"What if we find something we didn't expect?"

That question is exactly why a premarital health screen exists. Not to introduce doubt into a relationship, but to replace it with something more useful: clarity.

Here is what a screen with Dr Ryan Lee, Obstetrician and Gynaecologist at Thomson Women’s Clinic (Woodleigh), can tell you — and why couples who go through it often say the same thing afterwards.

"I just wish we had done this earlier."

Here are three things a premaritial health screening can reveal about you, your partner, and your shared future

1. You may both be carrying genetic conditions that could affect your future children

After 12 years of premarital consultations, one question surfaces almost every time, usually after everything else has been covered.

"Will our children be healthy?"

"It is not a question couples expect to asking at this stage," says Dr Ryan Lee.

"But understanding your combined genetic profile before marriage gives you and your partner a much clearer picture of what family planning may look like for you both."

Each of us carries genes that produce no symptoms on their own. Individually, neither partner would ever know. But when two carriers of the same recessive condition conceive, the picture changes, conditions such as thalassemia, G6PD deficiency, and cystic fibrosis can be inherited this way.

At Thomson Women’s Clinic (Woodleigh), Dr Ryan Lee offers a premarital health screen designed to give couples a clearer picture of the genetic and reproductive health factors that may affect their future children

Here is what each component examines, and why it matters.

The blood tests in this screen — 14 components in total for the female partner — cover three areas:

• Carrier and blood status

A Full Blood Count can indicate thalassaemia carrier status.When both partners carry the trait, there is a meaningful likelihood of a child being affected. Knowing this before conception opens the conversation about options.

• Immune status

Screening for Hepatitis B, Hepatitis C, and Rubella IgG establishes whether the female partner carries infections that can be transmitted to a child during pregnancy or delivery, and whether immunity to Rubella is in place before conception.

• STD status

HIV and Syphilis screening are included as both infections can be passed from mother to child during pregnancy, with serious consequences if undetected.

Dr Ryan explained that: “A positive result does not mean someone has been unfaithful. Both infections can be carried silently for years, with no symptoms,  from long before the current relationship.

"Knowing early simply means both mother and child can be protected in time.”

What if the results are bad? Do we cancel the wedding? 

A result that raises a question is not a reason to stop. It is a reason to speak to a doctor who can help you understand what that question actually means for your future.

Additional genetic testing is available as an add-on

The base screen does not include expanded genetic testing, but it can be added:

• G6PD deficiency:

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common genetic blood disease that can cause red blood cells to break down prematurely (haemolysis). 

This medical condition can lead to haemolytic anaemia, which occurs when red blood cells are destroyed faster than they can be replaced by the body. 

• Cystic fibrosis:

Cystic fibrosis is a genetic condition that causes thick, sticky mucus to build up in the lungs and digestive tract. This medical condition can lead to long-term lung infections and digestive issues. 

• Sickle cell anaemia:

Sickle cell anaemia is a genetic blood disease characterised by abnormally shaped red blood cells (crescent or sickle-shaped) that can block blood flow and cause pain and organ damage.

Dr Ryan can advise which add-ons are relevant based on your family backgrounds during the first consultation. 

2. Both of you may have reproductive health factors worth knowing about, before you start trying 

Dr Ryan Lee has consulted with more than 100 couples at Thomson Women’s Clinic (Woodleigh). Some arrived as engaged couples planning ahead. Others came as married couples who had been trying to conceive for months, or longer, without success. 

"What stays with me," he says, "is not just the medical complexity. It is the strain it puts on a marriage. The self-blame. The quiet distance. Many of these conversations could have started much earlier." 

Two components of the Premarital Health Screen speak directly to this. 

• Semen Analysis — because a child's health begins with both parents

There is a long-held assumption in Singapore, and across much of Asia, that reproductive health is primarily a woman's concern. The evidence does not support this. 

Male factor fertility is a contributing element in a significant proportion of couples who experience difficulty conceiving. Stress, poor diet, smoking, alcohol, and environmental exposures all show measurably in sperm count, motility, and morphology.  

Semen Analysis gives couples an honest picture of male reproductive health that no amount of guesswork can replace, and where results indicate concerns, early awareness opens the door to meaningful change before conception becomes the priority. 

Suggesting a screen can feel like raising doubt about each other. In practice, most couples find the opposite — going through it together is one of the more quietly bonding things they do before the wedding. 

• Pelvic Ultrasound Scan 

Conditions such as fibroids, ovarian cysts, and uterine abnormalities frequently present no symptoms A Pelvic Ultrasound Scan examines the female reproductive system for structural concerns that would otherwise go unnoticed until they become relevant (often at the worst possible time). 

3. What the screen finds is the beginning of the conversation, not the end of it

"Doctor, how can I improve my health, for her sake?" 

Dr Ryan Lee hears this more than most people might expect. Responsibility in a marriage, he believes, is not measured by the grandeur of a wedding or the size of a ring.

It is measured by the quiet, consistent accountability two people offer each other, and often before the vows are even spoken. 

Some conditions carry no symptoms. That does not mean they are not there, or that nothing can be done. 

• For him: 

Semen Analysis results showing concerns around sperm count, motility, or morphology are frequently linked to lifestyle factors. Smoking, alcohol, chronic stress, and poor sleep are measurable contributors — and in many cases, addressable with the right guidance. 

• For her: 

Hormone markers such as AMH and TSH can reveal declining ovarian reserve or thyroid irregularities that respond well to early attention. Where the Pelvic Ultrasound identifies fibroids or cysts, knowing early allows for monitoring or management well before conception becomes the priority. 

• For both: 

Low immunity to Rubella or undetected Hepatitis B can be addressed through vaccination or treatment, straightforward steps that carry meaningful protective value for any future pregnancy. 

For most couples, the screen confirms what they already hoped — that there is nothing to be concerned about. That confirmation, and the peace of mind it brings, is itself something worth having. 

Two consultations, not one 

This is where Dr Ryan's approach differs from a standard blood draw and report. 

The first consultation takes place before any tests are conducted. This is where Dr Ryan sits with the couple, understands their health histories, their family backgrounds, and their plans for starting a family.  

It is a conversation, not a checklist, one that shapes which results in paying closest attention to, and why. 

The second consultation follows once all results are in.  

Rather than handing over a report and leaving couples to interpret it alone, Dr Ryan walks through every finding together with them, explaining what the numbers mean in plain language, addressing concerns, and where relevant, outlining the options available to them moving forward. 

You will not leave with just a report. You will leave with a clear picture of where you both stand, and what, if anything, the next step looks like. 

What is included in the Premarital Health Screen at Thomson Women’s Clinic (Woodleigh) 

Premarital Health Screen (Woodleigh) — SGD 545 

For her: 

• Comprehensive Blood Tests across 14 components: 
  • Blood status: Full Blood Count, Blood Group & Rhesus Factor
  • Immune status: Hepatitis B, Hepatitis C, Rubella IgG
• STD status: HIV, Syphilis
  • Hormone levels: FSH, LH, Oestrogen, Prolactin, Progesterone, TSH, AMH
• Pelvic Ultrasound Scan to examine the reproductive system for any structural abnormalities

For him: 

• Semen Analysis to assess sperm count, motility, and morphology

For both: 

• Two consultations with Dr Ryan Lee — one before testing to review reproductive health history, and one after to discuss results and outline any relevant options

Optional add-ons: Expanded genetic testing (G6PD deficiency, Cystic fibrosis, Sickle cell anaemia) 

Every couple's picture will look different. What the screen offers is not a verdict — it is a starting point for an informed, honest conversation between you, your partner, and your doctor. 

To find out more or to schedule a consultation with Dr Ryan Lee at Thomson Women’s Clinic (Woodleigh), you can Whatsapp us at +65 8684 0153. 

FAQ 

Can we undergo premarital screening after marriage? 

Is premarital screening only for couples planning to have children? 

Why is a thalassaemia test done before marriage? 

Thalassaemia is a hereditary blood disorder. If both partners carry the gene, there is a risk of passing a more severe form to a future child. Testing early gives couples the time and information to: 

• Understand the genetic risks
• Explore options for family planning and medical support
• Make informed decisions together.