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Re-Examining Genetic Screening and Oral Contraceptives: A Patient-Centered Review.

Bridget Hiedemann1, Erin Vernon2, Bonnie H Bowie3

  • 1Department of Economics, Seattle University, 901 12th Avenue, Seattle, WA 98122, USA. bgh@seattleu.edu.

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Routine thrombophilia screening before combined oral contraceptives (COCs) is not patient-centered. Optional screening and improved education are recommended for personalized care.

Keywords:
combined oral contraceptivesgenetic screeningpatient-centered carethrombophilia screening

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Area of Science:

  • Reproductive Health
  • Genetics
  • Pharmacogenomics

Background:

  • WHO classifies combined hormonal contraception as high risk with thrombogenic mutations.
  • Routine thrombophilia screening before combined oral contraceptives (COCs) is not recommended due to cost and low prevalence.

Purpose of the Study:

  • To examine arguments for and against thrombophilia screening before COCs from a patient-centered care perspective.
  • To evaluate cost, prevalence, and other factors influencing screening decisions.

Main Methods:

  • Patient-centered review of empirical evidence on thrombophilia screening.
  • Analysis of genetic testing attitudes and policy shifts.

Main Results:

  • Current one-size-fits-most approach contradicts patient-centered care.
  • Individual factors like risk tolerance and genetic discrimination concerns necessitate personalized approaches.

Conclusions:

  • Advocating for enhanced patient and provider education on thrombophilia screening implications.
  • Recommending optional thrombophilia screening before initiating COCs for personalized risk assessment.