The Impact of Sickle Cell Disease and Its Treatment on Ovarian Reserve in Reproductive-aged Black Women

Overview

Journal Br J Haematol

Specialty Hematology

Date 2024 Jun 6

PMID 38841818

Authors

Lisa M Shandley

Ross M Fasano

Jessica B Spencer

Ann C Mertens

Laura J McPherson

Meredith A Dixon

Natalie Poliektov

Hailly E Butler

Sonjile M James

Penelope P Howards

Affiliations

Soon will be listed here.

Abstract

We compared serum anti-Mullerian hormone (AMH) levels in women with sickle cell disease (SCD) (n = 152) to those of Black comparison women (n = 128) between the ages of 20 and 45 years and evaluated the impact of hydroxyurea (HU) and iron overload on ovarian reserve in those with SCD. SCD treatment was abstracted from medical records. Linear regression models were fit to examine the relationship between log(AMH) and SCD, adjusting for age. The analysis was repeated to account for HU use (current, previous, never) and iron overload (ferritin ≥1000 ng/mL vs. <1000 ng/mL). AMH estimates among women with SCD were lower than those among comparison women (2.23, 95% confidence interval [CI] 1.80-2.76 vs. 4.12, 95% CI 3.11-5.45, respectively). Women with SCD who were currently using HU had 63% lower (95% CI 43-76) AMH values than comparison women; those with SCD with prior or no HU use also had lower AMH estimates than comparison women, but the difference was less pronounced. There were no differences in predicted AMH values among women with SCD for those with and without iron overload. Women with SCD and low AMH may have a shorter reproductive window and may benefit from referral to a reproductive specialist.

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