Abstract:
:The pathophysiology of iron-induced compromised fertility in women with thalassemia major (TM) was evaluated in 26 adult TM females. Low gonadotropin secretion resulted in reduced ovarian antral follicle count and ovarian volume, but levels of anti-müllerian hormone (AMH), a sensitive marker for ovarian reserve independent of gonadotropin effect, were mostly normal. AMH correlated with non-transferrin-bound iron (NTBI), suggesting a role of labile iron in the pathogenesis of decreased reproductive capacity, possibly occurring in parallel to cardiac iron toxicity, as cardiac iron was associated with the presence of amenorrhea and with NTBI levels. AMH emerges as an important biomarker for assessment of reproductive capacity in TM, demonstrating that fertility is preserved in the majority of those younger than 30 to 35 years. AMH can be useful in future studies aiming at improved chelation for fertility preservation, whereas NTBI and labile plasma iron may be valuable for monitoring iron effect on the reproductive system.
journal_name
Bloodjournal_title
Bloodauthors
Singer ST,Vichinsky EP,Gildengorin G,van Disseldorp J,Rosen M,Cedars MIdoi
10.1182/blood-2011-06-360271subject
Has Abstractpub_date
2011-09-08 00:00:00pages
2878-81issue
10eissn
0006-4971issn
1528-0020pii
blood-2011-06-360271journal_volume
118pub_type
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