Effect of iron overload on impaired fertility in male patients with transfusion-dependent beta-thalassemia

Chen, Mei-Jou; Peng, Steven Shinn-Forng; Lu, Meng‐Yao; Yang, Yung‐Li; Jou, Shiann‐Tarng; Chang, Hsiu-Hao; Chen, Shee‐Uan; Lin, Dong‐Tsamn; Lin, Kai‐Hsin

doi:10.1038/pr.2017.296

Cited by 38 publications

(32 citation statements)

References 43 publications

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“…As it turns out, ferroportin is expressed on Sertoli cells, which is present only on cells substantially involved in maintaining adequate serum iron levels [62,63]. Besides, it has been also established that there is a significant iron deposition in the testis of patients with transfusion-dependent beta-thalassemia and such findings might explain the high prevalence of impaired fertility in male patients, even though the pituitary function seems not to be decreased [64,65].…”

Section: Ironmentioning

confidence: 99%

An impact of selected micronutrients on fertility

Żak

Leziak

Niedobylski

et al. 2020

J Educ Health Sport

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Introduction and purpose: The problem with infertility affects between 8 and 12% of reproductive-aged couples. Among the reasons, smoking, adulterated food, hormonal disorder are featured. Our purpose is to check how micronutrients impact fertility. Brief description of the state of knowledge: Micronutrients deficiency, specifically zinc and selenium deficiencies have also unpropitious impact on fertility. In this review, the potential role of these microelements in male and female reproductive health is considered. Zinc had been proved to regulate sperm motility, spermatogenesis and reduce oxidative stress. Lower delivery of selenium decrease testosterone level by causing changes in receptor of the luteinising hormone. It is also compared with lower spermatozoa concentration. In this review the role of iron, manganese, lead, nickel, copper, magnesium and cobalt is described as well. Summary: Deficiencies of some micronutrients may make worse the fertility. That's the reason why additional supplementation may be important in the treatment of infertility.

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Section: Ironmentioning

confidence: 99%

An impact of selected micronutrients on fertility

Żak

Leziak

Niedobylski

et al. 2020

J Educ Health Sport

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“…Primary hypogonadism was defined by low T and elevated gonadotropin levels (LH and FSH) [15,16]. Hypogonadotropic hypogonadism was defined as LH and FSH levels< 2 IU/l, a Ts concentration < 3 ng/ml [17].…”

Section: Fertility Indicators Assessmentsmentioning

confidence: 99%

Indicators of male fertility potential in adult patients with beta-thalassemia major: a comparative study between patients undergone allogeneic stem cell transplantation and transfusion-dependent patients

Rostami

Mohammadifard

Ansari

et al. 2020

Fertil Res and Pract

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Background: Allogeneic hematopoietic stem cell transplantation (HSCT) remains the only potentially curative treatment for thalassemia major (TM). Infertility and its indicators have been assessed in transfusion dependent TM men, but in this study, we sought to compare the fertility indicators of TM patients after HSCT with those in patients treated conventionally. The possible influential factors on reproductive capacity in TM patients undergone allogeneic HSCT were also evaluated. Patients and methods: In this cross-sectional study, we compared the gonadal hormones level, testicular volume, Tanner stage and sperm analysis in transfusion-dependent thalassemia major (TDTM) patients who survived matched sibling HSCT (n = 43) with patients conventionally treated by transfusion and iron chelation (n = 52). Results: The patients' age range was between 16 to 41 years. Tanner stage 4-5 was seen in 39 patients (41%). The prevalence of hypogonadism in our patients was 32.63% but its frequency was not significantly different between the two groups (p = 0.35). Azospermia, oligospermia, astenospermia, teratospermia and even having dry and low volume ejaculate were all significantly more frequent in the post-transplant patients compared to TDTM group. In the post-HSCT group, neither patients' age at transplantation nor the conditioning regimen used in their transplant process did significantly affect their hormonal status and sperm parameters. Chronic graft versus host disease (GVHD) occurred in 14 (40%) patients. No significant difference was observed between the grade of chronic GVHD and hypogonadism (P = 0.853). Conclusions: Thalassemia patients undergone allogeneic HSCT have lower fertility potential, mainly in sperm parameters compared with patients treated with blood transfusion and chelation. This information is important for thalassemic patients considering HSCT.

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“…Indeed, we found a significant correlation between transfusion-related iron overload and decreased reproductive capacities. 11,27,28 In addition, given the frequency of liver injuries related to the extent of iron overload in thalassemia patients, the metabolism and conversion of steroid hormones to their active metabolites can also be disrupted. 29 In fact, our data showed that the mean serum ferritin level was positively correlated with ALT (r = 0.366 and P = .000) and AST (r = 0.538 and P = .000) levels.…”

Section: Type Of Thalassemia and Pregnancy Managementmentioning

confidence: 99%

“…10 In addition, direct effects of iron on the gonads compromise primary ovarian and testicular function while iron effect on other organs, such as the liver and pancreas, contribute to the impaired metabolism and conversion of steroid hormones to their active metabolites. [11][12][13] Despite a large number reports of spontaneous fertility in the well-chelated and -transfused patients, the life expectancy of many patients is still affected by hypogonadism, coexisting infections and allo-antibodies, which highlight the magnitude of therapeutic and preventive advances in thalassemia management. 14 Therefore, this report focuses on the factors affecting the various aspects of fertility, couple health status and spontaneous or complicated pregnancies of married thalassemia patients as well as the intervention options to achieve a more desirable reproductive health.…”

mentioning

confidence: 99%

Fertility and pregnancy in Iranian thalassemia patients: An update on transfusion complications

Takhviji

Zibara

Azarkeivan

et al. 2020

Transfusion Medicine

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Background: Despite the significant advances in thalassemia pathobiology and efficacy of chelation regimens, complications of transfusion therapy have attenuated the reproductive health of thalassemia patients. Depending on clinical profiles, we aimed to assess the fertility status and stresses among thalassemia patients who desired to have children. Material and methods: A total of 213 couples in reproductive ages were enrolled in this study in Tehran. Patients' demographic, clinical, fertility and spouse's health status were documented. We evaluated the pituitary-gonadal axis, serum ferritin, liver enzymes, and alloimmunization before planning a pregnancy and reported them as a function of spontaneous conception and transfusion dependency. Results: Data showed that 131 patients (62%) had 228 spontaneous pregnancies leading to 198 (86.6%) successful pregnancies. A significant difference was observed in spontaneous pregnancy with respect to fertility complications and transfusion dependency. In addition, the clinical conditions of spouses in patients with any spontaneous pregnancy were more thalassemia carriers (P < .05). Moreover, serum ferritin levels had a significant negative correlation with the levels of Testosterone, Estradiol, luteinizing hormone, and follicle-stimulating hormone. Furthermore, a significant positive correlation was reported with the level of liver enzymes. Finally, alanine transaminase and aspartate transaminase had a significant negative correlation with pituitary hormones. Conclusion: We suggest that organised instruction in addition to good iron chelation, especially during the puberty period, would reduce the oxidative damage and related complications in thalassemia patients. Moreover, infertility seems to be attributed to iron deposition in various endocrine organs, pituitary, reproductive system and the liver, contributing to hormonal metabolism.

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Effect of iron overload on impaired fertility in male patients with transfusion-dependent beta-thalassemia

Cited by 38 publications

References 43 publications

An impact of selected micronutrients on fertility

An impact of selected micronutrients on fertility

Indicators of male fertility potential in adult patients with beta-thalassemia major: a comparative study between patients undergone allogeneic stem cell transplantation and transfusion-dependent patients

Fertility and pregnancy in Iranian thalassemia patients: An update on transfusion complications

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