Doubts, couple with Thal alpha and Thal beta trait

Hi, just found this wonderful forum for Thal related issues.
Few years ago i realized that I am a Thal alpha trait through a blood test.
On the other hand, my girl friend is a Thal beta trait carrier.

I would like to know that if we were married and decided to have babies, what are the risks ?
I asked a doctor and he told me that the baby will be either with a alpha trait, or a beta trait or a normal baby.

I would like to get some advise from the professionals here.
What is the risk for us ? We are quite concern about the impact to our baby in future.
Thank you.

Hi and welcome,

If you were to have a child it might also carry both traits, but there is no risk of thal major with the combination. Most alpha carriers are unaware that they even carry the trait as it has no symptoms. Some beta carriers (minors) do experience some health issues such as fatigue and lowered immune system, but you can get a very good idea from your girlfriend if she has any health issues related to thalassemia. For example, if she has any problem with anemia, your child may have the same problem. In any case, the problems will not be anything like what a major has and are not life-threatening in any way. The real danger lies in beta and beta thal mixing or alpha and alpha thal mixing (when at least one of the parents carries two alpha genes).

You mention having a blood test for alpha thal. Were you told if you carry one or two alpha thal genes? One gene is called silent carrier and two is called alpha thal minor.

Andy,
Thank you very much for your information.
My doc didnt tell me whether its one alpha gene or 2 alpha genes. What are the differences between 1 and 2 and how it will affect my next generation ?
My gf she does have some anemia problem but its not a very serious one. She can shop non-stop so i guess its alright 

Assuming if my child received 2 thal alpha gene from me and 1 thal alpha gene from my gf, what will happen?
To your knowledge is there many people who carry both trait with them ? Do they show any sign of serious health issues ? I want my child to be able to participate actively in his daily life, so i am quite concern base on 'worst case' scenario.

Assuming that my child has both alpha and beta trait, if he/she going to have children with a partner which is a alpha or beta trait, then the risk of having a thal major is there right ?

Kindly advise.
Thank you and regards.

There are four alpha hemoglobin genes. In alpha thalassemia, the most common condition is that one or more of the alpha genes is deleted, resulting in no alpha hemoglobin being produced by that gene. Silent carrier is one gene deletion. Alpha trait or minor is two genes deleted. At the most, alpha trait results in a mild anemia that can't be treated with iron. When three alpha hemoglobin genes are deleted, is called hemoglobin H disease and can range from mild symptoms to severe thalassemia, requiring regular blood transfusions. There is also the more severe Hemoglobin H-Constant Spring, which is also  three gene deletion, and usually results in a lower Hb and transfusion dependency. Four gene deletion alpha means no alpha hemoglobin can be produced. This results in death of the fetus during pregnancy or a stillbirth. In some rare cases that have been diagnosed in utero, babies have survived by being transfused while still in the womb.

If your girlfriend has not been tested for alpha thal, she should before you have children. If you are alpha trait and not silent carrier and she was a silent carrier, it would be possible, although with low odds, that you could have a child with three gene deletion. Silent carrier is very difficult to detect so family history is very important in diagnosing. Alpha thal is much more common in certain ethnic groups and this is also used for diagnosis. Genetic counseling would be a very good idea. Even though, it may be very likely that the most your child could be is a thal minor (beta or alpha) it would help to know if there is any other unknown risk.

Your children could possibly carry one beta thal gene and/or one or two alpha thal genes. It is extremely important that all carriers be aware of their status as this information is vital when they decide to have children. If a beta minor has children with another beta minor there is a 25% chance of having a major. With alpha thal, the possibility of having children with three alpha thal genes should be avoided.

If your gf does not carry alpha thal genes, there is no reason to not have children as the worst case would be minor. Keep in mind that regardless of who either of you have children with, there is the chance that your children will be minors, so it should not be a factor in whether or not you marry her. The same risk of passing on your respective thal genes will be the same with any partner.

I highly recommend seeing a genetic counseler before having children. 

If you are a 2 gene deletion alpha thal and your wife has a one gene deletion, then there is a one if four chance that your child will have three deletion alpha thal which can be symptomatic.  This is assuming that the two alpha gene deletions are on the same chromosome (cis variant-which is most common in south east asia).

The beta thal trait is inhereted separately from alpha, so having alpha thal does not protect your from also inheriting beta thal.

As you can see, things can get complicated.  It is important that you screen for other and less known asymptomatic hemoglobin variants additionally.  See a professional.