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Expanded carrier screening (ECS), which screens prospective parents for the carrier status of a large number of recessive disorders have recently become offered more widely [1]. Many prospective parents undergo ECS each year to learn about their risk of having a child affected by a disease [2]. The most commonly discussed benefit of ECS is its potential to enhance reproductive autonomy of prospective parents by allowing them to make informed reproductive decisions in line with their values [3-5]. This is particularly pertinent to couples found to be at risk of having an affected child (ie Lcarrier couplesL), who may choose to alter their reproductive plans. If identified preconceptionally, a carrier coupleLs options include in vitro fertilization through pre-implantation genetic diagnosis to select against embryos with the condition they carry, using donor gametes, or foregoing pregnancy, pursuing instead adoption, or …