My future spouse refuses to do extra health checks beyond the tests required before marriage. What should I do?

Ask the reason calmly, because refusal usually comes from fear, not an intention to hide something. Some fear a bad result will derail the marriage, some are embarrassed by the procedure, and some see it as a sign of not being trusted. Explain your purpose: ‘I want us both to know each other's condition, so we can plan well.’ Offer to do the checks together on the same day, and agree to share the results openly. Start with the most relevant test, for example thalassaemia screening if there is a family history. If they still refuse without a reason, weigh this as part of how they handle honesty. See thalassaemia screening.