Family Planning with Premarital Health Screening and Preconception Genetic Screening

Program	Promotion Price (THB)
Premarital Health Screening for Men \| Details	8,000 ~~12,000~~
Premarital Health Screening for Women \| Details	14,000 ~~18,000~~

Preconception Genetic Screening covers 400 genes associated with 400 illnesses	Promotion Price (THB)
1 person (Male / Female)	30,800*
Couple (Male and Female)	52,360* ~~30,800 per person~~

Terms and Conditions:

Prices include doctor’s fee and outpatient service fee.
*Prices do not include doctor’s fees or hospital service fees
Please make your appointment at least one day in advance
Receive services at the Women’s Health Center, 1st Floor, Building 2, Samitivej Sukhumvit Hospital

What is a Premarital Health Screening?

A Premarital Health Screening is a screening to assess overall health in order to prevent the transmission of communicable diseases between spouses, and to protect future offspring who may unknowingly be placed at risk in the case of parents being carriers of disease. This screening helps mothers prepare for pregnancy, and can help families plan to give birth to healthy children. Generally, screening includes the following:

Blood Tests

ABO blood type: identifies a person’s blood group in order to make treatment easier in case of emergency.
Rh Factor: most people are Rh+ but some may find that they are Rh-. Some Rh- women will be at greater risk of a miscarriage or other serious problems occurring during pregnancy.
Hemoglobin (HB) typing: this screening detects hemoglobin irregularities related to Thalassemia. This disorder is genetically transferable, meaning that if both parents are carriers of the disease, their offspring’s health will be affected.
Complete Blood Count (CBC)
HBsAg: if this virus is detected it means the recipient is a carrier of the disease, which can be transmitted via sexual intercourse or through contact with blood. If proper precautions are not taken, it could lead to a fetus becoming infected.
Rubella IgG: if no antibodies are detected, recipients are advised to receive a rubella vaccination and take contraception for at least 3 months. This is because a rubella infection during pregnancy could lead to miscarriage, or the child being born with a disability.
Human Immunodeficiency Virus (HIV): if the virus is detected, precautions can be taken to prevent its spread via sexual contact by using condoms, while contraception may also be used to protect any offspring from contracting this disease.
Syphilis screening: if either party is found to have syphilis prior to a marriage, they can receive proper treatment to cure them of the disease so that they pose no risk to the other party. This disease is more often diagnosed following a blood test than when symptoms present.
Blood tests used to detect other diseases such as herpes and toxoplasmosis

General Physical Examination Performed By Doctors

Some women may require internal examinations, including cervical cancer screening, or a lower abdominal ultrasound to assess the uterus and fallopian tubes, as doctors deem appropriate.

What is Preconception Genetic Screening?

Preconception genetic screening, also known as carrier screening, is an option for individuals or couples planning to have children. The screening involves analyzing DNA to determine whether the individual being screened is a carrier of inherited gene mutations associated with genetic disorders. While carriers typically do not show symptoms of the disease, they can pass on mutated genes to their offspring, potentially resulting in the inheritance of genetic disorders, making this information of particular use in informing family planning decisions. Such genetic disorders can be hidden in parents who are carriers and can be found in both Thai and foreign populations. Currently, such screening can detect more than 400 genetic disorders.

Which Groups Are Suited to Preconception Genetic?

Any couple planning to conceive.
Couples who have genetic disorders or are carriers of recessive genes, or who have a family history of genetic disorders.
Couples experiencing difficulties conceiving and who would like the best chance of giving birth to a healthy child.

What Are the Benefits of Preconception Genetic Screening?

It enables doctors to identify genetically transferable diseases in a couple before they have children. Such disorders are found in around 3-5% of the general population. In cases where a genetic disorder that can be passed on to a child is detected during screening, there is no need for parents to feel shocked or anxious. There are now reproductive specialists on hand to offer advice related to the process of in vitro fertilization.

In addition to selectively screening embryos, doctors will also assess the readiness of the endometrium which plays a crucial role in successful reproduction. This is done with a uterine receptivity test alongside mitochondrion screening, as these are the power sources of embryonic cells that can help increase the chances of successfully conceiving by up to 50%.

Preconception genetic screening provides analysis of over 400 potentially problematic recessive genes, giving doctors the chance to conduct a search for any genes carrying serious diseases before they are allowed to disable and debilitate vital organs in the unborn child.

What to Do If You Wish to Undergo Preconception Genetic Screening

Preconception genetic screening is possible after consulting your OB-GYN. It involves taking a blood sample. There is no need to abstain from food or drink prior to this process, and the results of the test will be available approximately three weeks after the sample is sent to the laboratory for testing.

It is easy to see how preconception genetic screening is another key tool that all potential parents should be careful not to overlook due to the vast number of hidden illnesses which may be lurking inside our DNA, ready to disrupt the health of your little ones. Preconception genetic screening is not merely something that can benefit parents. It can also be crucial in ensuring the health and wellbeing of your unborn child.

If Both the Father and Mother Are Carriers of a Genetic Mutation, What Risks Will the Child Face at Birth?
There are two common types of genetic transmission from parent to child: autosomal recessive inheritance and X-linked recessive inheritance.

1. Autosomal Recessive Inheritance:

If both parents are carriers of a genetic disease with a recessive gene on an autosome (autosomal recessive), the offspring have the following risks:

25% (1 in 4) chance of having the disease
50% (2 in 4) chance of being a carrier

2. X-linked Recessive Inheritance:

If the mother is a carrier of a genetic disease with a recessive gene on the X chromosome (X-linked recessive) and the father is not affected, the offspring have the following risks:

For daughters:
- 50% (1 in 2) chance of being a carrier
For sons:
- 50% (1 in 2) chance of having the disease

Genetic diseases may not be visible through ultrasound examinations. Preconception Genetic Screening at the genetic level can help prevent conditions like thalassemia, spinal muscular atrophy (SMA) and cystic fibrosis. This screening enables the detection of over 400 disease-carrying genes, covering 400 diseases. Results are 99.5% accurate (information updated March 2024).

6 Genetic diseases hidden among the genes of parent carriers commonly found in both Thai and foreign populations include:

Thalassemia Syndromes

These diseases result from abnormal red blood cells and are the most common inherited genetic disorders in Thai people. If both parents are carriers or have the trait, there is a 25% chance of the child developing thalassemia. However, if both parents have thalassemia, the child has a 100% chance of inheriting it.

Spinal Muscular Atrophy (SMA)

A genetic disorder that is inherited as a recessive gene. Spinal muscular atrophy affects individuals of all ethnicities and is a disease of motor neuron deterioration, resulting in muscle weakness and degeneration due to a lack of signals being sent from the spinal cord to the muscular system. It can be present from infancy to adulthood.

Cystic Fibrosis

It is an inherited genetic disorder resulting from abnormalities in genes. It affects the respiratory and digestive systems, resulting in thickening of secretions in various organs such as the lungs, liver, pancreas and intestines, causing illness in the respiratory, digestive and reproductive systems. There is currently no complete cure for this disease, and treatment is focused on symptom relief, improving patients' quality of life and reducing the risk of complications.

Fragile X

It is a condition that causes developmental disabilities and intellectual impairment. It is inherited through the dominant X chromosome and is both more common and more severe in males than in females. Some individuals may also exhibit autistic traits, such as a short concentration span, restlessness, and language and communication difficulties.

G6PD (glucose-6-phosphate dehydrogenase) Deficiency

It is an inherited genetic disorder passed from parents to offspring through the X-linked recessive inheritance pattern. It results from abnormalities in the G6PD gene located on the sex chromosome. For carrier mothers, there is a 50% chance of having affected sons and a 50% chance of having carrier daughters. (Source: Thai Society of Hematology, https://tsh.or.th/Knowledge/Details/43, https://www.tsh.or.th/Knowledge/Details/29 )

Hemophilia

It is a type of inherited genetic disease found worldwide, where blood cannot clot properly, leading to severe bleeding episodes. If not controlled, it can result in disability or death, as bleeding can occur spontaneously or after only minor injuries. It is inherited from carrier mothers to offspring through X-linked recessive inheritance. For carrier mothers, there is a 50% chance of having affected sons and a 50% chance of having carrier daughters. This condition arises from a deficiency in blood clotting factors and can be classified into two types:

Hemophilia A is the most common type, resulting from a deficiency of factor 8 protein in the blood.
Hemophilia B occurs due to a deficiency of factor 9 protein in the blood.

Both factors play a crucial role in blood clotting. The incidence of hemophilia in the Thai population ranges from 1:13,000 to 1:20,000, while in North American or European populations, it's approximately 1:5,000. (Source: ttps://www.roche.co.th/solutions/focus-areas/haematology/haemophilia, Thai Society of Hematology, https://tsh.or.th/Knowledge/Details/90)