Fragile X Syndrome, Fetal Analysis

CPT 81243; 81244
Synonyms
  • Fragile X testing

Test Details

Turnaround Time

8 - 14 days. If culture is needed, an additional 14 - 21 days may be required. Additional culture fee may be applied.

Use

This test is used for prenatal diagnosis for pregnancies at risk for fragile X syndrome (FMR1).

Special Instructions

Labcorp clients with eight-digit client account numbers should call 800-345-4363, and Labcorp Genetics & Women's Health clients with six-digit client/subclient account numbers should call 800-255-7357 to speak with a laboratory genetic coordinator before collecting specimens. In some circumstances, specimens from both parents and other family members may be required. All fetal specimens, including cord blood, must be accompanied by a maternal blood, PurFlock buccal swab kit or Oragene Dx 500 saliva kit for maternal cell contamination (MCC). A separate requisition should be submitted with the maternal specimen.

Limitations

Technologies used do not detect germline mosaicism and do not rule out the presence of large chromosomal aberrations including rearrangements and gene fusions, or variants in regions or genes not included in this test, or possible inter/intragenic interactions between variants, or repeat expansions. Variant classification and/or interpretation may change with time if more information becomes available. False positive or false negative results may occur for reasons that include: rare genetic variants, sex chromosome abnormalities, pseudogene interference, blood transfusions, bone marrow transplantation, somatic or tissue-specific mosaicism, mislabeled samples or erroneous representation of family relationships. This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.

Methodology

Fragile X syndrome: Polymerase chain reaction (PCR) followed by capillary electrophoresis and methylation PCR analysis

Maternal cell contamination analysis (MCC): Analysis of short tandem repeat markers by multiplex fluorescent polymerase chain reaction (PCR) and capillary electrophoresis

References

Hunter JE, Berry-Kravis H, Hipp H, et al, editors. In: GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993. 1998 Jun 16 [updated 2019 Nov 21].20301558
Nagan, M, Faulkner NE, Curtis C, Schrijver I, MCC Guidelines Working Group of the Association for Molecular Pathology Clininical Practice Committee. Laboratory guidelines for detection, interpretation, and reporting of maternal cell contamination in prenatal analyses a report of the association for molecular pathology. J Mol Diagn. 2011 Jan;13(1):7-11.21227389
Spector E, Behlmann A, Kronquist K, et al. Laboratory testing for fragile X, 2021 revision: a technical standard of the American College of Medical Genetics and Genomics (ACMG). Genet Med. 2021 May;23(5):799-812.33795824

Specimen Requirements

Information on collection, storage, and volume

Specimen

Chorionic villus sample (CVS), or cultured CVS or cultured amniotic fluid, or cord blood. Direct amniotic fluid specimens with gestational ages less than 19 weeks or specimens that do not meet minimum volume requirements will be placed in culture. Additional culture fee may be applied.

Chorionic villus sample (CVS), or cultured CVS or cultured amniotic fluid, or cord blood. Fragile X analysis is not performed on direct amniotic fluid specimens; submitted specimens will be placed into culture. Direct CVS specimens are accepted for testing. Additional culture fees may be applied.

Chorionic villus sample (CVS), or cultured CVS or cultured amniotic fluid, or cord blood. Direct amniotic fluid specimens with gestational ages less than 19 weeks or specimens that do not meet minimum volume requirements will be placed in culture. Additional culture fee may be applied.

Volume

Amniotic fluid: 20 mL from >19 weeks gestational age; or CVS: 10 mg; or amniotic fluid or CVS culture: two confluent T-25 flasks; or cord blood: 4 mL. If amniotic fluid or CVS are cultured at another facility, please maintain backup cultures.

CVS: 10 mg; or amniotic fluid or CVS culture: two confluent T-25 flasks; or cord blood: 4 mL. If amniotic fluid or CVS are cultured at another facility, please maintain backup cultures.

Amniotic fluid: 20 mL from >19 weeks gestational age; or CVS: 10 mg; or amniotic fluid or CVS culture: two confluent T-25 flasks; or cord blood: 4 mL. If amniotic fluid or CVS are cultured at another facility, please maintain backup cultures.

Minimum Volume

Amniotic fluid: 20 mL from >19 weeks gestational age; or CVS: 10 mg; or amniotic fluid or CVS culture: two confluent T-25 flasks; or cord blood: 3 mL

Container

Amniotic fluid or CVS: sterile plastic conical tube or T-25 flask

Cord blood: Yellow-top (ACD-A) or lavender-top (EDTA) tubes

Storage Instructions

Maintain specimen at room temperature. Do not freeze.

Causes for Rejection

Frozen or hemolyzed specimen; quantity not sufficient for analysis; improper container

Collection

Standard sterile techniques; transfer aseptically to sterile tubes.

Amniotic fluid: Discard first 2 mL of fluid aspirated to avoid maternal cell contamination.