Send message to Authors

Paper short abstract

Originating in communities with a high prevalence of genetic conditions, the contemporary use of 'genetic compatibility' promotes universal preconception testing through responsibilisation of prospective parents, normalising identifying and acting on genetic risk.

Paper long abstract

Over the last 15 years, expanded carrier screening (ECS) has emerged as a technique for prospective parents to identify their joint likelihood of transmitting a large number of disease-causing recessive genes to their future children. It is only available commercially in the UK, though offered in some countries through their public health service. This paper examines the framing of ECS in the online marketing materials of fertility and genetics clinics, specifically, the deployment of the term ‘genetic compatibility’ in three routes to pregnancy: unassisted conception, assisted conception and donor conception.

Through a thematic analysis of web content, we show that ‘genetic compatibility’ is used to position ECS as a preconception test for everyone planning conception, promoting universal genetic surveillance (Petersen and Pienaar, 2021). Normalising that “everyone is a carrier” can make a positive result appear commonplace, while framing the 2–4% of couples with a positive result as 'incompatible' misrepresents the outcome as at-risk or not-at-risk, rather than at an increased risk. ECS then serves as an avenue for medicalising and responsibilising prospective parents before conception has even occurred (Waggoner, 2017).

We argue that presenting ECS in this way is a form of reproductive governance of preconception couples, holding both partners jointly responsible for the health of their future children. The expectation to anticipate risks compels preconception risk management, where risk is read not only into routine activities such as eating and exercise, but materialised through the normalisation of genetic testing, and the evasive action expected if results are positive.