Method to avoid a sickle cell SS child being an AS - AS Genotype Couple


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The most prominent blessing to couples is having atleast a child. Not just a child or children but healthy ones.

To achieve this feat, intending couples need to go extra miles, sometimes exposed to psychological, financial and social trauma while achieving this.

Healthy babies are frequently deemed a priority but some couples go through trepiditions to get this. Some say the purpose of marriage is own bouncy children - infact one of my friend is a subscriber to this claim. 'Love is scam, it's inconsequential! One just marry to raise children only' - he opined. How he got such claim into his head is of his care, however, people mostly do marry only to get children, on the other hand otherwise. Let's stay with the former objection, people need healthy children.

Decisions could batter couple's chances of getting healthy children. And you hold the mantle to decide on the type of children you need get. The sickle cell disease is one ailment that is easily preventable than treated.

Although manageable, it's uncurable and affects the oxygen-carrying red blood cells on it's host. To demonstrate the need to atleast prevent this disease, the complications of the disease are:

  • » Increased risk of severe bacterial infections due to loss of functioning spleen tissue

    » Stroke, which can result from a progressive narrowing of blood vessels, prevents oxygen from reaching the brain.

    » Silent stroke

    » Decreased immune reactions due to hyposplenism (malfunctioning of the spleen)
    » Priapism and infarction of the penis Osteomyelitis (bacterial bone infection)

    » Acute papillary necrosis in the kidneys

    » Leg ulcers

    » Background retinopathy, proliferative retinopathy, vitreous haemorrhages, and retinal detachments can result in blindness.

    » Pulmonary hypertension

Lifespan for the sickle cell anemia victims is between 40 - 60 years(for developed countries). It might be lower than that for countries in Africa.

The ailment got a date to enlighten people on the complications. It's the 19th day of June every year.

There are some genotypes like the AA,AS and the SS (these are the prevalent ones). The SS genotype is the accursed sickle cell anemia. Anyone with the genotype is advised to only marry an AA genotyped person. In fact an AA genotyped individual can marry anybody and expect an SS-free baby.

 An SS individual marrying another SS genotyped individual would seem like budding a disaster - why?

All their offspring would be SS-genotyped.

An SS individual isn't also advised to marry an AS individual because the probability of getting an SS offspring is 2-in-4 or 3-in-4.

Now the prevalent headache - an AS marrying to another AS( a case which both couple possess each an allele of S gene in their genotype.

According to scientists, there's a 25% chance that the couple would get an SS child(meaning 1 in 4 children would have the dreaded SS gene).

It's isn't to appease you, but you can be lucky and all your children(whatsoever the number) aren't SS genotyped. However the probability of not getting an SS child out of about 4 children is so so slim that it's not advisable. You know it's against ethics to go beyond the advise of elders?

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The burden of coping with a sickler is unquantifiable. The child would have to live on drugs and intense care inorder to maintain his/her delicate depreciating organs.

What if your prodigious search for the soulmate endeared to you should be underestimated. Can there be a way to bypass getting an SS child being an AS + AS couple?

Hopefully there is!

Atleast your relationship is safe but other aspects of your life would suffer.

Ways AS + AS couples can marry without having an SS child

Some relationship are put aside so as to ensure a healthy future for the kids. You might not want to make the same move; the following ways might be expensive and psychological:

1. Pre-Implantation Genetic Diagnosis (PGD)

In this process, the sperm and egg of the couple are fertilized in a petri dish and allowed to grow. This is kept for about three to four days, and a biopsy of some cells is carried out.

The final stage involves the non-SS embryos only being transplanted into the mother. The other SS embryos are destroyed. This is a recommended way to avoid an SS baby as it has a high success rate - 99%.

Due to the inability of Nigerian fertility centers to do the biopsy, the samples are sent abroad for the test. This triggers the cost upward to about 5 million Naira. It's one of the safest way to get an SS-free baby without dissolution of relationship as an AS - AS couple.

2. In-Vitro Fertilization (IVF)

IVF is an effective way couples who do have difficulty to conceive naturally opts for. It's eventually a popular method to artificial fertility in Nigeria.

Couples who are AS - AS genotyped could also be served with this method. To do this, the sperm or egg of another person aside the couples is used.

Either an AA man's sperm or an AA woman's egg is used to make the embryo before it is transplanted into the mother.

IVF procedure costs about 1 to 2 million Naira in Nigeria, depending on the center. The donor of the egg or sperm might need some monetary compensation, and that goes to add to the cost.

The downside here is the thought of having a baby partly of the male partner and an anonymous female(who contributed the egg). Aswell the anxiety of getting a baby partly the female couple and an anonymous male(who contributed the sperm).

Does it sound good?

3. Natural Conception

This is another method to avoid an SS baby as an AS -AS couple. It involves natural fertility devoid of the first two methods above.

After about 10 weeks after being pregnant, a test to check the genotype of the embryo is taken. This is done by the Chorionic Villous Sampling (from 10 weeks) or Amniocentesis (from 13 weeks). A needle is inserted into the pregnant abdomen to collect the cells needed. The cells are cultured and testing carried out.

Unfortunately, if the embryo has the SS genotype, the pregnancy is terminated. If the embryo luckily does not have the SS genotype, it is left to develop to full term. 

If a couple got the nerves to wait about 10 weeks in a pregnancy before determining whether it should be terminated or not, then they should key into it.

Another downside is the risk of miscarriage. 0.5 to 1 % of women who undergo this test end up miscarrying the pregnancy. Expense is another backlash - The test costs about N250,000 while a medical abortion costs between N20,000 and a surgical abortion costs between N30,000.

4. Childless Marriage

Since your current relationship is so dear to you, why not try marrying without any child?

This would require a good display of maturity by the couple involved. There would be stigma by members of the public which need matured nerves to manage. This safe method goes a lot to prevent getting an SS child.

5. Adoption

Getting a child adopted as yours is a good option for avoiding an SS child safely. The emotional effects in the extended family is always excessive and that needs tolerance on the part of both couple. 

Meanwhile, the Guava fruit is a popular fruit prescribed to young couples as well as it's leaf. It's a fruit rumoured to have effects on female fertility and the male sperm count. How does the guava fruit and leaf effect fertility?

Those are the ways to prevent getting an SS genotyped baby as a AS + AS couple.


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