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5 ways for AS + AS couples to get married and still break the Sickle Cell Cycle

Break the sickle cycle
Break the sickle cycle

In recent times, there has been widespread awareness about the Sickle Cell Disease and ways to prevent more babies being born with the Sickle Cell Disease.

On the 19th of June 2018, the 10th World Sickle Cell Day was celebrated.

The most common of these pieces of advice is for carriers of the Sickle gene (AS, SS, SC) not to marry fellow carriers of the Sickle gene. Thus, people with AS, SS and SC genotype are advised to marry only people who have the AA genotype to avoid the possibility of having SS babies.

This is good advice because the financial, emotional, psychological and physical stress that comes with raising a child with Sickle Cell Disease are unquantifiable. Even more so because the child shares in these burdens.

Many a love affair have been doomed to ruin because both lovers are AS; they have to part ways for the sake of their future children.

However, there are options for AS + AS couples who are determined to be married at all costs. These options may not be popular and they are sometimes expensive, but they are options nonetheless.

Here are 5 ways an AS + AS couple can get married and still break the Sickle Cycle.

  1. Natural Conception:

When the couple conceive naturally, they wait till the pregnancy is about 10 weeks old. Then they take a test to check the genotype of the embryo. 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 ad a genetic testing is carried out.

If the embryo has the SS genotype, the pregnancy is terminated. If the embryo des not have the SS genotype, it is left to develop to full term.

The major downside to this is that the procedure is expensive and not everyone can afford it. The test alone costs about N250,000 while a medical abortion costs between N10,000 to N20,000 and a surgical abortion costs between N25,000 to N50,000.

Other downsides include the risk of miscarriage. 0.5 to 1 % of women who undergo this test end up miscarrying the pregnancy.

There is also the anxiety of waiting for 10 weeks at least to find out the embryo’s genotype and another one week to get the result of the test. The couple also has to endure the emotional trauma of going through an abortion. It is also quite possible that the woman changes her mind about having an abortion and then she goes ahead to give birth to an SS baby.

  1. Pre-Implantation Genetic Diagnosis (PGD):

Pre-implantation Genetic Diagnosis works like In Vitro Fertilization (IVF). Unlike with natural conception, this doesn’t involve termination of pregnancy. The couple goes through an IVF cycle; the sperm and egg are fertilized in a petri dish and allowed to grow, then after three to four days, a biopsy of some cells is carried out. Only non-SS babies are then transplanted into the mother. SS embryos are destroyed.

Most fertility centers in Nigeria do not have the ability to do the biopsy and so the samples are sent abroad for the test. PGD has a 99.99% success rate.

The downside to this is the cost. It costs about 4 million Naira.

  1. In Vitro Fertilization (IVF):

In the past few years, assisted fertility has gained ground in Nigeria and IVF is one of the first options couples who are finding it difficult to conceive naturally turn to. IVF can also help AS + AS couples have babies that aren’t SS.

This is done by using the sperm or egg of someone else who isn’t a Sickle carrier. So, the sperm of an AA man or the egg of an AA woman can be used to make the embryo before it is transplanted into the mother.

Although it costs less than the PGD, it still costs more than going through the process of natural conception.

IVF procedure costs about 700,000 to 2 million Naira in Nigeria, depending on the center the procedure is done at. If the couple uses an anonymous donor, the sperm or egg costs about N50,000 to N100,000 extra. However, it may cost them less or even nothing if the sperm or egg is donated by someone they know, depending on the couple’s agreement with the donor.

The major downside is the anxiety the couple has to deal with as there is the risk of the IVF procedure failing.

  1. Adoption:

There are lots and lots of babies who need a home and an AS + AS couple can provide them one. If the couple are bent on marrying, then they may decide not to have their children biologically and opt for adoption instead.

The downside to this is the stigma the couple may face from family and friends as adoption is not yet seen as a valid, viable option by a lot of Nigerians.

  1. A childless marriage:

While your Nigerian mother may threaten to fall down and die if you don’t provide her with grandchildren, there are some people who do not want to have children of their own. And if two of these people happen to be AS and they happen to get married with the agreement that they will have no children, then they will not continue the Sickle Cycle.

 

The above options may be frowned upon by a lot of people for moral, religious or cultural reasons, but at the end of the day, they are valid options nonetheless. If two AS people want to get married against popular opinion, it is important that they are provided with all the available options so they can make an informed decision. That way, they can make better choices instead of continuing the Sickle Cycle by putting their ‘faith’ to the test.

Written by Temitope Adeiye

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    • I am still crying till the moment it’s saddening my heart 😭😭😭😭 I can’t marry whom I love so much please can I get ur contact nd talk privately

  1. Which hospital is doing those tests u mentioned there, I’m so excited that there is a way out,

  2. Am AS my Husband his AS unknowingly to us my I known am AS and I told my husband before we got married but my husband went lab and did his test and it came out AA
    We are blessed with 5 beautiful queens after 16th years of marriage my husband fell sick and he visit clinic they did another genotype for him and it came out AS when he told me I said isn’t possible that his AA he went visit another lab same result hmm we took our kids to the hospital for their genotype
    And we have 4 AA and 1 AS
    Our family doctor it was a miracle
    That is one out 100

    • OMG I am so happy for you, I intend breaking off my engagement in December because my present Genotype results came out as AS, but I have a hospital test result from when I was younger that confirms I am AA, I have done the test twice but it says I am AS. People say genotype don’t change but I wonder if mine changed…i have to break up with my fiance because of this💔💔

  3. Indeed learning is the only way to add value to our life. Thanks alot. Contact Brekete Human Right Radio & Tv station 100.1 Abuja, they no some of the best Doctors in the Country

  4. Extremely great knowledge, I am about getting marriade while I went different hospital with my fiance, some said AS and AA while others side AS and AS. Can I have your contact so that we talk more on the possibilities of me spending the rest of my life with my wife to be.

  5. I am facing this problem now me and my man are As and we are planning on getting married but our family member say no and and we have one child out of marriage and him is As but my mum is afraid that the second child may be As and we told her we may not hv another child but she say no and my man don’t HV too much money and we love our self very much we don’t no what to do

  6. this is exact what am facing now ,am confused i dnt know what to do,can i get a contact to cal or what is the possibilities for us having 3-4 as kids atleast

  7. I am also going tru the issue of being AS and my partner too is AS what is the probability of us giving birth to SS we love each other and have spent 5years in relationship, I have been crying since all this why because we make finding from many hospitals and we are told to breakup or go for text during pregnancy which we can’t afford ,I am praying if we can give birth to three children without SS

  8. Pls I having same challenge now, any hospital here in Abuja you can link me to for counseling or way forward

  9. The most important thing AS-AS couples need is adequate information to make informed decisions. The present ‘one size fits all’ recommendation is simply a reflection of the vast knowledge deficit that exists in our health sector and wider society.

    Finally, while literacy and financial status may have encouraged the blanket recommendation, it is important to realise that a lot has changed in the last decade, especially with the Japa trend providing access to global standards healthcare.. But also, there is a rise in centres offering top quality healthcare right here in Nigeria.

    To the writer, thank you for a brilliant article.

  10. Am as well having the same issue here,Am As and my partner is As with different blood group O positive and A positive,is it possible for us to get married, According to my guy white doctor,he said that one of our gene must be strong, But me am kind of confuse because am thinking about Future

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