Can AS genotype marry AS genotype sickler and bear Non-sickler children? This question has broken a lot of relationships and left many devastated and heartbroken because the popular answer you get on the street is NO. It is not possible.
Doctor’s consulting room has seen a lot of tears and frustrations because of this question too. But technology has reminded us in many ways that impossibility is nothing. Follow this article word for word to find out what sickle cell is, how the genotypes AS and AS interact and how they can bear non-sickler children.
In the simplest of terms, let’s explain sickle cell disorder.
The body has two types of blood, the red blood cells and the white blood cells. These red blood cells are the ones that carry oxygen around your body. So for each time you breathe in, the red blood cells carry the oxygen you breathed round your body- your brain, your legs, your stomach and this is what makes these parts of the body function properly.
The red blood cell has the shape of a biconcave discoid, this is the shape of a normal red blood cell.
But, the red blood cells of sickle cell patients are shaped like a sickle, this makes it difficult for them to move easily, so when the red blood cells carry their oxygen, they are not moving fast as normal, they are obstructed. That is why sicklers fall sick due to deficiency of oxygen in certain areas.
For everybody, red blood cells die, for normal red blood cells it dies and replenishes every 120 days that is 3 months, but for sicklers it is 10 to 20 days at most before the red blood cells die leaving them with a deficiency of blood cells called Anemia.
In time, it leads to organ damage which may or may not include the skin, bones, joints, brain, eyes, lungs, heart, spleen, liver, kidneys and penis.
There’s no cure for most people with sickle cell anemia. But treatments can relieve pain and help prevent complications associated with the disease.
How can a child get sickle cell anemia?
For a baby to be born with sickle cell anemia, both parents must carry a sickle cell gene.
There are four hemoglobin genotypes (hemoglobin pairs/formations) in humans: AA, AS, SS and AC (uncommon). SS and AC are the abnormal genotypes or the sickle cells. All genotypes are inherited from both parents.
Everyone has two copies of the hemoglobin gene in every cell in their body (apart from eggs and sperm). They get one from their mother and one from their father. When eggs and sperm are made, only one of the two genes goes into each egg or sperm cell. This is so that when the egg and sperm come together to make a new baby this new person has two genes in every cell in their body as well. The genes the baby gets will therefore depend on the genes carried in its parents.
The disease develops when a baby receives two copies of the mutated HBB gene: one from the mother and one from the father. A person with just one copy of the mutated gene and one healthy gene is said to have the sickle cell trait (AS). Although they are a carrier of the disease, these people generally do not display any symptoms but can pass the disease to their children.
When someone with AS genotype marries an AS genotype- they give at least one of their children the SS genotype.
Below are the set ground rules to avoid sickle cell and have non-sickler children
- AA can marry anybody
- AS is better off with AA
- AS and AS, AS and AC are too risky
- Two sickle cells = avoid reproducing at all cost.
At all costs obey these metrics but in strange cases where you have found yourself in a difficult situation, say the genotype results were wrong and you have gone ahead with the union, there is still a way out.
This article tells you that AS can marry As and not have non-sickler children here’s how.
In countries like the United states, abortion is legal. In countries like Nigeria, medically engineered abortion is legal.
The genotype of the foetus is tested through to check for the Sickle cell trait and if established, the mother is asked to abort the baby and try again. As taboo-ish as abortion will sound to many who says it is the killing of a child, brining a child into this world as a sickler gives the child a pre existing short life span expectancy of 47 to 50 excruciating years. Most of them die below age 15.
Which is better, having a child who will die in your arms or foetus who is blood and water.
IVF and PGT
In Vitro Fertilization (IVF) is synonymous with infertility but that is not true. Most people think only couples who are unable to conceive use the IVF method.
Couples who have a high risk of SS conception can have their eggs and sperms fertilized and planted. Wherefore up to 6 eggs are fertilized, only those who are sickle cell free are implanted. This is done through Preimplantation genetic testing (PGT) which is a procedure during which fertility specialists can test embryos for genetic conditions.
Parents can adopt non-sickler children as their own. This is a safe method as should be considered by parents who have a high risk of producing sickler children.
With these options available in clinics even in Nigeria, a couple should not have to bring sickle cell children into this world. The safest method remains to follow the ground rules as shared above.
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