Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care

Authors

Robert Sheppard Nickel, Children's National Hospital, Division of Hematology, Washington, DC 20001, USA.
Jacqueline Y. Maher, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Pediatric and Adolescent Gynecology, National Institutes of Health, Bethesda, MD 20810, USA.
Michael H. Hsieh, School of Medicine and Health Sciences, The George Washington University, Washington, DC 20001, USA.
Meghan F. Davis, Department of Urology, MedStar Georgetown University Hospital, Washington, DC 20001, USA.
Matthew M. Hsieh, Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20810, USA.
Lydia H. Pecker, Division of Hematology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD 20810, USA.

Document Type

Journal Article

Publication Date

4-21-2022

Journal

Journal of clinical medicine

Volume

11

Issue

9

DOI

10.3390/jcm11092318

Keywords

bone marrow transplant; fertility; infertility; sickle cell disease

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.

APA Citation

Nickel, Robert Sheppard; Maher, Jacqueline Y.; Hsieh, Michael H.; Davis, Meghan F.; Hsieh, Matthew M.; and Pecker, Lydia H., "Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care" (2022). GW Authored Works. Paper 765.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/765

Department

Urology