A few weeks ago, I watched a couple sit down with a doctor to review a single sheet of paper. On it were two letters: AS.
It wasn't a diagnosis. It wasn't bad news. It was information - the kind that, decades ago, most couples never had access to before starting a family. And that single sheet of paper is exactly why the Hemoglobin (Hb) Electrophoresis test deserves far more attention than it gets.
What Exactly Is Hb Electrophoresis?
Hb Electrophoresis is a simple blood test that identifies your genotype - the specific combination of hemoglobin genes you carry. The most common results are: • AA - no sickle cell gene present • AS - a carrier of the sickle cell trait (usually healthy, but able to pass the gene on) • SS - sickle cell disease • SC, AC, and other rarer variants
Most people with AS live completely normal, symptom-free lives. The real significance of this test shows up when two carriers plan a family together.
Why This Test Matters More Than Most People Realize
Here's the math that rarely gets talked about: when both partners carry the AS gene, every pregnancy carries a 25% chance of the child inheriting SS - sickle cell disease - regardless of how healthy either parent is.
This isn't a rare, distant concern. Nigeria carries the highest global burden of sickle cell disease in the world. Roughly 1 in 4 Nigerians carries the sickle cell trait (AS), and the country accounts for close to 150,000 babies born with sickle cell disease every year - nearly a third of all cases globally.
Sickle cell disease brings a lifetime of chronic pain crises, increased infection risk, organ complications, and significantly higher childhood mortality. And in the vast majority of cases, it is entirely foreseeable - simply not foreseen.
The Conversation We Need to Normalize
There's still a quiet stigma around genotype testing - as if asking "what's your genotype?" is less romantic than it is responsible. But knowing your genotype (and your partner's) isn't a verdict on your relationship. It's information that puts you back in control:
• AA + AS → no risk of SS in children, but children may inherit AS
• AS + AS → 25% risk of SS, 50% risk of AS, 25% risk of AA per pregnancy
• AS + SS or SS + SS → significantly higher risk, requiring genetic counseling
None of these outcomes are a reason for panic. They're a reason for planning - whether that means genetic counseling, informed family planning, or simply entering a marriage with full clarity.
It Takes Minutes. It Changes Everything.
The most striking part of this test is how undramatic it actually is. A small blood sample. A short wait. A laboratory result you can hold in your hand. That's it.
Yet that few minutes can shape a family's next generation - preventing a lifetime of avoidable suffering, or simply offering peace of mind that lets you move forward with confidence.
At Amex Diagnostics & Genomics, this is a test we run every day for couples who choose to know before they commit - not out of fear, but out of care for each other and for the family they hope to build.
Before the Big Day, Ask the Big Question
If you're planning a wedding, planning a family, or simply haven't checked in a while - your genotype is one data point that costs almost nothing to obtain and offers immeasurable value in return.
Know your genotype. Know your partner's. Plan with clarity, not chance.