Should people with AS genotype marry?

Recently, a client asked us this really important question. We think there are many people who struggle with this dilemma particularly in Africa; and we wanted to share our reply to others who may have this on their mind as well.

Knowing your genotype is a very important part of your health care status.

Sickle Cell Disease (SCD) is inherited and is present from birth. The problem is that the red blood cells in the blood of a 'sickler' have changed from the normal 'circular' or spherical shape to a sickle shape. A child who is a 'sickler' has received the sickle genes from BOTH parents.

In a relationship where both partners are AS, it means that for every pregnancy they have together, there is a 25% chance that the child born of the pregnancy would have SS genetic combination i.e. a 'sickler' (will have sickle cell disease).

People who are 'sicklers' are prone to several health problems through life from childhood.

These include:

*Very painful episodes of the bones and joints called 'crisis' that may happen because of cold weather, infection, dehydration, or exertion.

*Anaemia - people with SCD have low blood (haemoglobin) levels usually, but sometimes because of infection they can develop even lower blood levels. When they have anaemia, they become very pale, find it difficult to breathe, and very tired. This can affect their normal body functions.

*Infections - they easily develop infections like malaria or pneumonia etc. which can increase the risk of anaemia.

*Blocked blood vessels because of the abnormal sickle cells can cause a syndrome with pain in the chest, fever, breathing difficulties. This can also affect important organs of the body and their functions e.g leading to certain types of stroke.

So these are some of the problems that people with sickle cell disease suffer - FROM CHILDHOOD.

All of these problems could lead to death if not properly managed. People with sickle cell disease need VERY Prompt attention when they become ill.

They need fast access to pain relief and oxygen, they need injections and intravenous fluids to manage infections, they may need blood transfusions to quickly treat anaemia.

They need a lot of care and support, but with the right treatment, they can thrive and lead fulfilled and happy lives.

The decision for 2 people to marry is left to themselves, but I will encourage that they think very hard about the issues, options and implications if they choose to do so when both of them are AS.

Issues:

1.These may center around the financial and psychological support for the family having a child or children who are SS.

Options:

2. The AS+AS couple can decide to marry and have no children. Or they may decide to marry, have no children and adopt children instead.

3. If they decide to marry and have a family together, they should realise that in each pregnancy, there is a 25% chance that the child that is born from the pregnancy will have the SS genetic combination i.e. a sickler, and can suffer from all of the above problems described.

(Some AS+ AS couples have 1 child with SS, and others have 2 or 3 children with SS.)

If an AS+AS couple become pregnant, they can have prenatal testing and counselling - this is a procedure carried out early in the pregnancy to determine whether the foetus has the SS gene and a decision taken on whether or not to continue the pregnancy. It is not available in every country, and people who want to use this method should check if it is available to them.

Implications:

4. If they decide to keep the pregnancy, it is important to be aware of the child's health needs and how prepared they are to meet these needs.

*Are there hospitals close by that can manage the condition?

*Do they have transport to get the child to hospital quickly?

*Do they know what needs to be avoided in children with SS to prevent the risk of developing some of the problems listed above?

*Do they know the emergency managements and drugs that can be given at home (school) if problems arise?

*Do they live in an area/town/Country where there is much support available for people with SS from childhood to adulthood.

Supporting a child with these needs has financial and psychological implications, and can have a huge impact on the mental well being of the entire family. Some couples can handle this with help from friends and families; some may not.

These are some of the issues that surround the family with AS+AS parents and are worth considering when making the decision.

Please feel free to contact me if you wish to clarify anything or need more information. Or comment below if you want to tell us your view of the issue.

The important thing is to realise there are options and for people to decide with their partner which best suits them; and no one else can make this decision for the couple.

Stay Well!

About the Author

Editing by AskAwayHealth Team Disclaimer All AskAwayHealth articles are written by practising Medical Practitioners on a wide range of health care conditions to provide evidence based guidance and to help promote quality health care. The advice in our material is not meant to replace management of your specific condition by a qualified health care practitioner. To discuss your condition, please contact a health practitioner or reach us directly through info@askawayhealth.org

#HealthCareQuality #Healthawareness #FamilyPlanning