Premarital Genetic Compatibility Matching: A Public Health Perspective
Year: 2026
Type: article
Abstract: Sir, The burden of genetic diseases in India is largely attributed to consanguinity and recessive disorder carrier status. Premarital genetic compatibility testing provides an opportunity to lessen this burden through informed decision-making, which involves analyzing carrier states of prospective couples for common inherited conditions like thalassemia, sickle cell disease, and metabolic disorders. In several countries, premarital screening programs have been successfully implemented with measurable reductions in the incidence of genetic disorders. For example, in Iran, Turkey, and Iraq, premarital screening for thalassemia has been associated with reductions of more than 65% in births with thalassemia major.[1] In Saudi Arabia, a mandatory premarital screening programme has contributed to lowering at-risk marriages.[2] In India, most pilot programs and regional studies have concentrated on hemoglobinopathies. For instance, the premarital screening initiative in Gujarat’s Anand District screened nearly 2,200 college students and reported a carrier prevalence of about 7.06%, comprising 2.73% with β-thalassemia trait, and 3.82% with sickle cell trait.[3] Likewise, the “Sankalp” prenatal screening program conducted across five states reported an overall carrier rate of 6.8%, successfully identified at-risk couples and affected fetuses, and prevented one affected birth for roughly every 787 families enrolled.[4] Despite such promising results, premarital screening in India remains restricted to extended family testing, outpatient settings, or specific high-prevalence communities rather than being implemented universally.[5] The lack of a comprehensive national policy, limited public awareness, cultural sensitivities surrounding marriage, and consanguinity, and concerns about cost, privacy, and potential discrimination continue to hinder wider adoption.[6] A comprehensive and ethically guided approach is essential for the way forward. To avoid stigma or discrimination, premarital genetic screening should continue to be optional, private, and required to be combined with expert genetic counselling. Priority must be given to cost-effective carrier screening for genetic disorders, starting with hemoglobinopathies, that have a high prevalence and substantial clinical impact. Coverage can be improved through awareness-raising initiatives, integration into current healthcare systems, and subsidies for high-risk populations. Moreover, like the culturally accepted practice of Kundali matching, genetic compatibility testing should be promoted at the community level, encouraging families, and local groups to consider genetic risk in matchmaking decisions. India stands at a critical juncture in shaping its public health policy. The need of the hour is to invest strategically in well-structured, ethically governed premarital genetic screening programs. Ensuring confidentiality, voluntary participation, and access to professional genetic counselling will be key to safeguarding privacy and preventing social stigma. With such safeguards in place, India can uphold individual dignity and significantly reduce the burden of preventable genetic disorders at the population level. Yours sincerely, Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Author: Sneha Sagarkar
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $80
OpenAlex ID: W7124140549