Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care
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 dama...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/9/2318 |
| _version_ | 1797504276871774208 |
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| author | Robert Sheppard Nickel Jacqueline Y. Maher Michael H. Hsieh Meghan F. Davis Matthew M. Hsieh Lydia H. Pecker |
| author_facet | Robert Sheppard Nickel Jacqueline Y. Maher Michael H. Hsieh Meghan F. Davis Matthew M. Hsieh Lydia H. Pecker |
| author_sort | Robert Sheppard Nickel |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T04:02:21Z |
| format | Article |
| id | doaj.art-5a4facdee2a440d484ab126d11f434c7 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T04:02:21Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-5a4facdee2a440d484ab126d11f434c72023-11-23T08:30:37ZengMDPI AGJournal of Clinical Medicine2077-03832022-04-01119231810.3390/jcm11092318Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide CareRobert Sheppard Nickel0Jacqueline Y. Maher1Michael H. Hsieh2Meghan F. Davis3Matthew M. Hsieh4Lydia H. Pecker5Children’s National Hospital, Division of Hematology, Washington, DC 20001, USAEunice Kennedy Shriver National Institute of Child Health and Human Development, Pediatric and Adolescent Gynecology, National Institutes of Health, Bethesda, MD 20810, USASchool of Medicine and Health Sciences, The George Washington University, Washington, DC 20001, USADepartment of Urology, MedStar Georgetown University Hospital, Washington, DC 20001, USACellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20810, USADivision of Hematology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD 20810, USACurative 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.https://www.mdpi.com/2077-0383/11/9/2318fertilityinfertilitysickle cell diseasebone marrow transplant |
| spellingShingle | Robert Sheppard Nickel Jacqueline Y. Maher Michael H. Hsieh Meghan F. Davis Matthew M. Hsieh Lydia H. Pecker Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care Journal of Clinical Medicine fertility infertility sickle cell disease bone marrow transplant |
| title | Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care |
| title_full | Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care |
| title_fullStr | Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care |
| title_full_unstemmed | Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care |
| title_short | Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care |
| title_sort | fertility after curative therapy for sickle cell disease a comprehensive review to guide care |
| topic | fertility infertility sickle cell disease bone marrow transplant |
| url | https://www.mdpi.com/2077-0383/11/9/2318 |
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