Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care
Year: 2022
Type: review
Abstract: Curative therapy for sickle cell disease (SCD) currently requires gonadotoxic conditioning that can impair future fertility. Fertility outcomes after curative therapy are likely affected by pre-transplant ovarian reserve or semen analysis parameters that may already be abnormal from SCD-related damage or hydroxyurea treatment. Outcomes are also likely affected by the conditioning regimen. Conditioning with myeloablative busulfan and cyclophosphamide causes serious gonadotoxicity particularly among post-pubertal females. Reduced-intensity and non-myeloablative conditioning may be acutely less gonadotoxic, but more short and long-term fertility outcome data after these approaches is needed. Fertility preservation including oocyte/embryo, ovarian tissue, sperm, and experimental testicular tissue cryopreservation should be offered to patients with SCD pursing curative therapy. Regardless of HSCT outcome, longitudinal post-HSCT fertility care is required.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm11092318
Authors: Robert Sheppard Nickel, Jacqueline Y. Maher, Michael H. Hsieh, Meghan F. Davis, Matthew M. Hsieh, Lydia H. Pecker
Institutions: Children's National, George Washington University, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Heart, Lung, and Blood Institute, MedStar Georgetown University Hospital, Johns Hopkins University, Johns Hopkins Medicine
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,513
OpenAlex ID: W4224219815