Successful twin pregnancy in homozygous β-thalassemia after ovulation induction with growth hormone and gonadotropins

Surbek, Daniel; Koller, Andreas; Pavic, N.

doi:10.1016/s0015-0282(16)58175-8

Cited by 9 publications

(8 citation statements)

References 5 publications

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“…Discussing the possible treatment strategies, the authors do not recommend intrauterine embolisation of the shunt in cases which already show symptoms of intrauterine cardial insufficiency and encephalomalacy. This is in concordance with other authors [14,21] and in concordance with our approach.…”

Section: Discussionsupporting

confidence: 94%

“…Prognosis depends on shunt volume and secondary cerebral lesions such as hydrocephalus, hemorrhage, atrophy and microcephaly. The shunts may lead to encephalo-chorioideal imbalance, intracerebal steal-phenomena and consecutively to en- cephalomalacy [2,12,14,18,21,25]. Furthermore increased heart minute volume due to shunt perfusion may lead to cardiac insufficiency.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, only a few reports could attribute serious fetal or neonatal cardiocirculatory complications to NSAID-induced premature ductal occlusion [5,9,15,20,25], probably because only sustained constriction causes such problems [10,24]. More severe and longer lasting ductal narrowing by NS AID has been demonstrated in near-term compared with preterm fetuses [6,14,22]. Thus, fetal NSAID exposure in late gestation provides a possible explanation for increased susceptibility to irreversible ductal constriction in our case.…”

Section: Discussionmentioning

confidence: 99%

“…Recently we reported details of infertility treatment of a patient with homozygous /3-thalassemia major with a successful twin pregnancy following a novel ovulation induction protocol including growth hormone and gonadotropins [14]. In the present report we describe the course of gestation and clinical and laboratory data of the follow up of the newborn twins during breast feeding while desferrioxamine therapy was continued in the mother.…”

Section: Introductionmentioning

confidence: 88%

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Keck

Wilhelm²,

Wellens³

et al. 1998

Jpme

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Intracerebral aneurysms are rare. However they are potentially life-threatening. Today by means of ultrasound investigations these malformations can occasionally be identified prenatally. In these cases questions of intrauterine therapy, mode and time of delivery and postnatal treatment have to be discussed with the parents. We describe two cases with prenatal diagnosis of intracerebral arteriovenous malformations, diagnostic workup, therapeutic options and fetal outcome.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 88%

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Keck

Wilhelm²,

Wellens³

et al. 1998

Jpme

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“…The safety of pregnancy for both mothers with BTM and their babies, with proper care and guidance, has been repeatedly proposed by several studies, even in the case of intensive transfusion and chelation treatment [7, 15, 16]. Meanwhile, human GH as an adjunct to hMG and hCG seemed to be a sensible approach in the treatment of infertile homozygous BTM patients [17]. …”

Section: Btm and Fertility: Up-to-datementioning

confidence: 99%

Beta-Thalassemia Major and Female Fertility: The Role of Iron and Iron-Induced Oxidative Stress

Roussou

Tsagarakis

Kountouras

et al. 2013

Anemia

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Endocrine complications due to haemosiderosis are present in a significant number of patients with beta-thalassemia major (BTM) worldwide and often become barriers in their desire for parenthood. Thus, although spontaneous fertility can occur, the majority of females with BTM is infertile due to hypogonadotropic hypogonadism (HH) and need assisted reproductive techniques. Infertility in these women seems to be attributed to iron deposition and iron-induced oxidative stress (OS) in various endocrine organs, such as hypothalamus, pituitary, and female reproductive system, but also through the iron effect on other organs, such as liver and pancreas, contributing to the impaired metabolism of hormones and serum antioxidants. Nevertheless, the gonadal function of these patients is usually intact and fertility is usually retrievable. Meanwhile, a significant prooxidants/antioxidants imbalance with subsequent increased (OS) exists in patients with BTM, which is mainly caused by tissue injury due to overproduction of free radicals by secondary iron overload, but also due to alteration in serum trace elements and antioxidant enzymes. Not only using the appropriate antioxidants, essential trace elements, and minerals, but also regulating the advanced glycation end products, could probably reduce the extent of oxidative damage and related complications and retrieve BTM women's infertility.

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Infertility in β-thalassemia major

Surbek

Holzgreve

1996

American Journal of Obstetrics and Gynecology

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Successful twin pregnancy in homozygous β-thalassemia after ovulation induction with growth hormone and gonadotropins

Cited by 9 publications

References 5 publications

Short communications

Short communications

Beta-Thalassemia Major and Female Fertility: The Role of Iron and Iron-Induced Oxidative Stress

Infertility in β-thalassemia major

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