assisted reproductive technology, Condom for “AS” Couples, genotype compatibility, health, marriage, Olumide Adenmosun, Sickle Cell Anaemia, Sickle Cell Anemia, Sickle Cell Research, Sickle Cell Research Prospects, spermaSORT “Hb-A” Condom for “AS” Couples
By Olumide Adenmosun
Shhh!!! The hall was silent that you could hear the tingle of a pin drop. ‘Twas the Poetry Night and the hall was scanty, sparsely dotted amidst the rows by mature minds; no thanks to the Sound City show that got D’banj an open platform on the school field. Guys dumped the Poetry Night to go rock to the drunken rhythm of the KOKO-MASTER.
OMG! I was to be the recipient of an award, the cash prize of which hinged on students’ attendance and proceeds from ticket sales that night. For the romantic poem I’d written (for no one really) all night – some few months earlier; D’banj just stole my show. I had a N5,000 worth of hand shake and acknowledgement anyways. Hmmn, I later joined the tipsy crowd to dance away my sorrow. lol!
I vividly remember Shakespeare’s mime of “I AM MAD!” (Shakespeare’s a friend’s nickname here) –trust me Damola is almost one weird Shakespeare re-incarnate; and Tolu’s squeaky voice, with his romantic strums on the acoustic guitar, was ecstatic that night; then ‘twas finally a recitation from my bunk –mate’s former girlfriend. Like a dirge it was when she ended it in tears – “They’ve taken away my treasure!” Oh, this silly boy is not here – I said to myself as I looked round the hall. She obviously was now all alone on the emotional highway. They called it QUITS! But only a few knew why…. Dude, five years have gone down now and he’s never found her match. They would be a BIOLOGICALLY DANGEROUS PAIR – he reasonably moved on…
A simple cross sequence in genetics tells us that “AS” couples are no good pair. A typical probable progeny line could yield a 25% chance for an “AA” birth, a 50% chance for an “AS” birth and a 25% chance for an “SS” birth. Life is never easy for a Sickle Cell individual in crisis; matter-of-factly, I have lost two close friends to the Sickle Cell disease – the last just being some few weeks old now – after several worthy investments from her parents – a high quality and expensive University education and a graduate programme off the shores worth a fortune. She’d return to mother earth as a result of an autosomal recessive gene – a mutation in the amino acid sequence of the genes coding for her haemoglobin structure – which has only got glutamic acid substituted for valine, causing her red blood cells to sickle and become energy/oxygen starved.
It’s in your hands!
Every Sickle Cell Foundation on earth sings its tune; doctors sternly warn; even pastors preach its gospel; and informed parents tell its tale… DON’T YOU EVER MARRY ANOTHER “AS”! Make an informed decision! Just like they’ll tell you to know your HIV status, you got to also know your Blood Genotype. Trust me; they’re all very necessary and reasonable campaigns. If you’ve ever witnessed any of their painful crises, then you’d almost want to advocate a punitive measure for the love birds who erroneously (however innocent) inflict the Sickle Cell Disease. For the very volatile homes, the death of a crises-laden sickle cell kid may lead to a divorce or a summary death of the marriage. They see the union of their seeds as a POISONOUS GAMBLE.
But hey! I’m one of those fine endangered species. Beyond the foetal years, I’m the last to come down with malaria or some other blood related illnesses. I remember Mr. Chris teaching us Ovalocytosis and some other adaptive mechanisms we’ve got (that was probably Genetics and Evolution 201) as having the sickle cell trait in our genome line. I mean I’m one of the “AS” packs. And someday, I’m thinking the Sickle Cell allele in our genome line is gonna be extinct by natural selection – from the massively audacious sensitization of marrying right.
But why do we have to care about what we didn’t cause. I mean I wasn’t there when Glutamic Acid was selling its birth right to an idiotic Valine in a mutational process that distorts the amino acid sequence of our haemoglobin. Even when I’m loving what I’m seeing in another mate of like genotype, there’s already a billboard with red dripping blood – DANGER! Your genotype makes you no good match.
If I’m going to play against the rule, then that’s because I know there’s a functional alternative. Without playing the blind Hebrew faith, I know there’s a ransom in Science – which in itself is another dimension of faith – the Greek kind of faith. I wouldn’t gamble the 75% chance of birthing a healthy “AA” or “AS” kid; I’ll just ignore the dicey choice and rather resolve to PICK my TAKE.
Someday a law will be passed, and I think it’ll be framed thus: “If an AS-couple are ever going to tie the nuptial knot; then they must subscribe to a special planned parenthood in Assisted Reproductive Technology.”
The existent functional procedure for now is the PGD (Pre-implantation Genetic Diagnosis). Confusingly, before I joined in the IVF art, I’d think it’s the Pre-natal Testing that involves the CVS (Chorionic Villus Sampling) – that could be run on a 10-12week old pregnancy; or Amniocentesis – run on a 15-18week old foetus; or the Percutaneous Umbilical Blood Sampling. All these will indicate the genotype of the baby whilst still in the womb; and a subsequent decision will have to be made by both parents – whether or not the pregnancy should proceed to term – for the birth of the Sickle Cell child diagnosed. I wouldn’t live to subscribe to such a decision; neither will she!
The much more considerable option is the PGD (Pre-implantation Genetic Diagnosis) – where after an ovarian stimulation, the lady’s eggs (yea, she could be stimulated to produce as many as 20 eggs in one cycle) are retrieved and fertilized with her husband’s sperm – in vitro (outside the body). And at the time when the embryos have attained at least 8 cells in healthy divisions; just one of the cells (blastomeres) may be biopsied and genetically tested. Much more advanced procedures now consider a Polar Body Biopsy (such that the integrity of the embryo is preserved). Of the many biopsied embryos, just the very ones without the “SS” genotype are marked and selected for an Embryo Transfer back to the lady’s uterus. Just like you were formed in your mama’s womb, it’s the survival of the fittest. The remaining unused/untransferred embryos may either be discarded or cryo-preserved/vitrified – except you want to carry all 20 babies at once anyways. (lol!)
For me, and ethically speaking, PGD is a better choice; however, its limitations are:
– the procedure is damn expensive;
– it’s only got <20% success rate (meaning you could be lucky to have a pregnancy once in 5 trials);
– and the technology is not here yet in Nigeria (I’m not in the affirmative if it’s yet routinely popular in Africa – save South Africa!).
For the scribes who’d still insist – “I want to enjoy the God-given passion and the sexual experience of impregnating my wife myself!” Sure! But you really may have to be in the WAIT. Without some sort of in-vitro involvement or manipulations, it’s probably going to be possible with our “spermaSORT Hb-A Condom” someday. In the brood of my heart it lays – oozing with optimism (should some research faculty proffer investigational aids soon); and here is the pictorial analysis:
spermaSORT Hb-A Condom
This is going to be the end-product of a research protocol titled:
“Monoclonal Anti-sperm Antibodies for Sorting Preferential Fertilization in ‘AS’ Couples.”
On a good day, except there’s some sort of auto-immune disease (where the body’s immune system resort to attacking self cells); the human sperm cell has surface antigens or cellular markers that are recognisable in the human genome line; and as such not immunogenic. But one of the causes of infertility is a silly group called Anti-sperm Antibodies. In Andrology, when you observe under the microscope – some kind of “unholy associations” amongst a good number of sperm cells, such that their morphology shows a head-to-head joining or tail-to-tail joining (not Amorphous forms this time), or some bonding of any sort; then the suspected conjugating culprits are ANTI-SPERM ANTIBODIES. Such sperm cells may not fertilise an egg! You need to test for such antibodies from the semen sample or blood samples from both couples; then proffer an alternative fertility treatment in Assisted Conception if Immunologic Infertility is confirmed – else there’ll be no pregnancy ‘till the Kingdom come’.
With this baseline understanding and with advances in human genetics and biotechnology, I really think our “spermaSORT Hb-A Condom” is only a research away from the mind map. The haploid nature of the nucleic contents of the human sex cells tells us there are 23 chromosomes in there. One of these chromosomes contains the gene that codes for the complementary half of the human haemoglobin; in this case, and commonly – it’s the “A” or the “S” beta-globin chain. Except otherwise, genetic sequences should have complementary transcriptional proteins expressed on/in the resultant carrier cell as biomarkers (epitopes, antigens, glycoproteins, etc.). And from a previous patent whose chief investigator was tagged Th. Papayannopoulu; 1976: Brit. J. Haemat – 34, 25 (Identification of Haemoglobin S in Normoblasts and Red Cells Using Fluorescent Anti Hb S Antibodies); from their paper, these cell lines or biomarkers depicting the presence of Haemoglobin S gene were designated HuS-1 and HuS-2 – in somatic cells (cells with the diploid number of chromosomes). If only these cells can also be found on the sperm cell membrane or just a protein biomarker that indicates the presence of the Hb S gene – then I smell the birth of a new technology to stem the Sickle Cell Birth in a time machine – a black hole…
Like a pump action, the “spermaSORT Hb-A Condom” voids preferentially sorted/treated sperm cells. The Sort Grid comprises two major compartments – the Conjugating Chamber, and the Immuno-activated Capillary. These compartments are sufficiently filled and laced respectively with Monoclonal Antibodies specific for sperm cells bearing biomarkers that indicate the presence of Haemoglobin S; such that the conjugate thereof (Antibody – Hb S Carrier Sperm Cells) are inactivated and incapable of fertilization. Haemoglobin A (Hb A) carrier sperm cells are therefore preferentially sorted, and find their route to the beautiful egg that makes its way down the tubes for FERTILIZATION.
“Write the vision, make it plain, that he may run that reads it…”, so the Bible says in Habakkuk 2:2-3.
I’m writing this so that someone somewhere may also find a reason to run with it. I only have a clue here, and I believe it’s worth a damn try – as it’s got its merits… For the many agonising couples who’ve had the brunt of a Sickle Cell birth; and many others faced with an agonising decision of having to call it quits; the “spermaSORT Hb-A Condom” will someday find expression at some reputable research institutes, make it through all the clinical trial phases, and finally bag the FDA endorsement as a natural assisted conception alternative technology to stem the Sickle Cell Births on a global scale.
The days are sure here!
…be of good cheer!
Contact: ADENMOSUN, Olumide
Phone: +234 803 437 9442