Your doctor can recommend or encourage you to do more thorough genetic testing/screening but it is not required.
Thanks, I really appreciate all your comments
I'm 41 and will be taking the 10 week Harmony genetics test (due to advanced maternal age) on Monday which also tells the gender of the baby. Results in 1 week! The test is optional but my insurance (Blue Care Network) covers it. Otherwise it costs $200.
They usually do the genetic testing to make sure there are no defects since the older you get there's a higher chance.