Adolescent boys and young men with sickle cell disease are not sufficiently aware of the impact of the disease on their fertility.
Sickle cell disease is a genetic condition that causes abnormally shaped red blood cells. Sickle cells can bind together and block blood circulation throughout the body. This leads to poor nutrient and oxygen delivery, causing chronic pain, anaemia, and infertility, among other symptoms. It affects approximately one in 1000 live births worldwide, with a higher prevalence among individuals of African descent. A study published in Blood Advances has shown that awareness of the impact of sickle cell disease on fertility is low in families affected by the condition.
'Research to date shows semen parameters are abnormal in many men with sickle cell disease – both due to implications of the disease and its treatments. Experts have suggested offering fertility testing to male adolescents and young adults with sickle cell disease, yet formal guidelines have not been established, and patient and caregiver perspectives on this topic have not been examined,' said lead author Dr Leena Nahata, associated professor of clinical paediatrics at the Ohio State University College of Medicine and founder and medical director of the Fertility and Reproductive Health Programme at Nationwide Children's Hospital in Columbus, Ohio.
While sickle cell disease can affect fertility in men who have the condition as it can cause a range of problems in the testicles. A common medication hydroxyurea, commonly prescribed to decrease sickle cell disease-associated painful episodes, can also affect sperm counts.
A recent pilot study led by Dr Nahata published the results of 20 adolescents and young men aged between 14-21 diagnosed with sickle cell disease and 15 caregivers who had taken a questionnaire regarding their fertility-related knowledge and plans for parenthood. Eighty five percent of the young adults confirmed they had an interest in having biological children in the future, and 60 percent of the caregivers believed their sons to be keen on having a biological child too. Yet, 35 percent of young adults and 47 percent of their caregivers were unaware of how a semen sample would be obtained, and even fewer understood the purpose of it.
Over a third (37 percent) of young men surveyed said they were interested in semen analysis, and 45 percent of them said they would prefer to provide a sample in the hospital rather than at home.
The authors of this US-based study highlighted that many young men with sickle cell have poor access to healthcare and semen analysis is not covered by insurance laws in many states meaning it is not always available. They also suggest that patients would benefit from fertility focused education programmes from adolescence.
Sources and References
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Many male AYAs with sickle cell disease unaware of disease-related fertility issues
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Fertility testing knowledge and attitudes in male adolescents and youngadults with SCD and their caregivers: A pilot study
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Study shines light on fertility education gaps among adolescent and young adult men with sickle cell disease
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Male teens with sickle cell disease unaware of related fertility issues
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