Acute effects of blood transfusion on pituitary gonadal axis and sperm parameters in adolescents and young men with thalassemia major: a pilot study

Soliman, Ashraf T.; Yasin, Mohamed Salleh Mohamed; Elawwa, Ahmed; Osman, M. A.; Sanctis, Vincenzo De

doi:10.1016/j.fertnstert.2012.05.047

Cited by 23 publications

(16 citation statements)

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“…[1516] In addition, a study of diabetic men with low testosterone, 24% of them had anemia, which showed that lower testosterone levels were found to be independently associated with lower hemoglobin and iron levels. [38] In another study in old males, independent of age, total and bioavailable testosterone levels were linearly correlated with hemoglobin levels.…”

Section: Discussionmentioning

confidence: 99%

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Intravenous iron replacement therapy in eugonadal males with iron-deficiency anemia: Effects on pituitary gonadal axis and sperm parameters; A pilot study

Soliman

Yassin

Sanctis

2014

Indian J Endocr Metab

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Aim of the study:To evaluate semen parameters and to assess serum FSH, LH, Testosterone (T) concentrations before and 12 weeks after intravenous iron therapy (800-1200 mg elemental iron therapy - IVI) in adults with iron-deficiency anemia (IDA).Materials and Methods:We studied 11 eugonadal adults with IDA, aged 40 ± 5 years, due to defective intake of iron. Anemia was diagnosed when hemoglobin (Hb) was equal or below 10 g/dl. Serum iron, total iron-binding capacity (TIBC) and ferritin concentrations confirmed the diagnosis of IDA. Basal serum concentrations of FSH, LH, and T were measured. Semen parameters were evaluated before and 6-7 weeks after IVI therapy.Results:After IVI therapy and correction of anemia, a significant increase of Hb from 8.1 ± 1.17 g/dL to 13.1 ± 0.7 g/dL was observed and was associated with an increase of T (from 12.22 ± 1.4 nmol/L to 15.9 ± 0.96 nmol/L; P < 0.001), FSH (from 2.82 ± 0.87 to 3.82 ± 1.08 IU/L; P = 0.007), and LH (from 2.27 ± 0.9 to 3.82 ± 1.5 IU/L; P = 0.0002). Total sperm count (TSC) increased significantly from 72 ± 17.5 million/ml to 158 ± 49 million/mL (P < 0.001), rapid progressive sperm motility (RPM) increased from 22 ± 9.4 to 69 ± 30 million/ml (P < 0.001), and sperms with normal morphology (NM) increased from 33 ± 5 to 56 ± 7 million/ml (P < 0.001). Increment in Hb concentration was correlated significantly with LH, FSH, and T concentrations after IVI (r = 0.69 and r = 0.44, r = 0.75, respectively; P < 0.01). The increment in serum T was correlated significantly with increments in the TSC and total sperm motility and RPM (r = 0.66, 0.43, and 0.55, respectively; P < 0.001) but not with gonadotrophin levels.Conclusion:Our study proved for the first time, to our knowledge, that correction of IDA with IVI is associated with significant enhancement of sperm parameters and increased concentrations of serum LH, FSH, and T. These effects on spermatogenesis are reached by an unknown mechanism and suggest a number of pathways that need further human and/or experimental studies.

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Section: Discussionmentioning

confidence: 99%

“…iron toxicity and effect of chelation therapy in thalassemia, vaso-occlusive attacks in sickle cell disease, and the effect of uremic toxins in CRF. [151617] To the best of our knowledge, the effect of isolated IDA on spermatogenesis and fertility has not been studied.…”

Section: Introductionmentioning

confidence: 99%

Intravenous iron replacement therapy in eugonadal males with iron-deficiency anemia: Effects on pituitary gonadal axis and sperm parameters; A pilot study

Soliman

Yassin

Sanctis

2014

Indian J Endocr Metab

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“…It seemed that fertility was more compromised in male TDTM patients. Impotence, oligospermia and asthenospermia are common in adult male patients . Tremellen et al .…”

Section: Discussionmentioning

confidence: 99%

Marriage and child bearing in patients with transfusion‐dependent thalassemia major

Zafari

Kosaryan

2014

J of Obstet and Gynaecol

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“…[345678910111213141526] Recently, some data showed that blood transfusion produce significant acute changes in the hormonal milieu and sperm parameters of patients with chronic hemolytic anemia. [272829] Therefore, we studied the acute effects of PCTx on spontaneous spermatogenesis and pituitary testicular axis in young eugonadal males with transfusion-requiring SCD (10 were on TTx and eight were on ETx).…”

Section: Discussionmentioning

confidence: 99%

Does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease?

Soliman

Yasin

Elawwa

et al. 2013

Indian J Endocr Metab

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Objective:We evaluated the effect of packed red cell transfusion (PCTx) on serum concentrations of gonadotropins luteinizing hormone and follicle-stimulating hormone (LH and FSH) and testosterone (T) levels and measured sperm parameters in young adults with sickle cell disease (SCD) on top-up transfusion (TTx) and those on exchange transfusion (ETx) regimen.Materials and Methods:Basal serum concentrations of FSH, LH, and T and semen parameters were evaluated before and 7 days after PCTx in 18 young adults with transfusion-dependent SCD, aged 20.7 ± 2.88 years. They had full pubertal development (Tanner's stage 5), and capacity to ejaculate. They were regularly transfused since early childhood. Chelation therapy was started early during the first 2 years of life using desferrioxamine and was replaced by deferasirox for the last 4-5 years. Ten patients were on TTx and eight were on ETx regimen.Results:PCTx significantly increased hemoglobin (Hb) from 8.5 ± 1.17 g/dl to 10.5 ± 0.4 g/dl, T from 12.3 ± 1.24 nmol/L to 14.23 ± 1.22 nmol/L and gonadotropins’ concentrations. Sperm parameters improved significantly after PCTx including: total sperm count from 87.4 ± 24.6 million/ml to 146.2 ± 51.25 million/ml, total progressive sperm motility (TPM) from 40.8 ± 11.1 million/ml to 93.4 ± 38.3 million/ml, rapid progressive sperm motility (RPM) progressive motility from 29.26 ± 8.75 million/ml to 67.4 ± 29 million/ml. After PCTx the total sperm count, TPM and RPM were significantly better in the ETx group versus the TTx group. Before and after PCTx, T concentrations were correlated significantly with sperm total count, volume, TPM and RPM (r = 0.53, 0.55, 0.42, and 0.38, respectively, P < 0.01). Hb concentrations were correlated significantly with sperm count, TPM, RPM, and % of sperms with normal morphology (r = 0.60, 0.69, 0.66, and 0.86, respectively, P < 0.001).Conclusion:Our study suggests that in males with SCD blood transfusion is associated with significant acute enhancement of sperm parameters and with increased concentrations of serum T, LH, and FSH. Improvement of sperm parameters were significantly better in the ETx group verses the TTx group. These “acute” effects on spermiogenesis are reached with an unknown mechanism/s and suggest a number of pathways that need further human and/or experimental studies.

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Acute effects of blood transfusion on pituitary gonadal axis and sperm parameters in adolescents and young men with thalassemia major: a pilot study

Cited by 23 publications

References 47 publications

Intravenous iron replacement therapy in eugonadal males with iron-deficiency anemia: Effects on pituitary gonadal axis and sperm parameters; A pilot study

Intravenous iron replacement therapy in eugonadal males with iron-deficiency anemia: Effects on pituitary gonadal axis and sperm parameters; A pilot study

Marriage and child bearing in patients with transfusion‐dependent thalassemia major

Does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease?

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