“…The prevalence and severity of hypogonadism in thalassemia major varies among studies, depending on the age group studied, genotype of thalassemia [17,18], extent of transfusion, age at the beginning and type of iron chelation therapy [18,19].The anterior pituitary gland is sensitive, in a dose-dependent fashion, to the effects of iron overload from transfusions [20]. Studies of human anterior pituitary adenomas showed that gonadotropes require more iron as compared with other pituitary cell types [21]. Thus, these cells are most affected, resulting in declining synthesis of luteinizing hormone (LH) and follicle-stimulating hormone (FSH).…”