Patients with sickle cell disease (SCD), especially males, face a key problem in the form of infertility. Apart from low serum testosterone, abnormalities involving accessory sex organs are also observed in these patients. Infertility is a known complication among males with SCD, and it comes about due to reasons such as impotence, relative primary gonadal failure, priapism, and delayed or impaired sexual development. Infertility manifests due to multiple causes, including primary gonadal failure (hypogonadism), erectile dysfunction (ED) as a result of priapism, sperm abnormalities, and delayed or impaired sexual development. The ejaculate volume, sperm density, sperm motility, and normal sperm morphology were significantly reduced in these patients as compared with normal patients. Most importantly, primary testicular failure is marked by low levels of testosterone and infertility results mainly from diseases or conditions that affect and destroy the testis. The low levels of testosterone lead to fertility reduction, which is aggravated by impotence, secondary to earlier priapism. Studies among mice have shown that increased doses of HU increase testicular germ cell apoptosis, decrease sperm count, induce testicular atrophy, increase abnormal sperm morphology, and decrease sperm motility. A multifactorial etiology is responsible for impaired male fertility and it includes sperm abnormalities, ED, hypogonadism, and effect of therapy on sperm function. This paper summarizes some clinical manifestations which play an important role in the development of infertility among men with SCD. The author suggests that prospective studies among males with SCD should be carried out using various end points to determine cellular and functional impairment in fertility.

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I ndividuals with sickle cell trait (SCT), the heterozygous state of sickle hemoglobin β-globin gene (HbAS), are generally reassured that their health will not be affected by their carrier status. Renal disease, especially hematuria, is one of the most common and severe complications experienced by patients with sickle cell disease (SCD); but a complete understanding of the relationship between SCT and the development of chronic kidney disease (CKD) is still lacking. In this short review, we present an overview of SCT and renal complications in SCT, and discuss and identify SCT as a risk factor resulting from an interplay between genetic and environmental influences. Although SCT itself may not be a disease in itself, there is evidence suggesting clinical conditions related to SCT. Additionally, we highlight the rationale for further studies into this area, which could affect the global public health recommendations on any associated health risks.

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