Why is genetic screening before marriage essential for better family health

Experts say premarital genetic screening can help couples identify hidden risks and make informed decisions, reducing the burden of inherited disorders in future generations

  When it comes to marriages in India, horoscopes are matched for cosmic alignment, and background checks ensure social compatibility. Despite the focus on long-term stability, genetic health rarely enters premarital conversations.

 

As awareness around inherited disorders grows, experts are urging couples to look beyond tradition, as genetic screening offers a proactive way to understand risks, make informed decisions and reduce the burden of hereditary diseases in future generations.

 

What is genetic screening, and why does it matter?

 

Genetic screening involves testing individuals to identify whether they carry genes for inherited conditions, even if they show no symptoms themselves.

 

 

"The carrier screening test can identify if either or both parents carry a genetic mutation that could be passed on to the child. If both parents are carriers of the same genetic mutation, there is a chance that their child could inherit the condition," explains Dr Priya Kadam, Director of reproductive genomics, Medgenome.

 

Dr Puneet Rana Arora, Director-Gynaecology & IVF Expert, CIFAR, Gurugram, informs, “Some of the genetic disorders that are screened for before marriage in India include thalassemia, sickle cell anaemia, and some metabolic or chromosomal diseases.”

 

She adds, “Thalassemia screening is significant due to its high prevalence rate among carriers, who may appear normal but could give birth to offspring with serious conditions.”

 

Without screening, such conditions often go undetected until after childbirth, which can lead to lifelong medical complications and emotional and financial strain for families.

 

How screening helps couples plan better

 

The assessments enable healthcare providers to counsel parents, helping them prepare both psychologically and financially for potential challenges.

 

“Couples would have the chance to decide whether they want to conceive using other methods such as assisted reproduction techniques,” says Dr Arora.

 

This opens up possibilities such as IVF with genetic testing, donor options or more informed family planning, ensuring that couples are not caught off guard later.

 

Experts also highlight that genetic screening does not just identify risks, but also helps categorise the severity and implications of potential conditions.

 

Dr D Sandhya Rani, Lead Consultant Obstetrician and Gynaecologist at KIMS Hospital, Bengaluru, explains two categories of defects. “The first includes treatable structural defects like an extra finger, kidney swelling or diaphragmatic hernia. Some require surgery, while minor issues such as small holes in the heart may correct themselves.”

 

“The second involves defects that impact quality of life, such as spinal abnormalities, severe heart defects or renal issues. If chromosomal abnormalities affecting cognitive development are detected, couples receive detailed guidance on potential challenges, helping them make informed decisions regarding pregnancy continuation,” she says.

 

Who should consider genetic screening?

 

While anyone can opt for screening, some groups are at a higher risk and should be prioritised:

 

• Couples in consanguineous/ intra-family marriages
• Those with a family history of genetic disorders
• Individuals from high-prevalence ethnic groups
• Couples who have had previously affected children

 

Dr Arora explains that while targeted screening focuses on these groups, broader testing may be more effective. “Many experts recommend universal screening to detect hidden carriers, ensure early intervention, and reduce disease burden, especially for conditions like Thalassemia and Sickle Cell Disease.”

 

What are the ethical and social concerns involved

 

Despite its benefits, genetic screening before marriage raises important ethical questions. Concerns around privacy, consent and potential misuse of data cannot be ignored.

 

Although carrier testing is based on assessing risk rather than providing a definitive diagnosis, several misconceptions persist among the public. Concerns around genetic screening often stem from the fear of social stigma, as families worry that revealing inherited conditions could impact marriage prospects, job opportunities and access to insurance.

 

“Genetic testing can result in stigmatisation, discrimination against the carrier, and societal or familial pressure to avoid certain marriages,” adds Dr Arora.

 

This makes it crucial to approach screening with sensitivity, ensuring that it remains a tool for empowerment rather than exclusion.

 

How reliable are these tests?

 

Modern genetic tests are increasingly advanced, but they are not foolproof. They can detect known mutations, but cannot predict every possible outcome.

 

“Modern methods of genetic testing are quite reliable but do not provide complete coverage,” says Dr Arora. “They only pick up on known genetic mutations and not all possible outcomes.”

 

Importantly, being a carrier does not mean a person is ill. “Being a carrier does not mean having a disease, only a risk of one if the other partner is as well,” she clarifies.

 

Accessibility is improving in India, but awareness and affordability remain barriers. Insurance in India may cover genetic testing when medically necessary, but pre-marital or preventive screening is often excluded, making cost a key barrier to wider adoption.

 

The way ahead: Awareness and policy support

 

For genetic screening to become the norm rather than an exception, stronger public health efforts are needed. Experts believe that awareness campaigns and supportive policies can make a significant difference.

 

Key steps include:

 

• Educating people about the benefits of genetic screening
• Subsidising tests to make them more affordable
• Integrating genetic counselling into primary healthcare
• Encouraging screening through premarital programmes and schools
• Ensuring strict policies on confidentiality and non-discrimination

 

Dr Arora emphasises that government intervention is essential, as awareness alone is not enough without accessible and ethical systems in place.

 

Genetic screening before marriage is not about creating barriers, but about building healthier futures. As science advances and awareness increases, it offers couples a chance to make decisions rooted in knowledge rather than uncertainty.     

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This report is for informational purposes only and is not a substitute for professional medical advice.