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Effects of hydroxyurea on fertility in male and female sickle cell disease patients. A systemic review and meta-analysis

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  • Sarah Sewaralthahab
  • Lujain A Alsubki
  • Maram S Alhrabi
  • Abdulrahman Alsultan

Abstract

Background: Evidence supports the benefits of hydroxyurea (HU) in adults with sickle cell disease (SCD), but reservations remain due to long-term concerns of fertility. Retrospective analysis of clinical records of SCD patients (haemoglobin SS genotype) have identified gender-related differences in disease progression. This could inform risk stratification during SCD at diagnosis with the possibility to guide therapeutic decisions. Methods: This systemic review and meta-analysis evaluated fertility parameters in both children (aged ≥ 6 years) and adults with SCD receiving HU therapy. Studies were sourced from PubMed and EMBASE from inception to July 2023. A total of 160 potentially relevant articles were identified. Results: Four studies were included that evaluated the effects of HU on sperm parameters in males. A further 4 studies assessed anti-mullerian hormone (AMH) levels and ovarian reserves in females. Differences from baseline values were used to identify compromised fertility. Amongst males, HU treatment negatively impacted the concentration of spermatozoa (MD = -15.48 million/mL; 95% CI: [-20.69, -10.26]; p

Suggested Citation

  • Sarah Sewaralthahab & Lujain A Alsubki & Maram S Alhrabi & Abdulrahman Alsultan, 2024. "Effects of hydroxyurea on fertility in male and female sickle cell disease patients. A systemic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 19(6), pages 1-15, June.
    • Handle: RePEc:plo:pone00:0304241
    DOI: 10.1371/journal.pone.0304241
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    1. Rita V Masese & Dominique Bulgin & Mitchell R Knisely & Liliana Preiss & Eleanor Stevenson & Jane S Hankins & Marsha J Treadwell & Allison A King & Victor R Gordeuk & Julie Kanter & Robert Gibson & Je, 2021. "Sex-based differences in the manifestations and complications of sickle cell disease: Report from the Sickle Cell Disease Implementation Consortium," PLOS ONE, Public Library of Science, vol. 16(10), pages 1-16, October.
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