Medically, two AS or SS genotype individuals cannot marry, and if you are still questioning whether it is okay to go ahead with marrying someone with such an incompatible blood genotype, the answer will still be a “NO”. Two SS marrying each stand a risk of giving birth to a child with the SS genotype (known as commonly as sickle cell disease).
Aside from the risk of having an SS child when two AS or SS genotype couples consummate marriage, the experience of marriage is not the same knowing fully well that problems might arise from the union. You might find yourself worrying or spending more than you otherwise would instead of enjoying your marriage in totality.
Here are some genotypes that can and cannot marry:
- AA + AA = excellent
- AA + AS = good
- AA + SS = fair
- AA + AC = good
- AS + AS = bad
- AS + SS = very bad
- AS + AC = bad
- SS + SS = very bad
- AC + SS = very bad
- AC + AC = bad
Genotypes that can marry include:
- AA + AA
- AA + AS
But if you are already in an AS/AS, SS/SS, or AS/SS marriage, or any other incompatible combinations, and you want to find ways to make the marriage work and have healthy children, the following interventions might be helpful.
1. Tubal Ligation
Tubal ligation is the surgical procedure involving cutting and tying of the fallopian tube through which a released ovum/egg passes from a woman’s ovaries for fertilization. It is in the fallopian tube that a sperm fertilizes the egg for pregnancy to occur.
Cutting and tying the fallopian tube permanently prevents pregnancy from occurring naturally, and is regarded as female sterilization or a method of achieving permanent contraception in females. Hence, it can make you not worry about giving birth to SS children when you marry someone with an incompatible genotype.
However, this takes away your desire to have children normally if that is one thing you have always wanted.
2. Vasectomy
Vasectomy is the male version of tubal ligation. It is a type of permanent contraception procedure in males that involves cutting and typing of the vas deferens, a tube through which sperms produced in the seminiferous tubules and stored in the epididymis of the testes pass into the semen during ejaculation to migrate to the fallopian tube to fertilize the ovum to achieve pregnancy.
Cutting the vas also prevents pregnancy via natural means and allows you to enjoy your marriage with your partner without having to worry about giving birth to SS children.
3. In-vitro fertilization (IVF)
IVF is an assisted reproductive technology (ART) that fertilizes the egg outside the body. It involves taking one or more eggs from the female ovaries and sperm from the male and thereafter fertilising both in a glass tube. The fertilized ovum is then implanted back into the woman’s uterus (womb) for normal development like every other pregnancy.
The usefulness of IVF for preventing SS children in a genotype-incompatible marriage is that it allows the fertilized eggs to be screened for the SS genotype before they are implanted into the woman, such that they can be carefully selected to implant egg(s) that have a desired genotype.
IVF is expensive and there is no guarantee for immediate success, as it has a higher chance of miscarriage. In addition, DNA testing of the in-vitro fertilized eggs also requires a lot of money. Hence, even though it serves as a viable option for genotype-incompatible partners, it is not cost-effective.
4. Surrogacy
Surrogacy is the process of bearing another person’s child. It involves a surrogate, a woman who agrees to accept an in-vitro fertilized egg to nurse the developing child throughout gestation. After the baby is born, the surrogate mother relinquishes ownership of the baby to the surrogate parents.
There are two types of surrogacy, one is more related to infertility or couples who are not able to achieve or carry pregnancy to term for any reason. This is referred to as “gestational surrogacy”, and it involves implanting the fertilized egg from the couple into another woman who agrees to sign the surrogacy contract and agreement for the couple.
The second type of surrogacy is more related to genotype incompatibility than infertility because the major problem is not infertility but the risk of giving birth to an SS child. In this case, the couple agrees to donate the man’s sperm to be artificially inseminated into a woman with an AA genotype and for her to carry the pregnancy to term.
The resulting baby will be either of AA or AS genotype but it will be genetically related to the surrogate mother instead of the parents. There are a lot of other drawbacks as well, including issues with surrogacy agreements, lack of emotional attachment to the baby, and so on.
5 Adoption
If you don’t want to go through the hassle of assisted reproduction and the expenses involved, you can opt-in for permanent contraception discussed above and adopt as many children as you want. You won’t need to worry about giving birth to SS genotype children anymore.
6. Bone marrow transplant (BMT)
Bone marrow transplant is currently the only promising cure for SS, SC, or CC genotypes. It changes a person’s genotype by replacing the blood-producing cells in the bone marrow. The procedure is relatively new, expensive, and not available in most parts of the world, especially in places where the SS genotype poses a major threat.
Final words
While the above options are available for genotype-incompatible couples who still wish to marry, the risks far outweigh the benefits. It is, however, advisable and medically recommended that one marry a partner who is genetically compatible with them to avoid problems later in the future, even if it means calling off the wedding with someone you love.
