Influence of sickle cell disease and treatment with hydroxyurea on sperm parameters and fertility of human males
Influence of sickle cell disease and treatment with hydroxyurea on sperm parameters and fertility of human males
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DOI：
10.3324/haematol.11515
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发表时间：
2008-07-01
期刊：
影响因子：
--
通讯作者：
Mandelbaum, Jacqueline
中科院分区：
文献类型：
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作者：
Berthaut, Isabelle;Guignedoux, Geoffroy;Mandelbaum, Jacqueline
背景镰状细胞病治疗的最新进展，特别是羟基脲的使用，极大地改变了该病的预后。现在有更多的患者达到了生育年龄。本研究的目的是评估羟基脲对患者精液的潜在影响。设计与方法在这项回顾性多中心研究中，我们评估了44例患者的精子参数和生育能力，并分析了羟基脲的潜在影响。我们报告了迄今为止最大的镰状细胞病患者精液分析系列数据：分析了108份样本，其中76份是在治疗前收集的。我们发现91%的患者在治疗前至少有一个精子参数异常，这与已发表的文献一致。在羟基脲治疗期间收集的精液样本中，所有精子参数似乎都受到了影响，这种损害在不到6个月的时间内发生，随后达到平稳期。此外，停用羟基脲后，虽然30例患者的总体结果在羟基脲治疗前后没有统计学差异，但在4例患者中，随访的精子参数似乎没有迅速恢复，每次射精的精子总数在大约一半的病例中低于正常范围。结论羟基脲治疗可加重镰状细胞病患者精液参数的改变。在前瞻性研究显示令人放心的结果之前，我们建议在治疗前进行精子分析，并在羟基脲治疗前为患者提供精子冷冻保存。
BackgroundRecent progress in the treatment of sickle cell disease, in particular the use of hydroxyurea, has considerably modified the prognosis of this disease. Many more patients now reach reproductive age. The objective of this study was to assess the potential impact of hydroxyurea on the semen of patients.Design and MethodsIn this retrospective multicenter study, we evaluated the sperm parameters and fertility of 44 patients and analyzed the potential impact of hydroxyurea.ResultsWe report data from the largest series so far of semen analyses in patients with sickle cell disease: 108 samples were analyzed, of which 76 were collected before treatment. We found that at least one sperm parameter was abnormal in 91% of the patients before treatment, in agreement with published literature. All sperm parameters seemed to be affected in semen samples collected during hydroxyurea treatment, and this impairment occurred in less than 6 months, later reaching a plateau. Furthermore, after hydroxyurea cessation, while global results in 30 patients were not statistically different before and after hydroxyurea treatment, in four individuals follow-up sperm parameters did not seem to recover quickly and the total number of spermatozoa per ejaculate fell below the normal range in about half the cases.ConclusionsThe observed alterations of semen parameters due to sickle cell disease seem to be exacerbated by hydroxyurea treatment. Until prospective studies reveal reassuring findings, we suggest that a pre-treatment sperm analysis be performed and sperm cryopreservation be offered to patients before hydroxyurea treatment.