Ur report is absolutely and according to ur age so better reconfirm anomlalies at 5 months scan

Age risk for down syndrome is bound to be high at 39 years. But if u see the combined risk of age, NT Scan and biochemical markers..it is 1:1456 something. Which is way above the cutoff.. So I don't think there is any requirement of NIPS or amniocentesis. Hoping that your anomaly scan was also normal...that u mentioned a mid pregnancy scan..

The high risk is due to your age. Other reports are normal. Take an Anomaly scan to clear your doubts. Further test like amniocentesis and NIPT are not required in my opinion.

Your adjusted risk is 1 in 619 on the FMF report, which factors in age, NT, nasal bone, and even lower (1 in 1400+) on including serum double marker findings. This makes it low risk overall for downs syndrome. Amniocentesis is not recommended. If you are still worried, you may go for NIPT using cell free DNA as that gives 99% assurance.  All these tests give you an answer it terms of probability, eg 99% probability of downs syndrome being ruled out. Amniocentesis is the only 100% assurance test , i e an answer in yes or no.