Experiences and outcomes of fertility testing in male adolescents with sickle cell disease

Creary, Susan; Liles, Sophia M.; Colton, Zachary A.; Stanek, Charis J.; Hudnall, Matthew C.; Quinn, Gwendolyn P.; Nahata, Leena

doi:10.1002/pbc.30848

Cited by 1 publication

(1 citation statement)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our analyses most importantly highlights how education regarding common infertility risks factors must be addressed alongside disease-and treatmentassociated fertility risks, and is of equal importance in both genders. Full education can avoid the possibility that adults with SCD refuse treatment due to infertility concerns [67][68][69].…”

Section: Discussionmentioning

confidence: 99%

Effects of hydroxyurea on fertility in male and female sickle cell disease patients. A systemic review and meta-analysis

Sewaralthahab,

Alsubki,

Alhrabi

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

Background Evidence supports the benefits of hydroxyurea (HU) in adults with sickle cell disease (SCD), but reservations remain due to long-term concerns of fertility. Retrospective analysis of clinical records of SCD patients (haemoglobin SS genotype) have identified gender-related differences in disease progression. This could inform risk stratification during SCD at diagnosis with the possibility to guide therapeutic decisions. Methods This systemic review and meta-analysis evaluated fertility parameters in both children (aged ≥ 6 years) and adults with SCD receiving HU therapy. Studies were sourced from PubMed and EMBASE from inception to July 2023. A total of 160 potentially relevant articles were identified. Results Four studies were included that evaluated the effects of HU on sperm parameters in males. A further 4 studies assessed anti-mullerian hormone (AMH) levels and ovarian reserves in females. Differences from baseline values were used to identify compromised fertility. Amongst males, HU treatment negatively impacted the concentration of spermatozoa (MD = -15.48 million/mL; 95% CI: [-20.69, -10.26]; p< 0.001), which continued following treatment cessation (MD = -20.09 million/mL; 95% CI: [-38.78, -1.40]; P = 0.04). HU treatment also led to lower total sperm counts (MD = -105.87 million; 95% CI: [-140.61, -71.13]; P< 0.001) which persisted after treatment (MD = -53.05 million; 95% CI: [-104.96, -1.14]; P = 0.05). Sperm volume, initial forward motility and morphology were unaffected by HU treatment. In females, HU treatment decreased the mean AMH levels 1.83 (95% CI [1.42, 2.56]. A total of 18.2.% patients treated with HU showed reduced ovarian reserves. Interpretation & conclusions This systemic review and meta-analysis suggest that the use of HU for SCD impacts seminal fluid parameters in males and can diminish AMH levels and ovarian reserves in females.

show abstract

Section: Discussionmentioning

confidence: 99%