Gonadal dysfunction in adult male patients with thalassemia major: an update for clinicians caring for thalassemia.

Abstract:

INTRODUCTION:Hypogonadism is the most frequently reported endocrine complication, affecting 40%-80% of thalassemia major (TM) patients. The prevalence and severity of hypogonadism in TM varies among studies, depending on patients' age, genotype, transfusion frequency and starting age and efficiency of iron chelation. Areas covered: The diagnosis requires careful clinical assessment and appropriate laboratory testing. Its management is more complex compared to other 'classical' causes of hypogonadism because of multiple associated disorders (cardiac, hepatic and endocrine) and other contributing factors basically iron overload and iron toxicity. Expert commentary: Early recognition and treatment of hypogonadism in TM patients is most important to prevent late complications and to enhance the chances of parenthood. The goal of management is to restore deficient glandular function. If fertility is the issue and the testis is under-stimulated because of gonadotropin deficiency, it is possible to induce or restore spermatogenesis with exogenous gonadotropins in some patients. Assisted reproductive techniques may supplementary help to overcome previously untreatable causes of male infertility. These positive achievements should encourage health care providers to pay closer attention to the reproductive health of TM patients. This would involve the collaboration of clinicians caring for thalassemia with endocrinologists and specialists in assisted reproductive technologies.

journal_name

Expert Rev Hematol

authors

De Sanctis V,Soliman AT,Elsedfy H,Di Maio S,Canatan D,Soliman N,Karimi M,Kattamis C

doi

10.1080/17474086.2017.1398080

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

1095-1106

issue

12

eissn

1747-4086

issn

1747-4094

journal_volume

10

pub_type

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