Before you say ‘yes’: Why every teen must know their genotype

By Al-Mustapha A. Mustapha

For many teenagers, marriage is still a long way off. Right now, school, friendships, sports and dreams about the future are probably more important. Yet doctors say there is one thing every young person should know as early as possible because it could have a major impact on the family they may one day have.

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That thing is genotype.

You have probably heard people ask questions like, “Are you AA or AS?” and wondered why it matters so much. The answer is simple: genotype can determine whether your future children are at risk of inheriting sickle cell disease.

Genotype is your genetic makeup. It is inherited from your parents and determines the type of haemoglobin in your red blood cells. The genotypes most commonly discussed in relation to sickle cell disease are AA, AS and SS.

A person with AA does not carry the sickle cell trait. Someone with AS is a carrier of the trait but usually does not have the disease. A person with SS has sickle cell disease.

According to Dr. Zainab Hayatu, a medical doctor in the Department of Radiology at Aminu Kano Teaching Hospital, genotype is much more than a topic students learn in biology class.

“Every individual is supposed to know his or her genotype,” she said. “If people do not know, it is very important for them to get tested before getting into a serious relationship.”

Many people who carry the sickle cell trait look completely healthy and may not even know they are carriers. Problems can arise when two carriers of the trait decide to have children.

For example, if two people with the AS genotype have children, there is a chance that some of their children could be born with sickle cell disease.

“There is a 25 per cent chance in every pregnancy that the child may have sickle cell disease if both parents are carriers,” Dr. Hayatu explained.

She said many people misunderstand what this means. Some believe that if a couple has four children, one of them must have sickle cell disease. However, that is not correct.

Every pregnancy is different and carries its own separate probability. This means a couple could have all healthy children, some healthy and some with sickle cell disease, or even several children living with the condition.

Sickle cell disease is not just a name or a medical term. Many people living with the condition experience severe pain crises, repeated hospital visits and blood transfusions. Some also develop complications that affect different parts of the body.

Dr. Hayatu said she has seen families struggle because they did not know their genotype early enough or did not fully understand the risks.

“I have seen many cases where parents were not aware of the importance of genotype testing before marriage. They ended up having children with sickle cell disease and spent a lot of time going in and out of hospitals,” she said.

The doctor noted that some couples know they are both carriers but still decide to marry because they believe they can somehow avoid having children with sickle cell disease. Unfortunately, things do not always go as planned.

“I have seen families where several children have sickle cell disease. The pain can be very serious because the children experience crises, blood transfusions and repeated hospital visits. Some children can even die at a very early age,” she said.

Knowing your genotype does not mean you should become worried about relationships or start thinking about marriage immediately. Instead, it means being informed about your health and making wise decisions for the future.

Doctors also warn against confusing genotype with blood group.

Although both are related to blood, they are different things entirely. Blood groups are important during blood transfusions and in some pregnancies involving the Rhesus (Rh) factor.

For instance, an Rh-negative mother can have an Rh-positive baby if the baby inherits the Rh-positive trait from the father. During the first pregnancy, the mother’s body may become sensitised and produce antibodies against Rh-positive blood cells. In later pregnancies, these antibodies can attack an Rh-positive baby and cause serious complications.

The good news is that doctors can prevent this problem if it is identified early and appropriate treatment is given.

However, experts stress that this situation is completely different from genotype incompatibility and does not determine whether a person will have sickle cell disease.

Dr. Hayatu has one simple message for teenagers: know your genotype early.

“They should take genotype issues very seriously and know their genotype before getting into a serious relationship because it can affect the health of the children they may have in the future,” she said.

Love may still seem far away for many teenagers. Marriage may be years ahead. But knowing your genotype now is a simple step that can help you make informed choices and protect the family you may one day have.