound during follow-up and genetic counseling when necessary.
How Reliable is the Triple Screen Test?
The triple screening test has a sensitivity of approximately 80–85% for Trisomy 21 and Trisomy 18, and a detection rate of over 90% for neural tube defects. The false positive rate is around 5–7%. In order to increase the reliability of the screening test, it is important to perform it at the correct gestational age, to ensure that the laboratory complies with standard protocols, and to correctly enter the mother’s demographic data (age, weight, smoking) into the risk calculation. However, no screening test provides a definitive diagnosis; in high-risk results, invasive diagnostic methods are used to ensure certainty.
What Steps Are Taken If Results Are Risky?
If the triple test result shows a risk above the determined threshold value, a detailed fetal anatomy ultrasound is planned first. If there is no structural anomaly detected by ultrasound, genetic counseling is obtained; then amniocentesis is recommended in the 16th–20th weeks of pregnancy. Amniocentesis provides definitive diagnosis of anomalies such as Down or Edwards syndrome by directly examining the chromosome structure of the fetus. In addition, if the risk of neural tube defects is high, cases such as spina bifida are confirmed with second trimester AFP measurement and, if necessary, fetal ultrasound.
Triple Screening Test Prices 2026
As of 2026, triple screening test packages in private laboratories and clinics range from ₺1,800 to ₺2,500. This fee includes blood collection, AFP, hCG and estriol analyses, risk calculation report and genetic counseling guidance. While the basic screening test is free for patients with SGK, a package difference fee may be applied in private hospitals.
Frequently Asked Questions
Is the Triple Screening Test Performed on an Empty Stomach?
For the triple screen test, 8–10 hours of fasting is required. Fasting blood sugar is the first stage of the test; any food or drink (except water) can affect the result. Therefore, even a light meal should be skipped before the test and only water should be drunk.
In Which Week Should It Be Done?
The triple test should be performed between the 15th and 20th weeks of pregnancy, ideally between the 16th and 18th weeks. During this period, AFP, hCG and estriol values give the most reliable results within the reference ranges; the false positive and false negative rates of the test increase with earlier or later application.
Will anything happen to the baby if there is a risky result?
A high-risk screening result does not mean that the baby has a definite disorder; it only indicates that the probability of a chromosomal or structural abnormality is increased. Early diagnosis allows for certainty with appropriate advanced diagnostic methods and pregnancy management is planned accordingly. The baby may be exposed to a minimal risk of infection due to invasive diagnostic procedures (such as amniocentesis), but with specialist monitoring this risk is very low.
Is the Triple Test Result Always Accurate?
No screening test is 100% accurate. Although the triple test has high sensitivity and specificity, misleading results may occur due to MoM calculation errors, laboratory variability, or maternal factors. Invasive methods and detailed ultrasound findings should always be considered for definitive diagnosis.
Can Gender Be Determined with the Triple Test?
The triple screening test is not a method for determining the sex of the fetus; AFP, hCG and estriol measurements screen for chromosomal and neurological risks, not the identity of the fetus. Detailed anatomy ultrasound or cellular genetic testing (NIPT) is used for gender determination between 18 and 22 weeks.