Pre Marital Screening - The leading Health & Diagnostic provider for DNA, Genetic Tests & Cancer Screening in Dubai, UAE

Pre Marital Screening

Pre Marital Screening

What is Pre marital Screening
A premarital test is defined as a test in which couples that are going to get married are tested for genetic, infectious and blood transmitted diseases to prevent any risk of transmitting any disease to their children.

Nowadays premarital testing is considered an important issue, as a result of the increasing in the number of children affected with genetic or blood transmitted diseases.

Importance of Premarital Screening

A hereditary disease, especially or specifically sickle cell disease and to a lesser extent thalassemia, are present with a high prevalence in Gulf and caused great suffering of the children. Since the 1950s, Arab countries have made progress in some health related aspects such as: infant mortality, life expectancy, and access to health care. Data from industrialized countries show that significant genetic diseases or birth defects that may affect approximately 3% of all pregnancies, account for up to 30% of pediatric hospital admissions, and cause about 50% of childhood deaths. In addition, recessively inherited disorders account for less than 20% of single gene disorders and less than 5% of congenital and genetic diseases (Alwan and Modell, 1997). On the other hand, genetic and congenital disorders are responsible for a considerable proportion of perinatal and neonatal mortalities in Arab populations.

Considering the facts, recently premarital screening has been made mandatory by the Ministry of Health, UAE and all couples should go through the screening process before getting married. The couples need to provide certificate stamped by the department of states of premarital screening to the court to proceed with the wedding.

Premarital screening mainly aimed at reducing the number of children with inherited diseases. It is a comprehensive group of tests for those who are planning to get married and highly beneficial for the couples who are under the following categories:

  • Couples going for consanguineous marriage
  • If either/both have family history of a serious genetic condition
  • If they are ‘carriers’ of the same faulty gene
  • If they have exposure to some chemical or other environmental agent
  • Any abnormalities in the chromosomes

What tests are done in Premarital Screening

Pre-marital screening varies from one region to another depending on the prevalence of the diseases in that region. We offer Pre marital screening at three levels:

1. Basic package includes:

  • Complete blood count (CBC)
  • Blood group (ABO & Rh typing)
  • Abnormal Haemoglobin studies (Hb Variants)
  • G6PD- quantitative
  • Sexually transmitted diseases,
    a. HIV ½ antibody screening (3rd Generation)
    b. Hepatitis BsAg screening
    c. Hepatitis C Total Antibodies to Hep C Virus
    d. VDRL (Syphilis) (RPR)
    e. Gonorrhea (Neisseria Gonorrhea) detection by PCR
    f. Chlamydia Trachomatis (IgG and IgA)

2. Advanced Package includes:

  • Basic Package
  • 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 Package Includes:

  • Basic Package
  • 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)
  • Karyotyping

Counselling for the advanced level of premarital screening should be done by genetic counsellor

Genetic counseling is or should be a part of the premarital screening. Genetic Counsellor can help to decide the type of test the couple should consider. Details of the family history, medical records and conditions of family members from both the sides need to be provided to the counsellors to have a proper advice from him.

If the couple are informed of the possibility that they are at an increased risk of having a genetically abnormal child, they can choose to plan conceptions according to medical advice and can make use of the genetic counselling services available, such as:

  • Couples may decide not to get married
  • If couples decide to get married, they may not wish to have children
  • If couples wish to have children, they must do the Pre natal Screening of the fetus at an early stage of pregnancy
  • Couples must understand the option of termination of the pregnancy
  • Couples must understand the social, economic perspectives of having children with genetic disorders.

1. Basic package:

The routine tests are done under this package to check the health status of an individual. Any abnormality will direct the couple for further analysis to an advanced level. These are the regular biochemical tests routinely done by the laboratories.

  • Complete blood count (CBC)
  • Blood group (ABO & Rh typing)
  • Abnormal Haemoglobin studies (Hb Variants)
  • G6PD- quantitative
  • HIV ½ antibody screening (3rd Generation)
  • Hepatitis BsAg screening
  • Hepatitis C Total Antibodies to Hep C Virus
  • VDRL (Syphilis) (RPR)
  • Gonorrhea (Neisseria Gonorrhea) detection by PCR
  • Chlamydia Trachomatis (IgG and IgA)

 

2. Advanced package:

This includes the basic package with the addition of infertility testing for both male and female. It is always important to know the about the fertility status of the couple as most of the time, specially in the South East Asia, women are condemned for not having children after years of marriage. Though its interesting to know in many cases, the male infertility was the reason behind this.

  • Male infertility test:

Although many people still think of fertility as a “woman’s problem,” up to half of all cases of infertility involve problems with the man. In fact, about 20% to 30% of the time, a man’s low fertility is the main obstacle to conception.

So it’s crucial that men get tested for fertility as well as women. Yes, it can be embarrassing, but discovering male fertility problems early can mean earlier treatment and a successful pregnancy. Male infertility testing can also spare women unnecessary discomfort and expense.

A semen analysis is the most common testing procedure for determining if there is a male infertility factor. Sperm is collected into a specimen jar and presented to a lab technician who examines the sperm under a microscope to evaluate the count, shape, appearance, and mobility.

When assessing sperm count, the technician will be checking to see whether the sperm concentration is above or below 20 million sperm cells per milliliter of ejaculation fluid.

If the sperm count is low, your fertility specialist will probably test the blood testosterone, FSH, LH and prolactin levels.

A urinalysis may be used to look for white blood cells which may indicate an infection. The urinalysis will also determine if there is sperm in the urine, which would suggest that there is a problem with ejaculation known as retrograde ejaculation.

  • Female infertility test:

Infertility is the inability to get pregnant after a year of unprotected intercourse. About 10% of couples in the United States are affected by infertility. Both men and women can be infertile. According to the American Society for Reproductive Medicine, 1/3 of the time the diagnosis is due to female infertility, 1/3 of the time it is linked to male infertility and the remaining 1/3 is due to a combination of factors from both partners. For approximately 20% of couples the cause can not be determined.

The tests performed by the specialists involves measuring the level of the hormones, like follicle stimulating hormone (FSH) and luteinizing hormone (LH) to establish a baseline. This is performed on the third day of the cycle. Other hormones and routine analyses are also done to complement the diagnosis.

3. Advanced genetic package:

This is the most comprehensive package which includes basic tests, fertility tests and adds karyotyping as to analyze the chromosomes of both of them. For advanced screening, blood karyotyping is suggested by the counsellor to the couples who do not have any particular genetic conditions. When the couples show the correct number of chromosomes, there is less likely that they have any genetic abnormalities in their chromosomes.

  • Blood Karyotyping:

Blood Karyotyping is a test to examine chromosomes in a sample of cells, which can help identify genetic problems as the cause of a disorder or disease. This test can:
• Count the number of chromosomes
• Look for structural changes in chromosomes

The sample is placed into a special dish and allowed to grow in the laboratory. Cells are later taken from the growing sample and stained. The laboratory specialist uses a microscope to examine the size, shape, and number of chromosomes in the cell sample. The stained sample is photographed to provide a karyotype, which shows the arrangement of the chromosomes.

Certain abnormalities can be identified through the number or arrangement of the chromosomes. Chromosomes contain thousands of genes that are stored in DNA, the basic genetic material.
Normal Results
• Females: 44 autosomes and 2 sex chromosomes (XX), denoted 46, XX
• Males: 44 autosomes and 2 sex chromosomes (XY), denoted 46, XY