Does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease?

Objective: We evaluated the effect of packed red cell transfusion (PCTx) on serum concentrations of gonadotropins luteinizing hormone and follicle-stimulating hormone (LH and FSH) and testosterone (T) levels and measured sperm parameters in young adults with sickle cell disease (SCD) on top-up trans...

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Main Authors: Ashraf T Soliman, Mohamed Yasin, Ahmed El-Awwa, Mohamed O Abdelrahman, Vincenzo De Sanctis
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2013-01-01
Series:Indian Journal of Endocrinology and Metabolism
Subjects:
Online Access:http://www.ijem.in/article.asp?issn=2230-8210;year=2013;volume=17;issue=6;spage=962;epage=968;aulast=Soliman
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author Ashraf T Soliman
Mohamed Yasin
Ahmed El-Awwa
Mohamed O Abdelrahman
Vincenzo De Sanctis
author_facet Ashraf T Soliman
Mohamed Yasin
Ahmed El-Awwa
Mohamed O Abdelrahman
Vincenzo De Sanctis
author_sort Ashraf T Soliman
collection DOAJ
description Objective: We evaluated the effect of packed red cell transfusion (PCTx) on serum concentrations of gonadotropins luteinizing hormone and follicle-stimulating hormone (LH and FSH) and testosterone (T) levels and measured sperm parameters in young adults with sickle cell disease (SCD) on top-up transfusion (TTx) and those on exchange transfusion (ETx) regimen. Materials and Methods: Basal serum concentrations of FSH, LH, and T and semen parameters were evaluated before and 7 days after PCTx in 18 young adults with transfusion-dependent SCD, aged 20.7 ± 2.88 years. They had full pubertal development (Tanner′s stage 5), and capacity to ejaculate. They were regularly transfused since early childhood. Chelation therapy was started early during the first 2 years of life using desferrioxamine and was replaced by deferasirox for the last 4-5 years. Ten patients were on TTx and eight were on ETx regimen. Results: PCTx significantly increased hemoglobin (Hb) from 8.5 ± 1.17 g/dl to 10.5 ± 0.4 g/dl, T from 12.3 ± 1.24 nmol/L to 14.23 ± 1.22 nmol/L and gonadotropins′ concentrations. Sperm parameters improved significantly after PCTx including: total sperm count from 87.4 ± 24.6 million/ml to 146.2 ± 51.25 million/ml, total progressive sperm motility (TPM) from 40.8 ± 11.1 million/ml to 93.4 ± 38.3 million/ml, rapid progressive sperm motility (RPM) progressive motility from 29.26 ± 8.75 million/ml to 67.4 ± 29 million/ml. After PCTx the total sperm count, TPM and RPM were significantly better in the ETx group versus the TTx group. Before and after PCTx, T concentrations were correlated significantly with sperm total count, volume, TPM and RPM (r = 0.53, 0.55, 0.42, and 0.38, respectively, P < 0.01). Hb concentrations were correlated significantly with sperm count, TPM, RPM, and % of sperms with normal morphology (r = 0.60, 0.69, 0.66, and 0.86, respectively, P < 0.001). Conclusion: Our study suggests that in males with SCD blood transfusion is associated with significant acute enhancement of sperm parameters and with increased concentrations of serum T, LH, and FSH. Improvement of sperm parameters were significantly better in the ETx group verses the TTx group. These "acute" effects on spermiogenesis are reached with an unknown mechanism/s and suggest a number of pathways that need further human and/or experimental studies.
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spelling doaj.art-a2d20cd0ccf641e5b5e8051e23c04c8f2022-12-22T03:18:57ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102230-95002013-01-0117696296810.4103/2230-8210.122599Does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease?Ashraf T SolimanMohamed YasinAhmed El-AwwaMohamed O AbdelrahmanVincenzo De SanctisObjective: We evaluated the effect of packed red cell transfusion (PCTx) on serum concentrations of gonadotropins luteinizing hormone and follicle-stimulating hormone (LH and FSH) and testosterone (T) levels and measured sperm parameters in young adults with sickle cell disease (SCD) on top-up transfusion (TTx) and those on exchange transfusion (ETx) regimen. Materials and Methods: Basal serum concentrations of FSH, LH, and T and semen parameters were evaluated before and 7 days after PCTx in 18 young adults with transfusion-dependent SCD, aged 20.7 ± 2.88 years. They had full pubertal development (Tanner′s stage 5), and capacity to ejaculate. They were regularly transfused since early childhood. Chelation therapy was started early during the first 2 years of life using desferrioxamine and was replaced by deferasirox for the last 4-5 years. Ten patients were on TTx and eight were on ETx regimen. Results: PCTx significantly increased hemoglobin (Hb) from 8.5 ± 1.17 g/dl to 10.5 ± 0.4 g/dl, T from 12.3 ± 1.24 nmol/L to 14.23 ± 1.22 nmol/L and gonadotropins′ concentrations. Sperm parameters improved significantly after PCTx including: total sperm count from 87.4 ± 24.6 million/ml to 146.2 ± 51.25 million/ml, total progressive sperm motility (TPM) from 40.8 ± 11.1 million/ml to 93.4 ± 38.3 million/ml, rapid progressive sperm motility (RPM) progressive motility from 29.26 ± 8.75 million/ml to 67.4 ± 29 million/ml. After PCTx the total sperm count, TPM and RPM were significantly better in the ETx group versus the TTx group. Before and after PCTx, T concentrations were correlated significantly with sperm total count, volume, TPM and RPM (r = 0.53, 0.55, 0.42, and 0.38, respectively, P < 0.01). Hb concentrations were correlated significantly with sperm count, TPM, RPM, and % of sperms with normal morphology (r = 0.60, 0.69, 0.66, and 0.86, respectively, P < 0.001). Conclusion: Our study suggests that in males with SCD blood transfusion is associated with significant acute enhancement of sperm parameters and with increased concentrations of serum T, LH, and FSH. Improvement of sperm parameters were significantly better in the ETx group verses the TTx group. These "acute" effects on spermiogenesis are reached with an unknown mechanism/s and suggest a number of pathways that need further human and/or experimental studies.http://www.ijem.in/article.asp?issn=2230-8210;year=2013;volume=17;issue=6;spage=962;epage=968;aulast=SolimanDesferrioxaminegonadotropinssickle cell diseasespermatogenesistestosterone
spellingShingle Ashraf T Soliman
Mohamed Yasin
Ahmed El-Awwa
Mohamed O Abdelrahman
Vincenzo De Sanctis
Does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease?
Indian Journal of Endocrinology and Metabolism
Desferrioxamine
gonadotropins
sickle cell disease
spermatogenesis
testosterone
title Does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease?
title_full Does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease?
title_fullStr Does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease?
title_full_unstemmed Does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease?
title_short Does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease?
title_sort does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease
topic Desferrioxamine
gonadotropins
sickle cell disease
spermatogenesis
testosterone
url http://www.ijem.in/article.asp?issn=2230-8210;year=2013;volume=17;issue=6;spage=962;epage=968;aulast=Soliman
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