Double Marker Test, Triple & Quadruple Marker Test in Pregnancy – At Home

The Double Marker Test (10–13 weeks + 6 days), Triple Marker Test (15–20 weeks), and Quadruple Marker Test (15–22 weeks) are non-invasive maternal serum screening tests used during pregnancy to estimate the risk of chromosomal conditions such as Down syndrome (Trisomy 21), Trisomy 18, Trisomy 13, and certain neural tube defects. These tests are screening tests—not diagnostic tests—and typically cost between ₹900 and ₹5,600 in India.

• Double marker test: hCG + PAPP-A, done 10–13 weeks+ 6 days, ₹900–₹1,800 approx.

• Triple marker test: AFP + hCG + uE3, done 15–20 weeks, ₹1,000–₹2,900 approx.

• Quadruple marker test: AFP + hCG + uE3 + Inhibin-A, done 15–22 weeks, ₹1,600–₹5,600 approx.

• All three are blood-only tests, no fasting needed, available at home.

Pregnancy is an exciting journey, but it also comes with important health decisions. One of the earliest steps in prenatal care is screening for certain chromosomal and genetic conditions that may affect your baby.

Double, Triple, and Quadruple Marker Tests are maternal serum screening tests that analyze specific substances in a pregnant woman's blood to estimate the risk of conditions such as Down syndrome (Trisomy 21), Trisomy 18 (Edwards syndrome), Trisomy 13 (Patau syndrome), and certain neural tube defects like spina bifida.

These tests are safe, non-invasive, and require only a simple blood sample. Depending on how far along your pregnancy is, your doctor may recommend a Double Marker Test during the first trimester or a Triple or Quadruple Marker Test during the second trimester.

At MyDiagnostics, you can conveniently book your prenatal screening test with home sample collection, NABL-accredited laboratory testing, and secure digital reports delivered directly to your device.

Book your Double, Triple, or Quadruple Marker Test at Home with MyDiagnostics and receive reliable prenatal screening without visiting a diagnostic centre.

What Is a Double Marker Test?

A Double Marker Test is a first-trimester maternal serum screening test that measures free β-hCG and PAPP-A to estimate the baby's risk of Down syndrome, Trisomy 18, and Trisomy 13.

The test measures two important substances present in the mother's blood:

These blood test results are combined with:

• Maternal age

• Gestational age

• Maternal weight

• Ethnicity

• Smoking status (if applicable)

• Whether the pregnancy was conceived naturally or through IVF

• Nuchal Translucency (NT) ultrasound measurement

Together, these factors generate a combined risk score rather than a simple positive or negative result.

What Does the Double Marker Test Screen For?

The Double Marker Test estimates the likelihood of:

• Down syndrome (Trisomy 21)

• Edwards syndrome (Trisomy 18)

• Patau syndrome (Trisomy 13)

It may also provide information that helps identify pregnancies requiring closer monitoring for certain placental complications, although its primary purpose is screening for chromosomal abnormalities.

It is important to understand that the Double Marker Test is a screening test—not a diagnostic test. A high-risk result does not mean the baby definitely has a genetic condition. Instead, it indicates that further evaluation may be recommended.

Double Marker Test vs. Dual Marker Test

Many parents wonder whether the Double Marker Test and Dual Marker Test are different.

Both names refer to the same prenatal blood test. The terms are used interchangeably by hospitals, laboratories, and healthcare providers.

Why Is the NT Scan Performed Alongside the Double Marker Test?

The Double Marker Test is usually combined with a Nuchal Translucency (NT) ultrasound, performed between 10 and 13 weeks + 6 days of pregnancy.

The NT scan measures the amount of fluid behind the baby's neck. Babies with chromosomal abnormalities often have increased nuchal translucency.

When the blood test is combined with the NT scan, the screening accuracy improves significantly compared with either test alone. This combination is often referred to as the Combined First Trimester Screening Test.

According to the American College of Obstetricians and Gynaecologists (ACOG) Practice Bulletin No. 226 (2020), developed in collaboration with the Society for Maternal-Fetal Medicine (SMFM), first-trimester combined screening using maternal serum markers and nuchal translucency ultrasound detects approximately 82–87% of pregnancies affected by Down syndrome, depending on gestational age, maternal characteristics, and ultrasound quality.

When Should You Take the Double Marker Test? (Timing/Weeks)

The timing of the Double Marker Test is critical because the levels of PAPP-A and free beta-hCG change rapidly during pregnancy, and it is usually paired with an ultrasound scan (NT scan) in the same first-trimester window.

This screening tool measures beta hCG alongside PAPP-A to estimate the chance of certain chromosomal abnormalities. The results are then interpreted with maternal age, gestational age, ultrasound findings, and other factors to give a risk estimate. It is important to remember that this is not a diagnostic tool, so it cannot confirm a condition on its own.

Recommended Timing

The best time to undergo the Double Marker Test is between 10 weeks and 13 weeks + 6 days of pregnancy, with the NT scan performed during the same period.

Why Does Timing Matter?

The test is validated only during the first trimester. After approximately 14 weeks, the concentrations of PAPP-A and free β-hCG no longer provide the same predictive value, making the screening significantly less accurate.

For this reason, laboratories generally do not recommend performing a Double Marker Test after the first-trimester screening window has passed.

What If You Miss the Double Marker Test Window?

Missing the first-trimester screening window does not mean prenatal screening is no longer possible, since the Double Marker Test is validated for early pregnancy screening.

Your obstetrician may recommend:

• Triple Marker Test (15–20 weeks)

• Quadruple Marker Test (15–22 weeks)

• Non-Invasive Prenatal Testing (NIPT), if clinically appropriate

The choice depends on your gestational age, medical history, and your healthcare provider's recommendations, with timing helping support early chromosomal risk assessment. When screening suggests a higher risk, your doctor may advise additional diagnostic tests or further diagnostic tests to confirm findings.

Proper timing also improves the predictive value of screening by supporting early detection and timely medical guidance. This is why the Double Marker Test matters most in the first-trimester window, when it can guide the next steps sooner.

Double Marker Test Price in India

The Double Marker Test price in India varies depending on the laboratory, city, accreditation standards, and whether the test is performed alone or combined with an NT scan.

Approximate Double Marker Test Cost

What Affects the Double Marker Test Price?

Several factors influence the overall cost:

• City: Prices are generally higher in metropolitan cities than in smaller towns.

• Laboratory Accreditation: NABL, CAP, or ISO-accredited laboratories may charge slightly more due to stringent quality standards.

• Home Collection: At-home blood sample collection may include a nominal convenience fee, though many providers offer it free as part of promotional packages.

• Bundled Packages: Combining the Double Marker Test with an NT scan or other prenatal investigations can affect the total price.

Choosing a quality-assured laboratory is often more important than selecting the lowest-priced option, as accurate prenatal risk assessment depends on standardized laboratory procedures and proper interpretation.

What Is a Triple Marker Test?

The Triple Marker Test is a second-trimester prenatal blood screening test that measures AFP, free β-hCG, and uE3 to estimate the risk of chromosomal abnormalities and neural tube defects.

Unlike the Double Marker Test, which measures two blood markers, the Triple Marker Test evaluates three substances in the mother's blood.

Using maternal age and gestational age along with these markers, laboratories calculate the likelihood of:

• Down syndrome (Trisomy 21)

• Edwards syndrome (Trisomy 18)

• Open neural tube defects, including spina bifida

• Certain abdominal wall defects in the developing fetus

Like the Double Marker Test, the Triple Marker Test is not diagnostic. It estimates the probability of a condition rather than confirming its presence.

Who Usually Needs a Triple Marker Test?

Your healthcare provider may recommend a Triple Marker Test if:

• You missed the first-trimester Double Marker Test.

• An NT scan was not performed.

• First-trimester screening was unavailable.

• Additional second-trimester screening is advised based on your pregnancy history.

• You begin antenatal care after the first trimester.

Although many women today opt for Non-Invasive Prenatal Testing (NIPT) due to its higher detection rate for common chromosomal conditions, the Triple Marker Test remains an important and widely available prenatal screening option, particularly where NIPT is not accessible or affordable.

When Is the Triple Marker Test Done?

The Triple Marker Test should ideally be performed during the second trimester, when maternal serum marker levels provide the most accurate screening information.

Recommended Timing

Most obstetricians recommend performing the test between 15 and 20 weeks, with 16 to 18 weeks considered the optimal window for screening.

Triple Marker Test vs. Double Marker Test

The Triple Marker Test is not a replacement for the Double Marker Test. Instead, it serves as an appropriate screening option for women who were unable to complete first-trimester screening or who require additional evaluation during the second trimester.

Triple Marker Test Cost

The Triple Marker Test price in India generally ranges between ₹1,000 and ₹2,900, depending on the laboratory, location, and any additional prenatal screening services included.

Factors Affecting Triple Marker Test Cost

The final price may vary based on:

• City and regional pricing

• Laboratory accreditation (NABL, CAP, ISO)

• Home sample collection availability

• Package inclusions

• Consultation or interpretation services

Always choose a trusted diagnostic provider that follows standardized quality protocols to ensure reliable prenatal screening results.

What Is a Quadruple Marker Test (Quad Test)?

The Quadruple Marker Test (Quad Test) measures AFP, free β-hCG, uE3, and Inhibin-A to provide a more accurate second-trimester screening for Down syndrome and neural tube defects.

Like the Triple Marker Test, it analyzes substances present in the mother's blood. However, it measures four markers instead of three, making it a more comprehensive second-trimester screening option.

What Does the Quadruple Marker Test Measure?

The laboratory combines these marker levels with important maternal information, including:

• Maternal age

• Gestational age

• Maternal weight

• Ethnicity

• Presence of diabetes

• Number of fetuses (singleton or multiple pregnancy)

Using these factors, a personalized risk estimate is calculated.

What Does the Quadruple Marker Test Screen For?

The Quadruple Marker Test helps estimate the risk of:

• Down syndrome (Trisomy 21)

• Edwards syndrome (Trisomy 18)

• Open neural tube defects, including spina bifida and anencephaly

• Certain abdominal wall defects, such as gastroschisis and omphalocele

Like all maternal serum screening tests, it does not diagnose these conditions. Instead, it identifies pregnancies that may benefit from additional testing.

Why Is the Quadruple Marker Test More Accurate Than the Triple Marker Test?

The primary advantage of the Quadruple Marker Test is the inclusion of Inhibin-A, an additional placental hormone.

Research has shown that adding Inhibin-A improves the screening performance for Down syndrome, increasing the overall detection rate while maintaining a similar false-positive rate.

For this reason, many healthcare providers now prefer the Quadruple Marker Test over the Triple Marker Test when second-trimester maternal serum screening is required.

The test is commonly referred to by several names:

• Quadruple Marker Test

• Quad Test

• Quad Screen

• Quadruple Screening Test

These terms all refer to the same prenatal blood test.

Quadruple Marker Test Timing

The Quadruple Marker Test is performed during the second trimester, after the first-trimester screening window has passed.

Recommended Testing Window

Although some laboratories accept samples beginning at 14 weeks, most professional guidelines recommend performing the test between 15 and 22 weeks, with 16–18 weeks often considered the optimal period.

Who Should Consider the Quadruple Marker Test?

Your healthcare provider may recommend the Quad Test if:

• You missed the first-trimester Double Marker Test.

• You did not undergo an NT scan.

• You present for prenatal care during the second trimester.

• You require second-trimester chromosomal screening.

• Additional evaluation is recommended based on your medical or pregnancy history.

The Quadruple Marker Test is particularly valuable for women who were unable to undergo first-trimester screening but still wish to receive non-invasive prenatal risk assessment.

Quadruple Marker Test Price

The Quadruple Marker Test price in India varies depending on the laboratory, city, accreditation standards, and whether home sample collection is included. The approximate Quadruple Marker Test Cost is ₹1,600–₹5,600.

Why Does the Cost Vary?

Several factors influence pricing:

• Laboratory quality and accreditation (NABL, CAP, ISO)

• Metropolitan versus non-metropolitan cities

• Home blood sample collection

• Report interpretation services

• Additional prenatal screening packages

Because it analyzes four biomarkers, the Quadruple Marker Test is generally more expensive than the Triple Marker Test, but it offers improved screening performance for Down syndrome.

Double vs. Triple vs. Quadruple Marker Test — Key Differences

Choosing the right prenatal screening test primarily depends on how many weeks pregnant you are. None of these tests is inherently "better" than another—they are designed for different stages of pregnancy.

If you are within the first trimester (10–13+6 weeks), the Double Marker Test combined with an NT scan is the recommended screening approach.

If you have missed the first-trimester screening window, your obstetrician may recommend a Triple Marker Test or Quadruple Marker Test during the second trimester.

Comparison Table

Which Test Do You Need?

Important: Missing the Double Marker Test does not mean you've lost the opportunity for prenatal screening. The Triple and Quadruple Marker Tests are recommended alternatives during the second trimester—they are not better or worse, simply appropriate for a later stage of pregnancy.

Is This a Screening Test or a Diagnostic Test?

One of the most common misconceptions is that a Double, Triple, or Quadruple Marker Test can diagnose a genetic disorder.

These are maternal serum screening tests, meaning they estimate the probability that the baby may have a particular chromosomal condition or neural tube defect.

Screening Test vs. Diagnostic Test

Why Are Screening Tests Still Valuable?

Maternal serum screening remains an important part of prenatal care because it is:

• Safe and non-invasive

• Affordable compared with advanced genetic testing

• Widely available

• Helpful in identifying pregnancies that may benefit from further evaluation

• Recommended as part of routine prenatal screening for many pregnant women

Current guidelines from the American College of Obstetricians and Gynaecologists (ACOG) recommend that all pregnant women, regardless of age or baseline risk, should be offered prenatal genetic screening and diagnostic testing options after appropriate counselling.

Where Does NIPT Fit In?

Non-Invasive Prenatal Testing (NIPT) is another prenatal screening test that analyzes cell-free fetal DNA circulating in the mother's blood.

Compared with maternal serum screening, NIPT generally offers:

• Higher sensitivity for Down syndrome

• Lower false-positive rates

• Earlier testing from around 10 weeks of pregnancy

However, NIPT is also a screening test—not a diagnostic test. A positive NIPT result still requires confirmation through diagnostic procedures such as CVS or amniocentesis.

The most appropriate screening strategy depends on your gestational age, medical history, ultrasound findings, and your healthcare provider's recommendations.

Pregnancy Blood Test Pricing at MyDiagnostics

MyDiagnostics offers affordable prenatal screening with transparent pricing, certified laboratory testing, and convenient home blood sample collection.

Pregnancy Screening Test Price Comparison

Package availability may vary depending on your city and laboratory partner.

What's Included?

Every prenatal screening booked through MyDiagnostics includes:

• Home blood sample collection by trained phlebotomists

• Testing at NABL-accredited laboratories

• High-quality laboratory processing

• Secure digital reports

• Online booking support

• Dedicated customer assistance

Who Should Get These Tests?

Prenatal screening is an important part of routine antenatal care. While Double, Triple, and Quadruple Marker Tests were once primarily recommended for women considered high risk.

Current international guidelines recommend that all pregnant women be offered prenatal genetic screening and diagnostic testing options, regardless of maternal age or baseline risk, after appropriate counselling. This recommendation is supported by ACOG Practice Bulletin No. 226 and the Society for Maternal-Fetal Medicine (SMFM).

The decision to undergo screening should be made after discussing the benefits and limitations with your obstetrician. Your healthcare provider may particularly recommend these tests if you have one or more of the following risk factors.

Age 35 Years or Older at Delivery

The risk of chromosomal abnormalities, especially Down syndrome (Trisomy 21), increases with maternal age. Women who will be 35 years or older at the expected time of delivery are generally offered prenatal screening and, when appropriate, counselling about diagnostic testing options.

Personal or Family History of Chromosomal Disorders

If you, your partner, or a close family member has a history of chromosomal abnormalities or inherited genetic conditions, prenatal screening may help assess the pregnancy's risk and determine whether further testing is appropriate.

Previous Pregnancy Affected by a Chromosomal Condition

Women who have previously had a pregnancy affected by conditions such as:

• Down syndrome (Trisomy 21)

• Edwards syndrome (Trisomy 18)

• Patau syndrome (Trisomy 13)

• Certain neural tube defects

may benefit from additional prenatal screening and individualized counseling in subsequent pregnancies.

Abnormal Ultrasound Findings

If an ultrasound identifies findings such as:

• Increased nuchal translucency (NT)

• Structural abnormalities

• Soft markers for chromosomal conditions

Your doctor may recommend maternal serum screening or more advanced prenatal testing.

Maternal Medical Conditions

Certain maternal conditions may influence pregnancy management, including:

• Pre-existing diabetes

• Autoimmune disorders

• IVF pregnancy

• Multiple pregnancy (twins or more)

These factors may affect screening interpretation, and your healthcare provider will determine the most appropriate screening strategy.

Routine Prenatal Care

Even if you have no known risk factors, prenatal screening remains valuable because many babies with chromosomal abnormalities are born to women without identifiable risks.

According to the American College of Obstetricians and Gynaecologists (ACOG), all pregnant patients should be offered both prenatal genetic screening and diagnostic testing options, regardless of maternal age or risk category.

Understanding Your Report

Receiving your prenatal screening report can understandably feel overwhelming. However, it is important to remember that Double, Triple, and Quadruple Marker Tests estimate risk—they do not diagnose a condition.

Your report should always be interpreted by your obstetrician in combination with your medical history, gestational age, and ultrasound findings.

How Are Results Interpreted?

Most laboratories report results in one or both of the following ways:

Low-Risk Result

A low-risk result indicates that your pregnancy has a lower probability of the screened conditions. However, no prenatal screening test can eliminate the possibility of:

• Chromosomal abnormalities

• Birth defects

• Genetic disorders not included in the screening panel

Routine antenatal care and scheduled fetal ultrasounds remain essential.

High-Risk Result

A high-risk result means the estimated probability is higher than the laboratory's screening threshold. When people hear double marker test results described as "Double Marker Test negative," it usually means a low-risk screening result, not a diagnosis. It does not mean your baby definitely has a genetic condition.

Instead, your doctor may recommend:

• Detailed fetal ultrasound

• Genetic counseling

• Non-Invasive Prenatal Testing (NIPT)

• Chorionic Villus Sampling (CVS)

• Amniocentesis

Further evaluation helps determine whether additional testing is necessary.

Multiple of the Median (MoM)

Blood marker levels are often expressed as MoM (Multiple of the Median). MoM compares your marker level with the expected median value for women at the same stage of pregnancy.

Healthcare providers evaluate:

• AFP MoM

• Free β-hCG MoM

• PAPP-A MoM (Double Marker)

• uE3 MoM

• Inhibin-A MoM (Quadruple Marker)

The pattern of these values helps estimate the likelihood of specific chromosomal conditions.

Many women who receive a high-risk screening result ultimately deliver healthy babies. Because these are screening tests, false-positive and false-negative results can occur. Your obstetrician will guide you through the most appropriate next steps based on your individual pregnancy.

Why Choose MyDiagnostics for Pregnancy Screening?

Your pregnancy deserves reliable laboratory testing and compassionate care. At MyDiagnostics, we make prenatal screening simple, accurate, and convenient by bringing diagnostic services to your doorstep.

Our Advantages

• Home blood sample collection by trained phlebotomists

• NABL-accredited laboratory testing

• Accurate maternal serum screening

• Digital reports with secure online access

• No fasting required

• Affordable pricing with transparent costs

• Dedicated customer support throughout your pregnancy journey

Whether you need a Double Marker Test, Triple Marker Test, or Quadruple Marker Test, MyDiagnostics offers dependable prenatal screening designed to help you and your healthcare provider make informed decisions.

Book your Double, Triple, or Quadruple Marker Test online with MyDiagnostics today and enjoy convenient home sample collection, trusted NABL-accredited testing, and fast digital reports—all from the comfort of your home.