Population based genetic counseling that promotes
public health goals is an appropriate health care
service. The genetic counseling center in Shiraz, southern
Iran serves most of the clients in the region. During a 4-year
period, 2,686 couples presented for genetic counseling. Data
files revealed that 85% had consanguineous relationships
(1.5% double first cousin, 74% first cousin, 8% second
cousin, 1.5% beyond second cousin). Most prevalent reasons
for referral were premarital counseling (80%), with 89%
consanguinity, followed by preconception (12%), postnatal
(7%), and prenatal counseling (1%). The most common
abnormalities in probands or relatives were intellectual and
developmental disabilities, hearing loss/impairment, and
neuromuscular dystrophies. Family history of medical
problem(s) and/or consanguinity was the main indication
for referral in nearly every family. Premarital consanguinity
poses unique challenges and opportunities. There is
considerable opportunity for genetic counseling and
education for couples in this population. The tradition of
consanguinity, which is likely to persist in Iran, requires
multidisciplinary agreement regarding the appropriate
process of genetic counseling. Effective genetic counseling
in Iran hinges on inclusion of data from genetic
counseling services in national genomic and epidemiologic
research programs.