What is sickle cell anemia?

Sickle cell anemia (SCA), sometimes called sickle cell disease, is a blood disorder that causes your body to make an unusual form of hemoglobin called hemoglobin S. Hemoglobin carries oxygen and is found in red blood cells (RBCs).

While RBCs are usually round, hemoglobin S causes them to be C-shaped, making them look like a sickle. This shape makes them stiffer, preventing them from bending and flexing when moving through your blood vessels.

As a result, they can get stuck and block the flow of blood through blood vessels. This can cause a lot of pain and have lasting effects on your organs.

Hemoglobin S also breaks down faster and can’t carry as much oxygen as typical hemoglobin. This means that people with SCA have lower oxygen levels and fewer RBCs. Both of these can lead to a range of complications.

Sickle cell anemia is a genetic condition that people are born with, meaning there’s no way to “catch” it from someone else. Still, you don’t need to have SCA in order for your child to have it.

If you have SCA, this means that you inherited two sickle cell genes — one from your mother and one from your father. If you don’t have SCA but other people in your family do, you may have only inherited one sickle cell gene. This is known as sickle cell trait (SCT). People with SCT only carry one sickle cell gene.

While SCT doesn’t cause any symptoms or health problems, having it does increase the chances of your child having SCA. For example, if your partner has either SCA or SCT, your child could inherit two sickle cell genes, causing SCA.

But how do you know if you carry a sickle cell gene? And what about your partner’s genes? That’s where blood tests and a genetic counselor come in.

You can find out whether you carry the sickle cell gene through a simple blood test. A doctor will take a small amount of blood from a vein and analyze it in a laboratory. They’ll look for the presence of hemoglobin S, the unusual form of hemoglobin involved in SCA.

If hemoglobin S is present, it means you have either SCA or SCT. To confirm which one you have, the doctor will follow up with another blood test called hemoglobin electrophoresis. This test separates out the different types of hemoglobin from a small sample of your blood.

If they only see hemoglobin S, you have SCA. But if they see both hemoglobin S and typical hemoglobin, you have SCT.

If you have any kind of family history of SCA and plan to have children, this simple test can help you better understand your chances of passing on the gene. The sickle cell gene is also more common in certain populations.

According to the Centers for Disease Control, SCT is most common among African-Americans. It’s also found more often in people with ancestors from:

  • sub-Saharan Africa
  • South America
  • Central America
  • the Caribbean
  • Saudi Arabia
  • India
  • Mediterranean countries, such as Italy, Greece, and Turkey

If you’re not sure about your family history but think you might fall into one of these groups, consider doing a blood test just to be sure.

Genetics is a complex subject. Even if you and your partner are screened and found to both carry the gene, what does this actually mean for your future children? Is it still safe to have children? Should you consider other options, such as adoption?

A genetic counselor can help you navigate both your blood test results and the questions that come up afterward. Looking at test results from both you and your partner, they can give you more specific information about the chances of your child having either SCT or SCA.

Finding out that any future children with your partner could have SCA can also be difficult to process. Genetic counselors can help you navigate these emotions and consider all of the options available to you.

If you live in the United States or Canada, the National Society of Genetic Counselors has a tool to help you find a genetic counselor in your area.

SCA is an inherited condition, which makes it hard to prevent. But if you’re concerned about having a child with SCA, there are a few steps you can take to ensure that they won’t have SCA. Remember, children inherit genes from both partners, so make sure your partner takes these steps as well.