A Case of Well-Tolerated and Safe Deferasirox Administration during the First Trimester of a Spontaneous Pregnancy in an Advanced Maternal Age Thalassemic Patient

Ricchi, Paolo; Costantini, Silvia; Spasiano, Anna; Matola, Tiziana Di; Cinque, Patrizia; Prossomariti, Luciano

doi:10.1159/000323289

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…Finally, it is worth noting that the clinical scenario of TM-related reproduction impairment may change in the next future. New intensive and more effective chelation therapies may reverse some endocrine complications as a result of reduction in total body iron overload: a case of reversal of hypogonadotropic hypogonadism with spontaneous pregnancy has actually been reported in the literature [26].…”

Section: Discussionmentioning

confidence: 99%

Oocyte quality in women with thalassaemia major: insights from IVF cycles

Mensi

Borroni

Reschini

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

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Background Women with thalassaemia major typically experience hypogonadotropic hypogonadism because of the toxic effects of iron overload on the anterior pituitary. Moreover, in affected women, serum anti-Mullerian hormone (AMH) and antral follicle count (AFC) are also shown to be reduced, suggesting that the peripheral excess of iron could also harm the ovarian reserve. To date, the detrimental effects of the disease on oocyte quality have not been investigated. Materials and methods Women with thalassaemia major who underwent in vitro fertilization (IVF) cycles were retrospectively identified over a 9 years period. They were matched (with a 1:5 ratio) by study period and age to a control group of infertile women undergoing IVF. Embriological variables were compared between the two groups. The primary outcome was the rate of top quality embryos. Results Twenty-one women with thalassaemia major (exposed group) and 105 controls (unexposed group) were ultimately included. Serum AMH was 0.6 [0.2–1.8] and 1.5 [0.7–3.5] ng/ml, respectively (p = 0.05). AFC was 4 (1–7.5) and 11 (5.5–16), respectively (p < 0.001). The total dose of gonadotropins used was higher in exposed women but the number of retrieved oocytes and oocytes used did not differ. The fertilization rate was higher in exposed compared to unexposed women, being 100% (76–100%) and 75% (50–100%). respectively (p = 0.03). The cleavage rate was also higher, being 75% (39–100%) and 50% (29–64%), respectively (p = 0.04). In contrast, the rate of top quality embryos did not differ, being 20% (0–76%) and 25% (5–50%), respectively (p = 0.98). Conclusions Despite lower ovarian reserve, oocyte quality is not significantly affected in women with thalassaemia major.

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Section: Discussionmentioning

confidence: 99%

Oocyte quality in women with thalassaemia major: insights from IVF cycles

Mensi

Borroni

Reschini

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Because of the potential teratogenicity of chelators, the use of chelation therapy during pregnancy has remained controversial. The current standard of practice is to cease any chelation therapy when pregnancy is established [21,22,23]. Only DFO chelation may be restarted after the first trimester when the benefits outweigh the risks of excess iron [24,25,26,27,28,29].…”

Section: Discussionmentioning

confidence: 99%

Fertility in Patients with Thalassemia and Outcome of Pregnancies: a Turkish Experience

Akıncı

Yaşar

Karadaş

et al. 2019

Tjh

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Objective:In recent years, the rates of marriage and pregnancy are increasing in patients with thalassemia major. The aim of the present study was to investigate the fertility rate of thalassemic patients and the course of pregnancies in terms of mother and infant health.Materials and Methods:In this observational study patients with major hemoglobinopathy were evaluated regarding marital status, the need for assisted reproductive techniques, fertility rate, iron status, and pregnancy complications.Results:Seventeen female patients gave birth to 21 healthy infants. About one-third of the patients needed assisted reproductive techniques. Thalassemia major patients showed increased serum ferritin levels from 1203±1206 μg/L at baseline to 1880±1174 μg/L at the end of pregnancy. All babies are still alive and healthy.Conclusion:Pregnancy in patients with thalassemia can be safe for the mother and newborn with close monitoring and a multidisciplinary approach.

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Hematologic Complications of Pregnancy

Samuels¹

2017

Obstetrics: Normal and Problem Pregnancies

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A Case of Well-Tolerated and Safe Deferasirox Administration during the First Trimester of a Spontaneous Pregnancy in an Advanced Maternal Age Thalassemic Patient

Cited by 4 publications

References 18 publications

Oocyte quality in women with thalassaemia major: insights from IVF cycles

Oocyte quality in women with thalassaemia major: insights from IVF cycles

Fertility in Patients with Thalassemia and Outcome of Pregnancies: a Turkish Experience

Hematologic Complications of Pregnancy

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