Fatteh Hamid
A genotype compatibility test for partners about to go into marriage is important. This test evaluates whether or not the partners, based on their individual genotypes, run the risk of having children with sickle cell disorder.
Sickle cell disorder is an inherited blood condition, in which the red blood cells have an abnormal shape that makes them prone to breaking down prematurely as they pass through narrow blood vessels. A sickle cell patient suffers from oxygen shortage because the red blood cells that transport oxygen to the body tissues are in short supply and are abnormal. The constant breakdown of red blood cells also causes an obstruction in blood vessels, resulting in pain, which is commonly referred to as a sickle cell crisis.
Several data have shown that Nigeria has one of the highest populations of sickle cell disorder patients in the world.
Families with sickle cell patients often find themselves in and out of the hospital and many are grieving the loss of children born with the disorder.
Sadly, despite the stories of pain and financial burden that come with caring for SCD patients, many people still don’t appreciate or understand the danger of getting married to a partner whose genotype is incompatible with theirs.
In a recent post on Twitter, a user said she was proceeding into marriage despite having a partner with an incompatible genotype.
She claimed that she had gotten spiritual assurance from her pastor that she and her partner would not give birth to a sickler or that none of their future children would have sickle cell.
But a relationship expert and marriage counsellor, Kehinde Atoba, warned that in such a situation it is dangerous to allow emotion to becloud reason.
He stressed that at the start of any relationship, questions about the partner’s genotype must be asked.
He said, “Immediately you realise that your genotype does not match, just stay away and do not allow emotions to build up. It is always difficult to let go when so much has been invested in a relationship, which oftentimes makes people proceed even after knowing the consequences that would come out of the affair. Partners should make sure to discuss their genotype very early in a relationship.”
Atoba added that for people in a relationship with an incompatible genotype partner, quitting is the best decision.
“Honestly, it is always very difficult, however, we have to use common sense when emotions want to cloud our sense of reasoning. Recently, I read a Facebook post about the death of a youth corps member who was a sickle cell carrier. Sadly, he had a few weeks left to his passing out parade. This, and many other cases of people who have lost their loved ones to sickle cell disorder, are rife because of the ignorance and indecision of the parents before they got married,” he stated.
A medical doctor, Abdulbasit Arilesere, noted that it was not medically advisable for couples with unmatched genotypes to tie the knot.
He added that though love was beautiful, it would not withstand the pressure that comes with having a child with sickle cell.
He said, “It would affect all facets of their life; psychologically, financially and even spiritually. That child would question why he or she was born. The couple might, later on, regret their decision to get married. It might reach a time where they would even be scared of having intercourse for fear of what they might experience. The experience, they say, is the best teacher, but they can avoid it. However, for every child they have, there is a 25 per cent chance that it would be a sickle cell patient.”
Arilesere noted that there were couples who checked the genotype of their unborn child and abort it when it had SCD.
He, however, noted that abortion is illegal in Nigeria except when the mother’s health is compromised.
“Can they also bear the psychological brunt of killing their unborn child? Also, the accuracy of these tests is not 100 per cent. What if the test was wrong?”
“There is also a genetic procedure that can isolate the genotypes through In-vitro fertilisation, it is very expensive, however, it is an option, but it is also not straightforward. The option of a bone marrow transplant, as treatment, is also not as straightforward even when the money to undergo it is available. It could fail.”
A social worker, Damilola Oni, stated that the future of marriage and relationships should be considered before venturing into one.
She explained that the couple’s genotype not only affects the children in the future but the finances of the parents as well.
She noted, “Prevention is better than cure. Why make unborn children go through the pain that could have been avoided? Partners should save themselves from heartache and give birth to children who would not be wishing for death due to the pains that come with having a sickle red blood cell.”
Oni explained that ending a relationship was better than having heartache in the future.
She, however, noted that when the couples have dated for a long time, exiting the relationship was always tough.
“Partners have to be sincere with one another; it requires determination. This is not a matter that would require having the families intervene; it is a matter that requires the two persons involved to be intentional about what their future would be and the children they would bear,” she added.
With tears in his eyes, a banker and father of one, Chris Nkong, narrated his experience of having a child with sickle cell disorder.
Nkong stated that he got married despite knowing that his wife and him were incompatible and after several warnings.
The banker said, “I was warned not to go into the marriage but I had my belief up and I trusted that prayers would change things, however, problems started when we had miscarriages.
“We had two miscarriages before we were able to give birth to our first child, who we would later lose at age five to sickle cell anaemia. I have given birth to the second child now and it has all been in hopes that I do not lose him too. It’s been 12 years since his birth.”
Nkong stated that if he had known how it would turn out, he would have avoided the marriage like a plague.
A real estate consultant and mother, Oluwatoyin Ajibola, said it was important for dating partners to know each other’s genotype and blood group. She stressed that it was the first thing to know about a partner’s health.
She stated, “Marriage apart, you may be in a state of emergency that would require being treated based on your genetic makeup. Would you rather have your results in handy or wait to do a fresh test? It is important to be guided in your marital choices.”
Ajibola noted that there were persons who got married before knowing the about genotype incompatibility. She said this might be a result of a laboratory error where the tests were conducted.
She added that people should seek medical guidance and ensure to have their compatibility is checked.
She said, “Will they be able to carry on eventually when things turn out bad? But I’m not sure they would want to or they should do that. I know persons who I’d refer to as warriors who eventually died especially because of the inability of the parents to afford care, some aren’t walking well due to crises, and many others.”
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