A recent multicenter study sought to elucidate trends and issues regarding fertility preservation in people undergoing treatment for sickle cell anemia. They found that half of those who used fertility preservation services did so through public insurance or clinical trials. Of those who accessed fertility preservation, complications were common.
“Fertility preservation benefits are balanced against procedural risks, potential low oocyte yield with diminished ovarian reserve, and access barriers,” wrote the authors, led by Marti Goldenberg, DO, of Johns Hopkins Hospital in Baltimore, Maryland. The group presented their findings at the ASH Annual Meeting.
The researchers collected retrospective data on 46 patients with sickle cell anemia who underwent controlled ovarian hyperstimulation (COH, 55 cycles) and oocyte cryopreservation (OC) at five centers from January 2016 to May 2024. The patients’ median age was 23.7 years. They had various types of insurance status: private (n=15), public (n=9), self-pay (n=6), or research protocol (n=15).
Most (44 of 46) received fertility preservation treatment before curative therapy. At the time of COH, most of the subjects were receiving chronic transfusion therapy (n=25), hydroxyurea (HU) (n=37), or both (n=19). Thirty-six subjects had one COH cycle, three cycles were canceled due to poor ovarian response, and six subjects required multiple cycles, either for low oocyte yield (n=5) or cycle cancelation (n=1). The median number of oocytes retrieved per cycle was 14, and the number of cryopreserved mature oocytes was 11. Maturity rate was 72%.
Complications occurred in 25 of 55 cycles, including unplanned transfusion (n=10), mild to moderate ovarian hyperstimulation syndrome (n=2), bacteremia requiring intensive care (n=1), and vaso-occlusive episodes (VOEs) (n=29). Analysis revealed that OC complications were associated with a history of three or more VOEs in the year prior.
The authors hope their study results can help inform counseling, care, and advocacy efforts among patients with sickle cell anemia.
https://ash.confex.com/ash/2024/webprogram/Paper194008.html
Reference
Goldenberg M, Cromack SC, Jessica Walter J, et al. Fertility preservation outcomes for people with ovaries and sickle cell anemia: a multi-center study. Abstract #802. Presented at the 66th American Society of Hematology Annual Meeting and Exposition; December 7–10, 2024; San Diego, California.
