Every year on my street i overheard most people talking about how important it is to know your genotype, as well as your partner’s. I agree with the rationale for this; it’s important to be as prepared as you can when dating. Understanding how genotypes work means you can prevent passing on genetic conditions like sickle cell disease to the upcoming generation.
Unfortunately, these discussions can often take a dark turn, as some people in the society believe health screening takes away from the organic nature of dating or put a stop to some interesting and last long relationships. In some sayings of people around me , I’ve seen this form of screening referred to as eugenics. “Selecting for genes is unethical,” they says.
As a patient with sickle cell, I do not agree with this saying or thinking.
From my own experiences, I understand how painful and discriminating, living with a condition like sickle cell is. It affects every aspect of one’s being, from mental to physical health, and there is no telling how severe it will be. And how painful and restless it is when the crises comes. I know how i have suffered with it and how my parents and big sister have spent a lot of money like almost every month. I would hate to pass on sickle cell to my future children, knowing how it has affected me and others in the community.
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My parents both have the sickle cell trait, but they had no idea because of olden days, education and technology wasn't like this era and they had no symptoms also. My Dad and Mum are both "AS" so they had a 50% chance of having a child with sickle cell, and that’s what fate decided for me at birth. Genotype testing wasn’t as common back then, so I understand it wasn't their fault and they didn’t realize the gamble they were taking. But for me to do the same with the knowledge I have feels irresponsible.
Therefore, the decision to have children is a well-considered process for me. I couldn’t bring anyone into this world to suffer from sickle cell the way I have suffered. My big sis, had an opportunity to marry a very generous and wealthy man but rejected him because, they were both are "AS" the man insisted that he would take care of it because money isn't his problem but things didn't work out. What was her reason ? it was because of me, she has seen me suffered with pains right from birth till now. Asking potential partners early on “what is your genotype?” lolz 😅 allows me to decide how to proceed.
I have researched my options if I did want to start a family with someone who has the sickle cell trait. I will go for
DIAGNOSTIC TESTS
As I have sickle cell disease (HbSS genotype), if I were to have children with someone with the sickle cell trait (HbAS genotype), there is a 50% chance the child would get the sickle cell trait and a 50% chance they would get sickle cell disease. Having a child through natural conception would require having a diagnostic test from 11 weeks into the pregnancy to find out whether the child has sickle cell or not.
Finding out at this stage would be difficult for both parents. This wouldn’t be an option for me because of my personal beliefs.
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IVF WITH PREIMPLANTATION GENETICS SCREENING
In vitro fertilization (IVF) with preimplantation genetic screening is one method to prevent having a child with sickle cell before conception. Embryos are taken from the mother, fertilized, and then screened for sickle cell. The embryos that do not have the full sickle cell gene are selected.
At first, I felt this would be a viable option as we could prevent the possibility of offspring inheriting sickle cell. Researching further, however, I realized the considerable strain on the mother to get the conditions needed for a successful procedure. IVF doesn’t have a 100% success rate, so the emotional and physical toll would be immense.
There are a considerable number of risks and preparations for this option, and I’m simply not comfortable with them.
ADOPTION OR SURROGACY
Not everyone has the ability to have their own child, and not everyone wants to. Adoption is another option I have thought about because I wouldn’t be passing on the sickle cell gene. If I were to date someone with the trait, I would strongly consider this option. I’ve always had a strong desire to create my own family, and I recognize there are many ways to do this.
In an ideal world, I wouldn’t have to think about these things and there would be an easy and inexpensive alternative. At the end of the day, I’m a strong believer in knowing your genotype and making the right decisions to support the upcoming generation.
What that looks like will always be a personal choice, but it’s important to be informed.
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Note: Sickle Cell Disease can be prevented
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