In India, before marriages there are compatibility concerns on various issues but medical issues are never given their due importance. People tend to overlook or are unaware of the health aspect of the marriage. Premarital checkup should be conducted for a soon-to-be-married couple in order to identify if there is any injury with genetic blood diseases, such as sickle-cell anemia – or infectious diseases, such as hepatitis B, C, and HIV/ Aids. It would provide the couple with a medical consultation on the odds of transmitting any discovered diseases and also to give options and alternatives to plan a perfectly healthy family. A premarital check-up also helps the couple on how to take care of each other on the basis of their health history. Basically, premarital check-up can be done anytime, however, the right time is six months before the wedding. It is vital for couples to be screened to help them understand their medical status and help them take the necessary precautions or treatments. Tests that should be done before getting married: Genotype: This test will reveal whether a person is a carrier of the sickle-cell gene. This test is a very important test as if both the partners carry the sickle cell gene, then they are in a high risk of having a baby born with a serious disease. Thalassemia Test:  This test is done to detect the thalassemia gene in a couple. Thalassemia is an inherited blood disorder characterized by the production of big, abnormal hemoglobin. A thalassemia major patient may need a regular blood transfusion. If both parents carry the thalassemia gene, their child may have completely normal blood, or it may be a carrier or may have a severe thalassemia disease. In each pregnancy, there is 25% chance that their child will have normal blood, 50% chance that the child will be a thalassemia carrier and 25% chance that the child will have thalassemia major disease. With a test called thalassemia profile (HPLC), a couple can know whether they carry the trait and if they do, they can implore assisted reproductive technology to prevent their babies from inheriting the disease. HIV and Other Sexually Transmitted Disease: Sexually transmitted diseases like HIV, Hepatitis B, Hepatitis C, and Syphilis are chronic and serious conditions which may put strain to a marriage. Many countries have laws that require you to tell your partner about your HIV status before vowing in. It gives an option to make an informed decision to go ahead with the marriage. This will reduce the risk of infertility and miscarriages during the marriage. Blood Group Testing: ABO-RH testing is important to screen out the RH-factor incompatibility and counsel women about the risks involved in pregnancy. If known in advance the doctor can give anti-Rh immune-globulin shots during her first pregnancy. The Rh immune-globulin shots work like a vaccine, which prevents the mother’s body from producing any dangerous Rh antibodies that can cause serious complications in the new-born or complicate any future pregnancies. Fertility Test:  This test is done to ascertain the fertility of a couple. More often, a couple is unaware that they have fertility problems until about 2 or more years of marriage and after unsuccessful trials at conceiving. The test is really important as fertility issues can be concluded earlier without going through any social or emotional trauma related to barrenness. Fertility test typically includes a semen analysis for the man to assess for male fertility and test for ovulation for the woman. Screening for Chronic Diseases:  Chronic diseases like diabetes and thyroid function problems must be screened for. This is because they have negative effects on the outcome of a pregnancy. Any couple intending to marry must know their thyroid and diabetic status because of the association of these conditions with infertility and high-risk pregnancies. Ideally, both the sides must discuss the “family medical history” in the presence of a doctor, as a comprehensive medical checkup for the prospective spouse is equally or more important than matching Janam patris. But the problem is with the acceptance of this advice. In a country like India, where parents hide even serious illnesses like heart problems, psychiatric problems, epilepsy, and even diabetes type I at the time of marriage, it may be too much to expect of such pre-marital checkups. But looking into several cases of disastrous consequences of “medically incompatible marriage”, it seems prudent to be considered mandatory.