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Rajeev Agarwal: Preconception Care Should Be about More than Preparing the Body for Pregnancy

Rajeev Agarwal/LinkedIn

Sep 26, 2026, 18:20

Rajeev Agarwal: Preconception Care Should Be about More than Preparing the Body for Pregnancy

Rajeev Agarwal, Director of Renew Healthcare, shared on LinkedIn:

“You may be perfectly healthy – and still carry a genetic condition that could affect your child.

This is one of the biggest gaps I see in preconception care.

We check sugars. We check thyroid. We prescribe folic acid. But how often do we ask:

‘Have you been screened to see whether you carry a serious recessive genetic condition?’

Take β-thalassemia. In India, approximately 3.7% of the general population are estimated to be carriers – around 1 in 27 people. Most carriers are completely healthy.

If both partners carry a pathogenic variant for the same autosomal recessive condition, each pregnancy typically has:

25% chance of an affected child
50% chance of a carrier child
25% chance of inheriting neither variant

And thalassemia is only one condition.

Expanded Carrier Screening (ECS) can assess carrier status for many serious autosomal-recessive and X-linked conditions, ideally before pregnancy.

Being a carrier does not mean you need IVF. The important question is whether both partners’ results create a significant reproductive risk.

If they do, genetic counselling can help couples understand options such as natural conception with prenatal diagnosis, IVF with PGT-M, or donor gametes in selected circumstances.

The goal is not to create ‘perfect babies.’ It is to give couples information before they have to make decisions during a pregnancy.

Preconception care should be about more than preparing the body for pregnancy. It should also include understanding the genetic risks we may unknowingly carry.”

Preconception Care