Paternity testing: Some straightforward answers to common questions

What is identity (paternity) testing?
Identity testing determines the genetic identity of an individual.  Identity testing is used to determine who is the father of a child.  Identity testing is also employed to verify that a baby was not switched at birth or that a baby conceived by advanced reproductive technologies is, in fact, the parents' child.  Police use this testing to identify individuals who are victims of crimes or accidents and to identify possible perpetrators of crimes.

How is the testing performed?
Until recently, identity testing relied mainly on checking blood types and HLA types.  These tests, which are still available, can be accurate.  However, compared to these older methods, DNA-based testing is cheaper, easier to perform accurately, and feasible in nearly every situation.  Because the genetic variation tested by DNA-based methods is far greater than in blood and HLA types, testing can confirm paternity with accuracy often exceeding 99.99%.  Since DNA is present in every tissue and bodily fluid, and since DNA is extraordinarily stable, testing can be performed on small blood samples or tissue samples.

What should be considered prior to testing?
Results of the testing may not be the expected ones, and it is important to remember that this may have major economic and social consequences.  For instance, if the presumed father of the baby is not actually the father, he may not be required to support the child, and he would most certainly view the child differently than if he were the biologic father.  Geneticists use the term non-paternity when the suspected and the biologic father are not the same.  Non-paternity is estimated to be present in over 10% of individuals.  Non-maternity is far rarer, since switching babies in hospitals is extremely uncommon.

We recommend that any couple thinking about identity testing for their child consider speaking first with a lawyer, in part because results of testing are often used as legal evidence.  Since the testing is so very accurate, it is nearly impossible to refute DNA-based testing results that may not be the expected results.  Also, consulting with a health professional may be helpful, especially if that health professional has had a long-standing relationship with the family.

How to get additional information on identity testing?
We offer genetic consultation for individuals or couples thinking about identity testing, and we will obtain the samples, arrange for the testing, and interpret the laboratory testing results.  However, since identity testing is not considered to be medical diagnostic testing, having the testing through our office or a doctor's office is not required.  Identity testing is typically NOT considered to be "medically necessary", and this means that virtually no insurance companies will pay for the testing.

Identity testing laboratories usually offer testing directly to interested individuals.  Points to consider before selecting a laboratory include price, length of time for obtaining results, availability of a convenient way to collect the required DNA samples, and availability of professionals at the laboratory who can assist in interpreting testing results.  Most laboratories require payment in full prior to releasing results.  Many require at least partial payment before even accepting samples.  Testing a child, mother, and a father typically costs $450-$650.  Prenatal testing, which would involve an amniocentesis to obtain DNA-containing cells from the unborn baby, entails additional laboratory costs, as well as the costs (which may or may not be covered by medical insurance) of the amniocentesis procedure.

Listed below are several identity testing laboratories which perform paternity testing.  The list we have compiled is not meant to be comprehensive, and comparison shopping is suggested.  In particular, make sure that a laboratory guarantees that it will do sufficient testing to ensure that the probability of paternity exceeds 99% or that is excluded with a greater than 99% probability.
 

^*     Parents & child  /  parents & amniotic fluid  ---  may not include sample collection fees
^**   Laboratory with which we have had personal experience and no reported complaints

Note:  Additional laboratories, which are not approved by the New York State Department of Health, perform this testing as well, but cannot accept specimens from New York State residents.  "Informational" rather than "legal" testing, when available,  may be less expensive than the prices quoted above.  Most laboratories offer the option of using samples collected from cheek swabs rather than blood samples.