Medical compatibility for intending couples

It’s a sensitive issue whose concept seems to have been misconstrued in many circles.
Medical compatibility for marriage implies health check of two intending persons, desiring to marry, for the
purpose of ensuring harmonious and agreeable relationship.

The aim of this presentation is not in a way to condemn or approve a relationship on account of outcome of medical evaluation, but guide intending partners on decision making before they say “I DO”.

Listing areas of medical check for the purpose of compatibility in marriage is not limited, but the following will surely be helpful:
Physical challenge
Implies challenge of a part of a body e.g. withered or weakened part of a body, blindness, deafness, paralysis etc
Faced with this circumstance does not mean affected partner will be a liability.
Area of strength can be fortified and with encouragement made resourceful.
Area of challenge can be strengthened and partner of affected person will need to go extra mile in showing care if he/she is willing to marry such person.
Also access to aid instrument can improve the quality of life of physically challenged partner, e.g. Braille, artificial limbs, corrective or replacement surgery and others.

Psychological challenge
Includes Anxiety, depression, panic attacks/ phobia, and personality challenges.
Above usually manifest following a trigger factor, this makes affected person display behavior or attitude that is at variance from norm.
An anxious person or partner with panic attacks and phobia are extremely fearful over what would not have been a concern normally.
Religious and psychological counselling to build the affected partner’s confidence will surely be helpful

Inherited diseases
Can manifest early or later in life
Broad but commoner ones include sickle cell disease, B-thallasemias, G-6-PD deficiency (increased breakdown of red blood cells on ingesting certain drugs, causing affected person to pass coke colored urine), cystic fibrosis.
Inherited diseases are not transmitted to partner by any means but can only be passed down to their offspring depending on the pattern of inheritance of such disease.
In sickle cell disease:
The red blood cells are fragile as a result of genetic defect in its formation. Affected individuals develop painful or anemic (low blood level) crisis whenever their red blood cells undergo stress e.g. malaria, poor oxygen delivery, dehydration
Its manifestation is dependent on the genotype pattern of inheritance
Partners are encouraged to ask each other about knowing their hemoglobin genotype, if unknown its advisable they check their hemoglobin genotype in any reliable laboratory
Result of hemoglobin genotype can be read as AA, AS,SS, SC, or AC
SS and SC are prone to red cell destruction hence come down with crisis-SS crisis worse than SC
AS, AC, are carriers and don’t usually manifest the illness. AA are free of the defective genotype i.e. normal genotype
If one’s genotype is AS/AC and the partner is AA, they can’t give birth to a sickler (SS/SC), their children’s genotype can only be AS/AC or AA.
If one partner is a sickler (SS/SC), and the other partner’s genotype is AS/AC i.e. carrier, there is 50% chance that they will give birth to SS/SC child and 50% chance of giving birth to carrier-AS/AC

If both are AS or AC( carriers), then there is 25% chance of giving birth to SS child, 25% chance of AA and 50% chance of having a child that has AS/AC genotype
If both are SS/SC, then all the children will be SS/SC
If you or your partner falls into any of the outlined category, it’s advisable to seek further counsel

Other medical conditions that are hereditary related:
Includes diabetes mellitus (especially type 2), systemic hypertension, and allergy related illnesses, e.g. Asthma, food allergy and others
Diabetes and hypertension often appear in middle age for those who are susceptible (history of its existence in the family)
Tests include fasting blood glucose test and 2hour postprandial test to rule out diabetes. Checking your blood pressure is a simple way of ruling out hypertension
Lifestyle modification goes a long way in preventing its emergence .

Infectious diseases
A long list, but those related to marriage compatibility will be enumerated
1. Viral hepatitis : includes Hepatitis B & C amongst others . These are infective viral agents that primarily affects the liver and can cause damage to the liver.
It can be transmitted through unprotected sex, unscreened blood transfusion, contact with secretions of infected persons and sharing of sharps or needles with infected persons
Treatment is available though cure may not occur in some instances
Vaccination is available against Hepatitis B but not C
Test that can be done include hepatitis B surface antigen screening and hepatitis C virus screening
If any of the partner test positive to Hepatitis B virus, and the other test negative, the latter( negative individual) can be vaccinated , which involve 3 scheduled doses of vaccination, before they marry or have any contact through which it can be transmitted. Tests are also available to ascertain that the vaccinated individual has developed adequate immunity against the virus
Further counseling will also be helpful for further clarification

2. Hiv/AIDS
A viral disease whose pattern of transmission is similar to that of viral hepatitis discussed above .
It is an infection that reduces the immunity of the infected person allowing other diseases to set in
It is not a death sentence and the affected person can live a normal: available drugs reduces the viral load and limits progression of the infection
Presently medicine is yet to discover a cure research is still ongoing but God‘s got a cure
No effective vaccine available
Tests are available: screening and confirmatory tests which are usually free in most test centres.
If one partner tests negative and the other positive, decision on whether to go ahead with the marriage should be based on further counseling and well informed choices

Fertility related issues
Testing for reproductive ability of either partner does not necessarily conclude on the person’s ability to bear children despite all test being normal but an abnormal fertility test guides in further investigation and treatment to improve fertility chance of the individual
Test include:
Fertility related hormonal profile for both partners
Semen analysis for men : method of semen collection may not be suitable for individual who is yet unmarried and has kept himself
Imaging. Include ultrasound scan to view reproductive organs; hysterosalpingogram to outline female genital tract and assess fallopian tube patency

Blood group compatibility
Every living human has a blood group which is a reflection of blood group of one’s parent . Also the blood group of both partners determines the blood group of the offspring
There are various blood group systems but most important group types are the ABO Blood group and the Rhesus D blood group. These two types of blood groups are used to describe individual’s blood group.
ABO blood group exist as A, AB,O and B
Rhesus(Rh) D Blood group is further classified based on absence(Rh –ve) or presence (Rh +ve) of the rhesus D antigens on the red cells
Intending couple are advised to check their blood group on account of its implication on pregnancy and its outcome
If a woman has a Rhesus –ve group and her husband is Rhesus +ve, possibility of being pregnant with a Rhesus +ve child exist. If it occurs and if the woman has been exposed to Rh+ve blood in the past, she immediately develop antibodies that destroy the baby’s red blood cells when mother and baby’s blood cell come in contact in pregnancy. This can result in recurrent pregnancy loss.
Partners who fall into this category can seek further medical counseling, especially when they want to start raising children in other to engage further test to know if the Rh-ve woman has been sensitized against Rh+ve blood group in the past.
If the woman is Rhesus +ve there shouldn’t be concern even though the man is Rh-ve since she won’t develop antibodies against the rhesus antigen that she also has.
For the ABO blood group, it is of less concern with respect to pregnancy but at delivery, child can develop hemolytic jaundice if there is ABO incompatibility between mother and child resulting from the blood group inherited from parent whose ABO blood group are not compatible. Again it is advisable to seek a specialist counsel when raising children.

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