Reproductive carrier screening: perspectives for a future implementation in Germany

Reproductive carrier screening (RCS) has made its way into the health care system in various countries. Current data suggest that 3.5 % of European couples are carriers for the same autosomal recessive disease and an additional 1.0 % of women are carriers of an X-linked disease. Once an increased genetic risk has been identified, couples can choose between a range of options, including prenatal or preimplantation diagnostics. Also alternatives apply such as gamete donation, reconsidering their desire to have children, adoption, or accepting a child with the condition. Improved reproductive autonomy is the main argument for RCS along with the concept of the best possible personalized medicine according to the current state of science and technology. The individual desire of couples to determine genetic risks for future children should be acknowledged and politically legalized. The authors outline the legal, genetic and reproductive, and ethical perspectives for RCS in the German healthcare system.