22

During the last bioethics law revision, there was a debate about extending preconception screening to all French couples. As it was not enacted in the law, the procedure still remains reserved to couples with a high transmission risk of genetic disease. The concept of preconception screening indicates the possibility to offer, on a voluntary basis, a genetic test prior to conception, in order to search for rare mutations which could put the couple at risk of transmitting a genetic disease. The parents could then know their risk and prevent the birth of a diseased child. If authorized by the law, this screening may possibly affect 750,000 French couples each year. The vast majority of people already surveyed are in favor of preconception screening. People in favor of this screening advocate the possibility to avoid disability in children. On the other hand, some worry that this screening supports a perfectionistic vision of society or that it could create anxiety among future parents. We identified a lack of qualitative studies about the decision-making process of couples in the context of preconception screening. This led us to explore, through interviews with four couples, the reasons behind choosing and justifying preconception screening. This inductive approach revealed the questions, perceptions, reflections, tensions, and arguments that French couples could face in the event that preconception screening is authorized in the coming years.