Photo/IllutrationMinoru Irahara, left, and Tomoyuki Fujii, both from the Japan Society of Obstetrics and Gynecology, speak at a news conference in Tokyo about the society's plan to allow more medical institutions to conduct prenatal genetic testing on March 2. (Kentaro Fukuchi)

The Japan Society of Obstetrics and Gynecology will allow more hospitals to conduct prenatal genetic screenings of fetuses for Down syndrome and other disorders.

The move is intended to discourage pregnant women from undertaking such tests at facilities not authorized by the society.

With the relaxation of the rules, the number of society-approved hospitals where non-invasive prenatal genetic testing, or NIPT, can be conducted is expected to double from the current 92, according to the society.

The proposal for the change was approved by the society's executive board on March 2.

“There have been many reports on problems associated with such tests being conducted inappropriately at unauthorized facilities,” said Minoru Irahara, a doctor who heads the society’s ethics committee, at a news conference in Tokyo the same day.

Expanding the availability of NIPT at a larger number of certified medical institutions will steer women away from unaccredited facilities, he added.

Apart from Down syndrome, NIPT can detect with a high degree of accuracy a fetus with trisomy 13 or trisomy 18, genetic disorders that include a combination of birth defects such as severe intellectual disabilities and health problems involving nearly every organ in the body.

The society is expected to implement the new arrangement this summer after receiving feedback from relevant groups of medical experts and the public.

Tomoyuki Fujii, chairman of the society’s executive board, noted at the news conference that many medical institutions are hoping to conduct NIPT because they can charge high testing fees.

The testing, which is not covered by the national health insurance program, typically costs about 200,000 yen ($1,800) at authorized facilities.

Unaccredited facilities often conduct the testing at a lower fee, attracting many pregnant women.

Fujii said the society will strive to lower the test cost at approved facilities so that they will become accessible to more women.

Prenatal genetic testing began in Japan in 2013 for pregnant women aged 35 or older.

Medical institutions with full-time obstetricians and pediatricians as well as a department treating outpatients with hereditary diseases, among other conditions, are authorized as NIPT facilities.

Under the planned setup, newly authorized medical institutions will be categorized as "affiliated facilities" and those already authorized will be designated as "core facilities."

A key criterion for a medical institution being approved is whether it has an obstetrician who underwent a training program. The institution also requires an outside pediatrician available to work closely with the facility.

The latter was added to the criteria in response to a request for the involvement of pediatricians in the testing, as they are experienced in treating children with disabilities.

About 100 medical institutions will be certified as affiliated facilities at an early date, according to the society.

The society has been concerned about a large number of NIPT being conducted at unauthorized facilities.

Some women also have reported that they were not provided sufficient explanations by hospital staff on the results of a test they took.

Counseling by experts before and after prenatal diagnosis plays an important role in NIPT, as women face the weighty decision of whether to have an abortion based on the result.

Obstetricians, pediatricians, counselors and others work together to provide counseling sessions under the current arrangement.

Under the new setup, if a woman takes the test at an affiliated facility, an obstetrician will provide counseling.

If the test is positive, she is then referred to a core hospital for counseling.

Women who test positive, in principle, will receive an amniotic diagnosis to finalize the NIPT results, and undergo an abortion or deliver the baby at an affiliated facility.

However, such women can have the same done at a core facility, if they desire.

Data from the association of authorized NIPT facilities show that about 65,000 women received the test over five and a half years through September last year.

About 90 percent of the women whose fetuses were diagnosed with a chromosome abnormality after further tests following NIPT had an abortion.