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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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 |
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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 |
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