Hi Dr. Purushottam welcomes you to HCM virtual clinic! Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options. 1] I will suggest indulging in a healthy diet and regular exercise regime. Include plenty of fruits, salads, vegetables in the diet. Have adequate water intake , say 8 – 10 glasses per day. Avoid deep fried foods, bakery products, and refined sugars.Avoid substance abuse, if any. Start on FOLIC ACID, B12 supplements at least 3 months before you plan to have baby. 2] You can also get genetic karyotyping done for both of you. If you both are normal , then your concern about repeat chance of Down s syndrome get statistically reduced. 3] In next pregnancy . 12 weeks scan with nuchal translucency and nasal bone with double marker ; and at weeks triple test will help to screen out for Down s syndrome. 4] In case of any doubts. CVB- chorion villous biopsy, and amniocentesis can be done to rule out fetal abnormality. I hope my answer helps you. Thanks. Wish you great health. Dr Purushottam