Carrier screening plays a vital role in identifying couples at risk of transmitting monogenic conditions to their offspring. Originally centered on specific single conditions and ethnic groups, this screening has transformed with the emergence of large-scale sequencing technologies, leading to a more inclusive approach called expanded carrier screening.
The evolution of expanded carrier screening platforms has seen continuous enhancements. Initial versions targeted specific genes, but subsequent iterations incorporated advanced techniques like full exon sequencing and copy number variant (CNV) analysis, significantly increasing sensitivity to pathogenic mutations across a broad spectrum of genetic disorders.
Expanded carrier screening panels cover a diverse array of diseases affecting different organ systems, including Cystic Fibrosis, Sickle Cell Disease, Tay-Sachs Disease, Spinal Muscular Atrophy (SMA), Duchenne Muscular Dystrophy (DMD), Fragile X Syndrome, Thalassemia, Hemophilia, Canavan Disease, and Gaucher Disease.
This approach provides prospective parents with a comprehensive analysis of monogenic conditions, enhancing their understanding of reproductive risks. It enables couples to make informed decisions preconceptionally, empowering them to take proactive measures to reduce the risk of having a child with an affected pregnancy. Options include in vitro fertilization (IVF) with preimplantation genetic testing for monogenic disease (PGT-M), using donor gametes without pathogenic variants, adoption, or choosing to avoid pregnancy altogether.
Whether implemented preconceptionally or during pregnancy, carrier screening equips couples with knowledge for informed choices about prenatal diagnostic testing and pregnancy management. The integration of expanded carrier screening into clinical practice signifies a significant stride toward personalized and comprehensive reproductive healthcare, offering a well-rounded approach to addressing genetic risks in family planning.