Technology has evolved and so has medicine since we learnt about the Sickle cell Anemia also known as Sickle cell disease (a recessive disorder) that could result from Genotype incompatibility. And also people will tell you now that they know a lot of people who have the condition and are 40 and above doing fine unlike before, when they would die younger. So this could cause you to start to wonder, should Genotype incompatibility still be a deal breaker for marriage relationship?
The question is understandable. But before I comment on it let’s remind you of what Genotype is and what’s compatible and what’s not.
Dr. Ademola Peter in one of his articles sometime ago on Genotype compatibility and Blood groups said this about what Genotype is.
Genotype simply refers to hemoglobin gene constituents. Genes are always in pairs and overall expression depends whether dominant, recessive or X-linked. So there is no problem when one of the genes is abnormal e.g. AS, AC. This is called a carrier state (Sickle cell trait). Only when the two are abnormal then there is a great problem.
The great problem the doctor referred to above that we have to avoid when choosing a marriage mate is Sickle cell anemia.
Sickle cell anemia is one of a group of inherited disorders known as sickle cell disease. It affects the shape of red blood cells, which carry oxygen to all parts of the body.
Red blood cells are usually round and flexible, so they move easily through blood vessels. In sickle cell anemia, some red blood cells are shaped like sickles or crescent moons. These sickle cells also become rigid and sticky, which can slow or block blood flow.
There’s no cure for most people with sickle cell anemia.
Compatible Genotypes
The Genotypes in humans are AA, AS, AC, SS.
We care about Genotype compatibility for two people intending to marry because if they have children like most married couples choose to do, they can pass the abnormal hemoglobin to their child or children.
Normal Hemoglobin
AA
Abnormal Hemoglobin
AS and AC (Medically known as having the sickle cell trait).
Then someone with SS is a person with the Sickle cell anemia.
To avoid having a child with Sickle cell anemia, a person with the abnormal hemoglobin which is translated as AS or AC MUST NOT marry someone who also has abnormal hemoglobin. However, the person with normal hemoglobin AA can marry someone with the abnormal hemoglobin and even someone with the Sickle cell disease without fear of creating any medical problem for their unborn children.
Please note that there are two things, sickle cell trait and sickle cell disease. They are NOT the same thing. While one is a serious medical condition (Sickle cell disease) the other is not a medical condition. Although if you research further on sickle cell trait you will come to find that it is possible for people with sickle cell trait to experience some conditions that can lead to serious health issues, but this rarely happens according to experts. Most people with sickle cell trait go on to live very normal lives. In reality I am yet to see a person with the Genotype AS having any health issue due to being a carrier of the defective gene.
So for Genotype combination for marriage, this means:
AA and AA – Compatible (Avoids passing the sickle cell trait to their child or children)
AA and AS or AA and AC – Compatible (but there is a chance of passing the sickle cell trait to their child or children).
AA and SS – Compatible (but ALL their children will have the sickle cell trait, meaning they will all be AS).
AS and AS or AC and AC – NOT compatible (there’s one in three chances that they will have a child with the disease, worse it’s possible that ALL their children will have it).
AS and SS or AC and SS – NOT compatible (there’s a one in two chances that they will have a child with the disease, worse it’s possible that all their children will have it.).
SS and SS – NOT compatible (All their children will have the Sickle cell disease).
Finally to round up the biological information on compatible Genotype for marriage let’s answer some commonly asked questions.
What happens if Genotype AS marry AS?
Like I said above, there’s a chance of conceiving a child with SS Genotype, a Sickle cell anemia child. Not that it is guaranteed to happen. But there’s a one in three chances of it happening. When AS marries AS the possible Genotype they will create are AA, AS and SS.
Can AS marry AA and give birth to AA?
As I have said above, yes they can.
Can AA marry SS and give birth to SS?
No. There’s no chance of that happening.
So is Genotype Compatibility for Marriage Still as Serious as it Used to Be?
I remember when I got to know about Genotype, I was barely an adult. Actually a Christian sister had lost her young son and I went with my mom to visit her. We didn’t know the cause of his death prior to visiting them. But when we got there the woman was telling some of her guests what happened to him, and mentioned that he was of the Genotype SS.
My mom hadn’t heard about the condition before and therefore was shook to hear it was life threatening. I know she was shook because the next day she took my sister and I (we were the two children still at home) and her two grandchildren then to a lab to check our Genotype. Fortunately our results were all AA including my mom’s. I repeated that test at least three times after that initial test before getting married. That is because of how important it is that one be compatible with their intended to avoid long term painful consequences both for the unborn child/children and their parents.
So to answer the question, technology may have evolved and medicine may have advanced, but it is still as important as it has always been to have a compatible Genotype with your intended, for most of us anyway. For the few rich who have lots of millions of Naira to spare and don’t mind the time and trouble involved, in the name of love, IVF now offers a way out for incompatible partners to have kids with zero chance of them having Sick cell Anaemia.
There’s a Way for AS and AS to Get Married and Have Kids Who Are Not Sicklers
In Nigeria we call those with Sickle cell Anemia Sicklers. Can AS and AS get married now and have kids who don’t have Sickle cell disease? The answer is Yes. Like I said at the beginning medicine has advanced. Here’s the solution to Genotype AS + AS.
The process that enables this is called Preimplantation Genetic Diagnosis (PGD) and it
refers specifically to a diagnostic method that allows intending parents to avoid the risk of passing on a known genetic disease to their child/children.
And one of such Genetic diseases is Sickle cell. The procedure has a 99.9 percent success rate.
However, any couple doing the procedure will have to artificially conceive all their children because it is the embryo that has been confirmed to be free of the disease that will then be implanted in the woman, making natural conception not an option for such ones.
If this is something that interest you and you want more information on how the process works and the actual cost, then please do some research and book appointment with a good fertility clinic. But I can tell you though that PGD is not cheap. And the fact that you have to conceive artificially means having a baby at the end of the day comes with all the cons that comes with IVF treatment, one of them being that conception is not guaranteed even after spending all the millions.
My Advice on Genotype Compatibility
I know it is not easy but trust me it is easier to wait however long it takes you to wait for a partner whose genotype is compatible with yours and that loves you, than it is to give in and marry someone whose Genotype isn’t compatible with yours because you think with love nothing else matters. It matters dear, except you won’t see how much it matters now until it will be too late.
It is true that when AS marries AS there’s a chance that they won’t have a sickle cell child. But there’s also a chance that all their kids will be SS. As long as that chance exists that you will have a child that has the disease, it is not worth it. I’ve been opportune to read about the condition from some of those who suffer from it and honestly it’s not something you wish on your enemy not to talk of someone you love. The condition is described with a lot of pain whenever there’s an episode. And the sufferer is in and out of the hospital for most of their lives. The condition also limits them sometimes from socializing and attending to their studies.
The sickle cells die early, which causes a constant shortage of red blood cells. Also, when they travel through small blood vessels, they get stuck and clog the blood flow. This can cause pain and other serious complications (health problems) such as infection, acute chest syndrome and stroke.
And aside the pain and trouble of having a child who is always sick, there’s the financial burden too. Keep in mind the condition has no cure. It can only be managed.
What if you just agree with your intended not to have kids, and never have to be bothered by Genotype compatibility. That works. But I don’t recommend it. The reason is because one or both partners down the road can have a change of mind and start to want kids, maybe due to peer pressure, I have seen it happen, so then what. Again, it’s not worth it.
Finally, now that we’ve clarified that Genetic compatibility for marriage is still very important, make sure to run Genotype test a number of times in different laboratory/hospital to be completely sure of your status. And this is whether you’re AA or AS. Stories abound of labs giving wrong results to people. So go to competent labs to reconfirm your Genotype.
If you did a Genotype test during your University/Polytechnic admission days, please don’t trust the result. I speak from personal experience. Those people sometimes mix up samples and give wrong result to students.
Also no second guessing your Genotype status, even when your parents claim to both be AA, still go check yours. It’s possible they are wrong. You can’t afford to second guess and be wrong. Also I’m sure there are some people out there who are not being told who their biological father is. That’s most likely not your case but you get the point 😊 .