Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Nickel, Robert Sheppard, Maher, Jacqueline Y., Hsieh, Michael H., Davis, Meghan F., Hsieh, Matthew M., Pecker, Lydia H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9105328/
https://www.ncbi.nlm.nih.gov/pubmed/35566443
http://dx.doi.org/10.3390/jcm11092318
_version_ 1784708013722959872
author Nickel, Robert Sheppard
Maher, Jacqueline Y.
Hsieh, Michael H.
Davis, Meghan F.
Hsieh, Matthew M.
Pecker, Lydia H.
author_facet Nickel, Robert Sheppard
Maher, Jacqueline Y.
Hsieh, Michael H.
Davis, Meghan F.
Hsieh, Matthew M.
Pecker, Lydia H.
author_sort Nickel, Robert Sheppard
collection PubMed
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.
format Online
Article
Text
id pubmed-9105328
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-91053282022-05-14 Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care Nickel, Robert Sheppard Maher, Jacqueline Y. Hsieh, Michael H. Davis, Meghan F. Hsieh, Matthew M. Pecker, Lydia H. J Clin Med Review 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. MDPI 2022-04-21 /pmc/articles/PMC9105328/ /pubmed/35566443 http://dx.doi.org/10.3390/jcm11092318 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Nickel, Robert Sheppard
Maher, Jacqueline Y.
Hsieh, Michael H.
Davis, Meghan F.
Hsieh, Matthew M.
Pecker, Lydia H.
Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care
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 Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9105328/
https://www.ncbi.nlm.nih.gov/pubmed/35566443
http://dx.doi.org/10.3390/jcm11092318
work_keys_str_mv AT nickelrobertsheppard fertilityaftercurativetherapyforsicklecelldiseaseacomprehensivereviewtoguidecare
AT maherjacqueliney fertilityaftercurativetherapyforsicklecelldiseaseacomprehensivereviewtoguidecare
AT hsiehmichaelh fertilityaftercurativetherapyforsicklecelldiseaseacomprehensivereviewtoguidecare
AT davismeghanf fertilityaftercurativetherapyforsicklecelldiseaseacomprehensivereviewtoguidecare
AT hsiehmatthewm fertilityaftercurativetherapyforsicklecelldiseaseacomprehensivereviewtoguidecare
AT peckerlydiah fertilityaftercurativetherapyforsicklecelldiseaseacomprehensivereviewtoguidecare