Article: If your doctor recommends a diagnostic test, it means they think you're at high risk for Down syndrome based on the results of screening test(s) combined with your age. However, although a prenatal diagnostic test can determine the presence of Down syndrome with certainty, they carry a higher risk to your health and that of your baby's because they are more invasive. As such, consult with your doctor about the pros and cons of such testing.  Invasive testing means that a needle or similar implement must be inserted into your abdomen and uterus to take a sample of fluid or tissue in order to analyze it. Diagnostic tests that can positively identify Down syndrome in pregnant women include: amniocentesis, chorionic villus sampling (CVS) and cordocentesis. However, keep in mind that these procedures do not come without risks. There is a risk of bleeding, infection, and harm to the fetus. An amniocentesis involves collecting a sample of amniotic fluid that surrounds your growing baby. A long needle is inserted into your uterus (through your lower abdomen) in order to withdraw fluid that contains some cells from your baby. The chromosomes of the cells are then analyzed, looking for trisomy 21 or other genetic disabilities.  An amniocentesis is usually performed during the second trimester, between weeks 14 to 22 of pregnancy.  The main risk of amniocentesis is a miscarriage and death of the baby, which increases if it's done before 15 weeks. The risk of a spontaneous termination (miscarriage) from amniocentesis is estimated at 1%.  Amniocentesis can also distinguish between the slightly different forms of Down syndrome: regular trisomy 21, translocation Down syndrome and mosaic Down syndrome. In a CVS procedure, cells are taken from a part of the placenta (which surrounds your baby within your uterus) called the chorionic villus and used to analyze the chromosomes for an abnormal number. This test also requires inserting a large needle into your abdomen / uterus. CVS is usually performed in the first trimester, between 9 to 11 weeks of pregnancy, although after the 10th week is considered less risky. This test be done sooner than amniocentesis, which is important if you plan to abort the baby if it has Down syndrome.   A CVS carries a slightly higher risk of miscarriage than a second trimester amniocentesis — perhaps slightly more than a 1% chance of miscarriage. A CVS can also distinguish between the slightly different genetic forms of Down syndrome. With cordocentesis, also called percutaneous umbilical blood sampling or PUBS, fetal blood is taken from a vein in the umbilical cord through the uterus with a long needle and examined for genetic mutations (extra chromosomes). This diagnostic test is performed later in the second trimester, between 18 to 22 weeks of gestation.  A cordocentesis is the most accurate diagnostic method for Down syndrome and can confirm the results from an amniocentesis or CVS procedure.  PUBS carries a much greater risk of miscarriage than amniocentesis or CVS, so your doctor should only recommend it if results from other diagnostic tests are unclear. If you didn't get any prenatal screening or diagnostic tests done prior to giving birth, then the initial diagnosis of Down syndrome is typically based on your baby's appearance. However, some babies may have the general appearance of Down syndrome, but not have the condition, so your doctor can order a test called chromosomal karyotyping.  A chromosomal karyotype requires a sample of your baby's blood to analyze for an extra 21st chromosome, which can be present in all or some cells. A significant reason for early screening and diagnostic tests is to give parents options before birthing, including terminating the pregnancy. If you believe you will be unable to care for your newborn with Down syndrome, ask your doctor about adoption options.
Question: What is a summary of what this article is about?
Consult with your doctor. Get an amniocentesis done. Consider chorionic villus sampling (CVS). Be very cautious with cordocentesis. Diagnose your newborn.

If you have friends or family members who have had IVF treatment before, talk to them about the clinic they used. Because they know you, they may have a recommendation for a place where you would feel comfortable.  Getting IVF treatment means opening up and dealing with sensitive personal issues. You want to make sure that you feel comfortable and at ease in the IVF clinic where you get treatment. You also want to make sure that the doctors and nurses at the IVF clinic are people you get along with and feel comfortable around. They will help you feel less stressed about the whole situation. Before you decide on an IVF clinic, check out several so you can compare them and choose the best one that suits both your needs, your personality, and your budget. You can find some possibilities through an online search or a discussion with your gynecologist. Factors to consider when making your list include:  Types of treatment offered Eligibility criteria Cost Location Ratings and reviews Birth and multiple birth rates Availability of counseling Most clinics offer a free initial consultation, during which they'll talk about the clinic and introduce you to some of the staff. You'll have the opportunity to ask the doctors questions and learn more about the treatments and services the clinic offers. You can also get a better idea of how well you get along with the people there and whether you feel comfortable in the clinic setting. Many clinics provide online consultations if you're not able to travel to the clinic's location immediately. Before you attend your initial consultations, make a list of questions to ask. If you ask the same questions at every clinic, you have a way to compare them more efficiently. Potential questions to ask include:  What medications will I have to take? Can I get my own medications elsewhere or do I have to get them from you? How many times will I need to visit the clinic? What kind of counseling do you provide? How many counseling sessions are included in the overall price? Can you break down the costs of treatment? Are there any other costs that might arise? After you've had your initial consultations, take a look at the answers to your questions and use them to decide which clinic would be the best fit for you. Take how you felt about each clinic and its staff into consideration.  Don't rely solely on cost. The cheapest IVF clinic might not necessarily be the best one for you. If your IVF isn't successful, it could end up costing you more in the long term. Be wary of IVF clinics that advertise better-than-average success rates. Although this might seem like a good thing, it usually indicates that the clinic is being less than honest about how they measure their success rate.
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One-sentence summary --
Ask friends and family for recommendations. Create a list of clinics you want to evaluate. Schedule an initial consultation with 3 to 4 clinics. Ask the same questions at each clinic. Compare the clinics to make your final decision.