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Couples’ unpleasant ordeals over incompatible genotype

By Babatunde Ayedoju

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Mr and Mrs. Adedeji (real names withheld) got married with high hopes and expectations like every other new couple. Their marriage was blessed with five children. Unfortunately, three of them showed signs of sickle cell, always breaking down with one ailment or the other, to the extent that they would have to be hospitalised.

Each time any of those children fell ill, life would be very unbearable for the parents. It tended to be worse when two of those children fell ill at the same time. They spent a lot of money taking care of the  children. Unfortunately, they  died one after the other. The parents were not only devastated but their lives were also  shattered.

Frank (not real name) and his wife almost escaped, having married each other despite the fact that both of them are AS. It was as if they had escaped the consequence as none of their first three children was a sickle cell carrier. Unfortunately, they had a fourth child who was a carrier and that was the beginning of their painful experience. They almost expended all their resources taking care of the child, due to his very frequent health crisis.

Remilekun got married and gave birth to a daughter. Two years after wedding, he suddenly disclosed to his wife that he was a sickle cell carrier, something he kept as a secret from her  till that time. Shortly afterwards, Remilekun died, leaving behind his wife and their only daughter who was still very young.

These are just some of the numerous tales of woe that follow marriage between a man and a woman with incompatible genotypes. There has never been a time when the issue of genotype was as germane as it now is, especially for people who are about to get  married. This is because of the pain some have passed through as a result of their marriage to  partners with incompatible genotypes and gave birth to sicklers.

Investigation revealed that there are about five genotypes, namely AA, AS, AC, SS, and SC. Among these five, the first two are said to be normal, the third is rare, while the remaining two are abnormal.

Usually, as a result of unpleasant experiences faced over the years, such as the ones cited above, two people with abnormal genotype are no longer advised to marry each other. Specifically, AA can marry anybody while anybody who has traces of S in his genotype, for instance AS or SS, should marry only AA.

Therefore, marriage between one AS and another AS or between AS and SS, not to talk of SS and another SS, is usually discouraged by medical personnel and some religious leaders. On one hand, this has led to several broken relationships which are sometimes painful. On the other hand, others, despite knowing the consequences, have gone ahead to still marry each other.

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In some cases, such couples claim that they love each other and will go ahead with the marriage. Others believe that they will escape giving birth to children who are sickle cell carriers.

Kayode Ogunmola, a microbiologist, explained that it is very unsafe for two people with AS genotype to marry each other, because there is a very high tendency that they would give birth to a sickle cell carrier, which would be difficult to manage.

He said that it is also not advisable for AS to marry AC, because the result is the same as when AS marries another as  stating that  they would give birth to a sickle cell carrier.

Explaining the science behind genotype, Ogunmola, who noted that the implication of marriage between two people with incompatible genotypes is on the children, said; “The red blood cells of someone with AA genotype are well formed. Therefore, oxygen circulates easily through the body. On the other hand, for somebody with SS genotype, the red blood cells are not well formed, making it difficult for oxygen to circulate in adequate quantities. The consequence is that the affected person becomes anaemic. He or she will also easily break down with conditions that the body would have coped with if the red blood cells were well formed.”

Dr Adeshina Akintan, a medical practitioner, opined, “When we talk about genotype, what readily comes to mind is the abnormal genotype S, which is dominant in people with sickle cell.” He said that if two people with S genotype marry each other, the possibility of giving birth to a child who is a sickle cell carrier is high.

Akintan pointed out that people who insist on getting married despite knowing that they have incompatible genotypes should be given adequate information through counsel, because “having a child who is a sickle cell carrier can be quite challenging, even right from the period of pregnancy in some cases. Therefore whoever wants to insist on getting married for the sake of love or whatever reason must be made aware of all the complications that may arise. Nevertheless, it is most advisable that people with incompatible genotypes do not marry each other at all.”

Damilola Daramola, a nurse, opined that it is not advisable, from a medical point of view, for a man and a woman who are both AS to marry each other, because of the possibility of giving birth to children who are sickle cell carriers. She said that it is a big risk, because while some did it and managed to escape giving birth to sicklers, others were not so lucky, as almost all their children ended up being sickle cell carriers.

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In her words, “the financial burden of taking care of a child who is a sickle cell carrier is so heavy that the parents may not be able to bear it, coupled with the fact that it would cause pain for both the parents and the child.”

She added that  some people had entered into marriage before discovering that their partners were also as partner calling or  those who are yet to be  married to be watchful as  prevention is better than cure.

She also said that potential couples should count the cost before taking a step that has permanent consequence.

Dr Daniel Ikuomola, a sociologist, attributed the knowledge of genotype to in-depth scientific researches and added that knowing one’s genotype helps to avoid troubles in marriage.

He noted that though science has devised means to make sickle cell carriers live long, adding that  the cost of taking care of them and the pain they have to pass through make prevention a very wise option to explore.

The social science scholar said, “Incompatible genotypes were responsible for high rate of infant mortality in the past, known as Abiku, but now people are becoming more aware of the significance of knowing one’s genotype and putting it into consideration before marriage, even in the villages.”

He, therefore, commended religious organisations that now take it upon themselves to counsel members against marriage between people with incompatible genotypes.

Another sociologist, Dr (Mrs) Kemi Adebola, while disclosing that marrying someone with a compatible genotype helps to prevent avoidable distress in the marriage, explained that  those who go ahead to marry without considering genotypic compatibility, despite the risks involved, are prepared for obvious  consequence.

She said, “Truly, some got to know their partner’s true genotype after wedding, but others who knew beforehand but chose to go ahead must be prepared to face the consequences. A lot have committed that error and are regretting it now. There’s no point taking a decision that one would live to regret for the rest of one’s life.”

Mrs. Funmi Odeyemi, a cleric, pointed out that today’s knowledge gives us an edge over yesterday’s ignorance, adding that a lot of children who died in the past would have lived, if only their parents were armed with the right kind of information.

She said, “The pains and unnecessary financial stress couples have to go through because of a child or children with SS are better imagined than experienced. Is it not better to avoid such pains before going ahead to get married to someone who does not have the genotype that is compatible with yours?

“In our  organization, your medical history is one of the first things we want to know, even before we give you a go-ahead with your relationship. If you decide to go ahead with your wedding, we will have satisfied our conscience that we did our part.”

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Concerning people who ignore genotype and go ahead to marry each other, Mrs. Odeyemi said that when the reality comes, such people will know that they took an unwise decision.

“Love does not overrule genotype. They say love is blind, but the truth is that lovers have eyes and can see. In fact, love will see when reality comes.  When a couple insist that their love for each another will not allow them to part ways, after asking them to go and pray again and they are persuaded to go on, we can only wish them good luck. The time of ignorance God overlooks,” she added.

Chidinma Dinwoke, a publisher, noted that it is very important to be sure of your partner’s genotype before committing to a marital relationship, because it saves the couple years of medical strain on the marriage, should one of the children turn out to be SS.

She said that it is a very crucial factor to consider before getting married to anybody, “especially in this part of the world where we have limited healthcare facilities. In some very advanced countries, they can detect the genotype of a foetus in the early months of conception and can decide on what to do.

It is  one of the questions I make sure to ask before committing myself to any relationship. So, until I’m sure of your genotype, nothing serious happens,” she added.

Timothy Ige, a business man, explained that genotype can make or mar a relationship or marriage the trauma of bringing forth a child with SS genotype to the world is better said than experienced.

While stating that genotype should be one of those things to find out before committing oneself a relationship, he said, “It has affected me several times and I learnt my lessons which are, before a boy or a girl who has attained marriageable age starts a relationship or fall in love, genotype of the two partners should be ascertained.”

Akin Ogunmola, a software engineer, while explaining the relevance of genotype to marriage, said, “It is very, if not extremely, relevant for both intending couple and the kids they plan to have. It’s beneficial, so as to avoid all kinds of strains and stresses that come with managing sickle cell disease.

“In my opinion, it is one of the first things to do when getting into a relationship. It shouldn’t be few weeks to the wedding that one will be doing such a test,” he added.

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