Last week, I watched a discussion among some group of people about genotype compatibility and possible solutions to incompatibility on a reality show about finding love. They suggested that the genotype of an embryo with sickle cell disease can possibly change if carried by a surrogate mother with genotype AA.I couldn't believe the level of ignorance so I deemed it fit to discuss genotype and genotype compatibility again on my page. I will make this as understandable as possible.
Genotype is the genetic constitution of every individual . Your genetic constitution are the genes you inherit from both of your biological parents, you get a part from your mother and a part from your father, the part becomes a whole that makes you.
Examples of genotypes include AA,AS,AC,SS,SC,Sβ-Thalassemia etc Your genotype is made up of different HAEMOGLOBIN GENES you inherit from both of your parents. A person with genotype AS can either donate the A haemoglobin gene or the S haemoglobin gene to his/her child , SC can donate the S or the C while a person with AA genotype can only donate haemoglobin A , a person with SS can only donate the S haemoglobin gene to his/her child etc
TYPE OF HAEMOGLOBIN GENES
1. Haemoglobin A which is actually the commonest
2. Haemoglobin A2 , seen in very few people,it is also referred to as normal haemoglobin
3. Haemoglobin F : This is the haemoglobin found in foetus and infants in the first few months of life before it declines. Note: The persistence of haemoglobin F can modify severity of sickle cell disease
ABNORMAL HAEMOGLOBINS are formed as a result of mutations and they include
Haemoglobin S (commonest), C,E, D-Punjab, O Arab etc
SICKLE CELL TRAIT /HAEMOGLOBIN C TRAIT AND BETA THALASSEMIA TRAIT
SICKLE CELL TRAIT
This is the inheritance of a normal haemoglobin A and an abnormal haemoglobin S from your parents giving the AS genotype. Anyone with AS genotype has sickle cell trait
HAEMOGLOBIN C TRAIT
This is the inheritance of a normal haemoglobin A and an abnormal haemoglobin C from your parents giving the AC genotype .
People living with sickle cell Trait or haemoglobin C Trait do not have sickle cell disease . They are asymptomatic most of the time except on some few occasions where they can be symptomatic.
BETA THALESSEMIA TRAIT
This is the inheritance of a normal haemoglobin A and an abnormal beta thalessemia haemoglobin giving the beta thalessemia Trait.
Note: If you have sickle cell Trait (AS) or haemoglobin C Trait (AC) or beta thalassemia trait and you marry/have kids with another partner with sickle cell trait or someone with sickle cell disease you can give birth to a child with sickle cell disease. So anyone with the Trait is advised to have kids with or marry a partner of AA genotype
SICKLE CELL DISEASE
This is a genetic blood disorder which is characterized by the inheritance of two abnormal haemoglobin genes (one from each parent) and at least one of them being haemoglobin S
The inheritance of Hamoglobin S from each of your parents (S + S =SS )
or inheritance of HbS from one of your parents with inheritance of another abnormal haemoglobin like C , E , D etc from your other parent ( S+C = SC , S + E = SE , S + D-Punjab= SD-Punjab )etc
or the inheritance of hemoglobin S with beta thalessemia (another blood disorder that is characterized by reduction in production of haemoglobin) S + Beta thalessemia = SBeta thalassemia
These all☝️ indicate you have sickle cell disease
Two partners genotype are said to be compatible when they have no possibility of birthing a child with sickle cell disease. They are said to be incompatible when they can possibly have a child with sickle cell disease. Genotype AA is the universally compatible genotype.
AA +AA= compatible
AA +AS= compatible
AA + SS = compatible
AA + AC= compatible
AS + AS = incompatible
AS+ AC= incompatible
AS + SS = incompatible
AS + SC = incompatible
SS + SS= Incompatible
AC+ SS= incompatible
SC+ SS= incompatible
AS+Sβ-Thal = incompatible
Anyone with any type of sickle cell disease or sickle cell Trait,haemoglobin c Trait, beta thalassemia trait can only be compatible with marrying someone with genotype AA to avoid having a child sickle cell disease
LOVE OR GENOTYPE ?(Just for the Singles)
This debate has been on forever , some think genotype compatibility should be the first priority in choosing a life partner while others think only love has the final say .
Instead of answering this question , I prefer to challenge your mind with my own questions, the answers you get might be what you need to make your decision.
Do you know anything about sickle cell disease?
Are you aware of the manifestations and complications of sickle cell disease?
Do you know the choice you make might be the difference between your child being born with a disease or not?
Do you know even if it's only one of your many children that ends up having the disease, that one child doesn't deserve to be subjected to a life of pain especially when it is your choice to make?
Do you know how much it costs to maintain just one child living with sickle cell disease not to talk of many? Do you know how expensive it is?
Do you know how many families have broken up because of the challenges of raising or losing children with sickle cell disease? Do you know how many loves have fizzled out because of these challenges?
Is it right to play a gamble over the possible good health of your unborn child?
Hope you know your love and happiness isn't attached to only one person, you can find it somewhere else?
Do you know your unborn child has a right to good health? Don't you think life has enough challenges already , why add another major challenge to it for your child?
To mention a few,do you know some people living with sickle cell disease have physical disabilities, depression, renal failure,stroke ,multiple organ failure , unfulfilled dreams and aspirations,untimely death because of the complications of sickle cell disease and that could be the fate of another unborn child if you do not take a stand now?
Do you realize the only approved cure for sickle cell disease is not affordable to majority of people living with the disease and for those that can afford it , not all of them are able to find a match and for those that have had a transplant done, not all of them have gotten a cure?
It is up to you to stop the cycle of this virulent disease, will you?
PRECAUTIONS YOU CAN TAKE IF YOU WANT TO BE WITH A PARTNER OF INCOMPATIBLE GENOTYPE
1. Choosing not to have biological kids or opting for adoption
2. Preimplantation genetic testing: This can be done if you want to get pregnant via invitro fertilization , before the embryo is implanted, it is investigated for genetic diseases or malformations. If the embryo has sickle cell disease it won't be implanted . Note: IVF is expensive for an average African and the success rate for IVF is not as high as you might wish
GENOTYPE DETERMINATION TESTS
1. Amniocentesis and chronic villous sampling : These tests can be used to determine genotype of a foetus early in pregnancy , yes you can determine the genotype of your unborn child
2. High performance liquid chromatography , isoelectric focussing, capillary electrophoresis etc can be used to determine genotype and diagnose sickle cell disease in newborns
3. Haemoglobin Electrophoresis: This is the most common way of diagnosing sickle cell disease and knowing your genotype especially in Africa
Note: 1.Do not check your genotype within 3months of blood transfusion , it might alter the result
2. Check your genotype at least twice , if possible thrice because of cases of genotype misdiagnosis
Do you know your Genotype? Check your genotype today so that we can start making informed decisions. You have a role to play in breaking the sickle cycle. Thanks