My DH is 11 years older than me, and was 42 when our first was born 45 for our second. Kiddos are now 3.5 and not quite 6, with no problems at all. DH had some learning issues as a child (probably undiagnosed very mild ADHD, Inattentive Type) and has a 14yo nephew who also has some learning problems (a visual processing issue and ADHD Combined Type). I knew all of this when we decided to have kids. None of it can be tested for, all of it can be treated, and so we're just keeping a close watch.

Some of the conditions you mentioned that may have a genetic component (Bipolar Disorder, Learning Disabilities) are not things that show up on genetic screenings, unless there is some underlying syndrome.

I was 5 weeks early, born after my mom had a 2nd trimester miscarriage. Her sister had 2 late miscarriages and then was on bed rest for months with the 2 children she did have. The 3rd sister had a hysterectomy and never had children.

I asked my RE if I needed more details on my mom and aunts' reproductive health, timing of miscarriage, etc. and he said no. His experience was that miscarriages for non-chromosomal reasons don't usually pass down through generations.

OP, just because your DH was premature and has no issues does not mean his sister's issues are unrelated to prematurity. One preemie can have significant deficits and another preemie be fine. Just as one child with a perfect genetic panel can have significant life issues just as well. No one gets a free pass.

The fact that your SIL was 2.5 months premature is a significant pre-disposing factor to her cognitive issues. It simply can't be ignored and it's highly likely to be involved.

There may be no genetic issues at all in this family. Genetics doesn't explain every issue. Nor do all genetic tests explain every genetic issue.

I'm at SG and both the RE and my OB recommend the Counsyl test for genetic mutations. The Counsyl company says you won't pay more that $99 if you submit it to insurance - and having just paid that bill - they were good on their word. The website has a list of things they can test for.

The genetic test is not a bad idea. Your husband's sisters issues do not sound like something that would be detected on that test. Unfortunately with kids there are never any guarantees no matter how many tests you do.

The genetic panel 14:52 is referring to is one of the initial bloodworks my RE ordered for me & my spouse when we first met with her.

I'd see if your OB or PCP can order them for you and your husband.

I met with a genetic counselor before I had CVS when I was pregnant with my son (CVS due to advanced maternal age). But aside from doing the CVS on me, they also did a simple blood draw where they could test me for a myriad of genetic disorders based on my race and ethnic origin (many genetic disorders are more prevelant in certain races/ethnicities). Had I tested positive as a carrier for any of them, they would have tested my husband also. My blood test was paid by my insurance because of my age. Yours would likely not be covered by insurance but you might want to spend the money on the test if this is a big concern for you. You can have this test done now before you get pregnant.

I'd ask your doctor what he/she thinks about the genetic issues. It might be hard to pre-test for something like that. However, 36 is not old so I wouldn't worry too much about his age. Good luck.