When love meets genetics: The importance of genotype testing

Love is a beautiful thing. It brings people together, creates lasting bonds and inspires many to build a future with someone they cherish. When two people fall in love, their thoughts naturally turn to commitment, marriage, family and the possibility of having children together.

However, amid the excitement of planning a future, there is one important conversation that should never be overlooked: genotype compatibility.

It is a conversation that can be uncomfortable for some couples, particularly when emotions are deeply involved. Nobody wants to imagine that their genetic makeup could influence their relationship or the health of their future children.

Yet, knowing one’s genotype is not an indication of how much two people love each other. Rather, it is an opportunity to make informed decisions about their future.

In Nigeria, where sickle cell disease (SCD) remains a significant public health concern, genotype testing should be an essential part of premarital health screening.

Unfortunately, many couples still approach the subject casually, sometimes assuming that because they appear healthy, they cannot carry a genetic condition. This is a dangerous misconception.

Sickle cell disease is an inherited blood disorder passed from parents to their children. It affects haemoglobin, the protein in red blood cells responsible for carrying oxygen around the body.

In people with sickle cell disease, abnormal haemoglobin can cause red blood cells to become rigid, sticky and crescent-shaped, leading to blockages in blood vessels, severe pain episodes, anaemia and potentially life-threatening complications.

The most commonly discussed genotypes include AA, AS and SS. However, other haemoglobin variants, such as SC and S beta-thalassaemia, can also cause sickle cell disease.

A person with the AS genotype is generally described as having sickle cell trait. They usually do not experience the symptoms associated with sickle cell disease, but they can pass the haemoglobin S gene to their children.

This is where the importance of knowing both partners’ genotypes becomes particularly significant.

When two people with AS genotype have a child together, each pregnancy carries:

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    A 25 per cent chance of the child inheriting AA.

    A 50 per cent chance of the child inheriting AS.

    A 25 per cent chance of the child inheriting SS and developing sickle cell disease.

These probabilities apply independently to every pregnancy. Having one child with AA does not change the genetic probabilities for the next pregnancy.

One of the most difficult situations a couple can face is discovering, after falling deeply in love, that they have incompatible genotypes in relation to the risk of having a child with sickle cell disease.

For example, when both partners have the AS genotype, there is a one-in-four chance with each pregnancy of having a child with sickle cell disease. The discovery can create emotional turmoil.

Questions arise about whether to continue the relationship, whether to marry, whether to have children and what alternatives might be available.

Some couples choose to proceed with their relationship after receiving genetic counselling and understanding the reproductive options available to them.

Others may decide that the risks are not something they wish to take. These are deeply personal decisions that deserve sensitivity, accurate information and professional guidance rather than judgement.

However, the conversation should ideally take place before a relationship becomes so emotionally invested that discussing genotype feels like a threat to the relationship. Love should not be used as a reason to avoid an important health conversation.

If you would like to get in touch with me about Sickle cell, do so via my email address: [email protected].  And do check out my blog:     https://www.dailylivingwithsicklecell.com/    My book on Sickle Cell – HOW TO LIVE WITH SICKLE CELL and my other books are available for purchase on www.amazon.com.