Premarital Screening and Counseling for prevalent infectious diseases and common genetic disorders is becoming more and more common and widespread today. Family physicians, reproductive biologists and Gynaecologists together play an important role early in the diagnosis of genetic disorders and therefore prevention of abnormal pregnancies or recurrent early pregnancy losses
Through pre marital counseling, couples are encouraged to discuss topics such as:
- The presence of any underlying disease or known genetic disorder like Thalesemia, Cystic fibrosis diseases, G6PD, Sickle cell disease, autoimmune disorders etc
- Any history of birth trauma, neonatal diseases or acute illnesses affecting the gonads, in particular infectious diseases like measles and mumps
- Systemic diseases which have affected the parents especially the mother during her pregnancy like diabetes, high blood pressure, thyroid dysfunction, Hepatitis etc
- History of early menopause in the family demands early recognition of any potential decline in ovarian function
For consanguineous couples risks may need to be calculated based on the degree of the relationship i.e. siblings, cousins, second cousins, uncle-niece etc. If an individual in the family is known to have an autosomal recessive disorder, Diabetes, Hypertension (high blood pressure) and/or allergies then risks for this disorder can be accurately calculated in the resulting offspring. It is sensible to offer carrier testing for autosomal recessive traits known to be common in particular ethnic groups. For example Cystic Fibrosis in Northern Europeans, Tay-Sachs disease in Ashkenazi Jews, Thalassemia in people from the Mediterranean region, the Middle East, South-East Asian and the Indian sub-continent and Sickle cell disease in people from the African continent, the Caribbean, the Eastern Mediterranean and the Middle East. Incidence of Polycystic ovarian disease in children of Diabetic parents is now alarmingly on the rise resulting in compromised reproductive health in the offspring.
Services of the pre-marital counseling program include –
- Review of medical and family history for genetic diseases.
- Relevant blood tests.
- Arranging for a specialist consultation if required
- Providing necessary vaccines such as Rubella and Hepatitis B to susceptible individuals.
- Health education and advice on a healthy pregnancy.
Your counselor, family physician, Gynaecologist will work together to help you interpret the results of your counseling session(s) and support you in overcoming challenges as you move towards beginning a family.
Who should seek pre-marital counseling ?
- If the age of the female spouse is more then 35 years
- If the female spouse has Rh –ve blood group type and/or if her BMI is > 25
- If either parent has had long-term medical illnesses, conditions, chemotherapy, radiotherapy and/or surgical history
- If one or both of the parents have worked in toxic environment like being in close proximity to dyes, radiation, extreme weather conditions, chemical exposure, petroleum or pesticide industry and/or fertilizers
- If one or both parent has a history of extreme psychiatric or mental health history