Getting a sickle cell test is straightforward: you need a simple blood draw, which your primary care doctor can order or which may already have been done at birth. Every state in the U.S. requires sickle cell screening for newborns, so if you were born in an American hospital, you were likely tested as an infant. If you’re an adult who needs results now, or if you’re planning a pregnancy and want to know your carrier status, you can request the test through your regular doctor, a hematologist, or a community health center.
Newborn Screening
All 50 U.S. states include sickle cell disease in their mandatory newborn screening panel. The test is done within the first day or two of life using a few drops of blood collected from your baby’s heel. Results typically come back before or at the baby’s first well-child visit. If the screen detects sickle cell trait or disease, the baby’s doctor will notify you and, in many cases, refer you to a pediatric hematologist for confirmatory testing and follow-up.
Because this screening is universal, it catches both sickle cell disease (where a child has two copies of the altered gene) and sickle cell trait (one copy). Many adults who carry the trait were identified this way as newborns but were never told, or the information was lost over time. That’s a common reason adults seek testing later in life.
How Adults Can Get Tested
If you weren’t screened at birth, don’t have your records, or simply want confirmation, you can get tested at any point. Start by asking your primary care doctor for a hemoglobin electrophoresis or a similar hemoglobin analysis. This is a routine lab test. No fasting or special preparation is needed. A technician draws a standard blood sample from your arm, and the lab analyzes the types of hemoglobin in your red blood cells.
You don’t need a referral to a specialist for the initial test. Any primary care office, urgent care clinic, or community health center can order it. If results come back showing sickle hemoglobin, your doctor will likely refer you to a hematologist for a more detailed workup and guidance on what the results mean for your health or family planning.
What the Lab Actually Measures
Your blood contains hemoglobin, the protein in red blood cells that carries oxygen. Normal adult hemoglobin is called hemoglobin A. People with sickle cell trait or disease produce an abnormal version called hemoglobin S. The test measures what percentage of your hemoglobin is type A, type S, and a few other variants like fetal hemoglobin (F) and hemoglobin C.
Labs use two separate methods on each sample to confirm results. The first screens for abnormalities, and the second verifies the findings. Common techniques include gel electrophoresis (which separates hemoglobin types using an electric field), capillary electrophoresis, and high-performance liquid chromatography, or HPLC. HPLC has become increasingly popular because it can detect more hemoglobin variants and precisely measure the percentage of each type present. You won’t need to know or choose between these methods. The lab selects them based on what equipment they have.
A person with sickle cell trait typically has a majority of hemoglobin A with a smaller proportion of hemoglobin S. A person with sickle cell disease has mostly hemoglobin S and little to no hemoglobin A. Your results will clearly indicate whether you carry the trait, have the disease, or have neither.
Testing During Pregnancy
If you’re pregnant or planning a pregnancy and want to know whether you or your partner carry the sickle cell gene, screening is available and recommended early. A blood test on the mother (and ideally the father) can identify carrier status. The NHS recommends having this screening before 10 weeks of pregnancy when possible, since earlier results give families more time to understand their options.
If both parents carry the sickle cell gene, there’s a 1 in 4 chance with each pregnancy that the baby will have sickle cell disease. In that case, diagnostic testing on the fetus itself can determine whether the baby is affected. Two procedures are available:
- Chorionic villus sampling (CVS): performed between 11 and 14 weeks of pregnancy, this involves taking a tiny sample of placental tissue.
- Amniocentesis: performed from 15 weeks onward, this involves collecting a small amount of the fluid surrounding the baby.
Both prenatal diagnostic tests carry a small risk. Roughly 1 in 200 procedures result in miscarriage. The initial blood screening on the parents, by contrast, carries no risk to mother or baby. It’s a standard blood draw, identical to the one used for non-pregnant adults.
Who Should Consider Getting Tested
Sickle cell disease is most common among people whose ancestors came from sub-Saharan Africa, but it also occurs in people with roots in the Mediterranean, Middle East, India, and parts of Central and South America. If you fall into any of these groups and don’t know your status, testing is worth doing, especially before having children.
You should also consider testing if you have unexplained episodes of pain, anemia, or fatigue that haven’t been diagnosed. Some people with sickle cell trait go their entire lives without symptoms, while others experience complications under certain conditions like extreme dehydration, high altitude, or intense physical exertion. Knowing your hemoglobin type gives you and your doctor a clearer picture.
If you’ve already been tested and received a diagnosis of sickle cell disease, periodic hemoglobin analysis remains useful. Doctors use it to monitor the balance of different hemoglobin types over time, particularly when treatment is adjusted.
What to Expect With Results
Results from a hemoglobin electrophoresis or HPLC test generally come back within a few days to a week, depending on the lab. Your report will list the types of hemoglobin found in your blood and the percentage of each. Normal results show mostly hemoglobin A (around 95 to 98 percent), with small amounts of hemoglobin A2 and fetal hemoglobin.
If hemoglobin S shows up, the percentage matters. A moderate amount of hemoglobin S alongside a majority of hemoglobin A points to sickle cell trait, meaning you’re a carrier. A very high percentage of hemoglobin S with little or no hemoglobin A indicates sickle cell disease. Your doctor will walk you through exactly what your numbers mean and whether any follow-up is needed.
For carrier results, the main practical implication is family planning. Sickle cell trait alone rarely causes health problems, but two carriers can have a child with sickle cell disease. Genetic counseling is available and can help you understand the odds and options if both you and your partner carry the gene.