Pre Marital Screening

Pre Marital screening is a comprehensive group of tests for those who are planning to get married. Having a child is one of the most important decisions in a couples’ life, however there are certain situations whereby the couple is likely to have a genetic makeup that would confer their child with a genetic disorder. In order to prevent this it is vital that a full genetic comparison is undertaken before conception in order to determine the risk of the child having a genetic birth defect such as Down ’s syndrome or Fragile X.

Inherited genetic disorders have been a major health concern in the Middle East. In the UAE alone,

  • consanguineous marriages increased from 39 per cent to 50.5 per cent in a single generation (1997)
  • genetic disorders and congenital anomalies cause for 40.3 per cent of all infant deaths in the country

Pre Marital screening is made mandatory by the Ministry of Health (MOH), UAE, for the people getting married. The Screening offered by MOH includes the following tests:

  • Thalassemia
  • Sickle Cell Anemia
  • Sexually Transmitted Diseases

Several other national health boards also have obligatory Pre Marital health screens, especially in countries with high rates of consanguineous marriage. The screening varies from country to country depending on the prevalence of the diseases in that region. But one needs to consider the following conditions especially when getting married to relatives:

  • Screen the hereditary conditions
  • Screen for fertility problems
  • Identify infectious diseases
  • Assess the over all health status
  • Screen the hereditary conditions:
    Advances in molecular biology have led to an explosion in genetics. On a daily basis a gene associated with disease is identified. Couples having a family history of a particular disorder should go for various different Molecular Cytogenetic or DNA tests which might be helpful for the couples, for example:
    • Alpha thalassemia – deletions
    • Ataxia telangiectasia - carrier screening by linkage
    • Congenital Adrenal hyperplasia- mutation analysis
    • Cystic Fibrosis- mutation
    • DMD Carrier test
    • Fragile X Screen
    • G -6-PD one mutation
    • Hemophilia A/B, Carrier test
    • Parkinson disease
    • Polycystic Kidney dis. PND by linkage etc.
    The complete list of the test will be found at: www.easternbiotech.com

    • To assess genetic abnormality in general, chromosomal analysis or Karyotyping needs to be done. Blood Karyotyping is a test to examine chromosomes, which can help identify genetic problems as the cause of a disorder or disease. People having genetic conditions in the family such as Down syndrome, Klinefelter syndrome, Philadelphia chromosome, Trisomy 18, Turner syndrome need to check the number or the arrangement of the chromosomes.

    The couples showing the correct number of chromosomes, there is less likely that they have any genetic abnormalities in their chromosomes.

    • Females: 44 autosomes and 2 sex chromosomes (XX), written as 46, XX
    • Males: 44 autosomes and 2 sex chromosomes (XY), written as 46, XY
  • Screen for fertility problems:
    Infertility screenings are done to help find out whether the couples are having any physical abnormalities to conceive babies. The tests help find whether the problem is with the man, the woman, or both. Tests usually include the following analyses for both male and female.
    • Male infertility test (CBC, FBS, PPBS, BUN, Urine rt, Semen rt, FSH, LH, Prolactin, Testosterone, ASAB, Chlamydia IgG/IgA)
    • Female Infertility test (CBC, FBS, PPBS, BUN, Urine rt, Blood group, FSH, LH, Prolactin, TSH, ASAB, Chlamydia IgG/IgA)
  • Identify infectious diseases:
    Infectious diseases are caused by germs like virus, bacteria, fungi and protozoa present in air, soil and water. Germs usually spread through animal and insect bites, kissing and sexual contact. That is the reason it is very important to know whether the future partner is having any contagious disease like- HIV, HPV or Hepatitis B infection which may get the other partner infected.
  • Assess the over all health status:
    This is an overall diagnosis of the general health conditions of the couple. Screening for the diseases like thalassemia and sickle cell anemia are highly recommended for the people of UAE and Middle East as these diseases are very common among the region's population.

Though pre marital screening is mandatory in some parts of the world, still people are unaware and confused to take the risk assessment or genetic diagnostic analysis. This is due to the burning need for professionals like genetic counselors who would discuss the couple’s unique concerns regarding potential or present genetic disorders that are encountered by them for which they have either carried out a test or are contemplating having a test. In either circumstance they would benefit greatly through a consultation with a genetic counselor.

Genetic counseling

Genetic Counseling for congenital disorders, would follow sequences to make the potential couples understand the consequences of their union on their offerings. In case of a positive screening test where one or both partners are found to have a transmissible genetic disorder, they must consider the following options:

  1. They may decide not to get married
  2. If they do decide to get married in spite of their conditions, they may not wish to have children
  3. If they wish to have children, they must understand the value of Pre natal Screening of the fetus at an early stage of pregnancy to determine if there has been a genetic transmission or identify the carrier status of the fetus
  4. They must understand the option of termination of the pregnancy
  5. If they are unwilling to consider any of the above options, they must understand the social, economic perspectives of having children with genetic disorders.

 
 

Eastern Biotech & Life Sciences offers various packages of pre marital screening with counseling. The consultations may be conducted either through email, telephone call arranged by us or where possible, in person co-ordinated by our staff. We offer the following test options:

  1. Basic Screening:
    • Thalassemia
    • Sickle cell anemia
    • Sexually transmitted diseases, - HIV 1/2 and Hepatitis B

  2. Advanced Screening: Basic screening plus the following tests
    • Male infertility test (CBC, FBS, PPBS, BUN, Urine rt, Semen rt, FSH, LH, Prolactin, Testosterone, ASAB, Chlamydia IgG/IgA)
    • Female Infertility test (CBC, FBS, PPBS, BUN, Urine rt, Blood group, FSH, LH, Prolactin, TSH, ASAB, Chlamydia IgG/IgA)

  3. Advanced Genetic Screening: Basic and Advanced screening plus
    • Karyotyping
Please contact us for further details at: 04 3692061 or email us: info@eastrenbiotech.com
 

News:

  1. Saudi Arabia Royal Cabinet approved Premarital Screening in 2002
    2. Royal Decree was issued on Premarital Screening and it says, “For Screening of genetic diseases, the premarital examination for both couples is recommended.  A certificate of examination is to be issued before wedding. The results of examination need to be explained to the concerned but not to prevent marriage”. Screening of the prospective couples for Thalaessemia and Sickle cell anemia is carried out at the approved governmental hospitals and centers. Genetic counseling is required if the couples are carrier or diseased.

  2. Premarital Screening launched in Qatar
    3. The Ministry of Public Health and Secretary General of the Supreme council of Health (SCH) H E Abdullah bin Kahlid Al Qahtani has urged all desiring couples to benefit from the premarital screening being launched in Qatar on 13th December, 2009. All nationals and residents getting married in Qatar will have to undergo the mandatory tests for their marriage to be legalized.

  3. Premarital Screening in Turkey
    4. A premarital screening program aiming at reducing the incidence of thalassemia major was started under the auspices of the Regional Health Administration in 1995 in the city of Denizli in the Aegean region of Turkey.

  4. Pre Marital check-ups to be mandatory in Bahrain
    5. A Pre Marital medical check-up to test couples for infectious diseases such as HIV, hepatitis and genetic ailments will be implemented on December 13, health officials said. Health officials said this would help prevent would-be couples from giving birth to children with complicated diseases or deformities. A media campaign aims to promote awareness as most conservative families, keen on inter-cousin marriages, will have to deal with it. Ahmad Teebi, professor of Paediatrics and Genetics at Well Cornell Medical College-New York and Qatar and adviser to the Supreme Council of Health, said that married couples in the Arab world are usually cousins or distant relatives, which explains why diseases spread in most Arab countries. He added that premarital screening was highly important, regardless of the relationship between couples.

  5. Mandatory Premarital Screening in Dubai
    6. Premarital screening became mandatory from September 9, 2007 in Dubai for both Emiratis and expatriates in Dubai. The step is taken to prevent the spread of genetic blood disorders like thalassaemia and sickle cell which are prevalent in the GCC. Couples are now tested for diseases like thalassaemia, sickle cell, hepatitis B and C and sexually-transmitted diseases. A compatibility certificate is issued within a week if the subjects are normal. If the report is positive, the procedure varies.
Pre Marital Screening