Do Iron Chelators Affect Fertility in Thalassemic Men?
Shahla Ansari
Department of Pediatric Hematology, Ali-asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran
Azadeh Kiumarsi *
Department of Pediatric Hematology, Ali-asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran
Azita Azarkeivan
Department of Thalassemia Clinic, High Institute for Research and Education in Transfusion Medicine, Iranaian Blood Transfusion Organization, Tehran, Iran
Mohammad Mahdi Allameh
Department of Radiology, Baghiatallah Hospital, Tehran, Iran
Maryam Razzaghy-Azar
Department of Pediatric Endocrinology and Metabolism, Hazrat Ali-Asghar Children's Hospital, Iran University of Medical Sciences. Tehran, Iran and Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Davoud Amirkashani
Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
*Author to whom correspondence should be addressed.
Abstract
Background: Iron overload is a major complication in patients with thalassemia, however, development of iron-chelating therapy has partly overcome this problem.
Objectives: The aim of this study was to evaluate the effect of iron chelator drugs on testicular volume, semen parameters and serum FSH, LH, and Testosterone concentrations in 62 young male patients with major and intermedia thalassemia.
Materials and Methods: Sixty two young male patients with major and intermedia thalassemia, aged 18–41 years who had different iron chelator drug using status were evaluated.
Results: At the time of the study their serum ferritin levels ranged from 182 to 11053 ng/mL (mean 2067 ng/mL). The mean volume of patients’ ejaculate was 2.3 cc. The mean concentration of sperm was 61.04 million per milliliter. The mean size of right testis was 11.4 cc and the mean size of left testis was 11.7 cc. Hypogonadism and hypothyroidism were seen in 22.6% and 17.7% of patients, respectively. The mean level of FSH was 3.7 mIU/ml, LH was 4.6 mIU/ml, and Testosterone was 4.8 ng/dl. The mean level of serum ferritin was 2067 ng/dl.
Conclusion: This study suggests that in thalassemic men, concentrations of serum Testosterone, LH, FSH has significant correlation with sperm parameters and testicular volume but iron chelators mostly do not impact the elements of fertility in these patients.
Keywords: Thalassemia major, thalassemia intermedia, spermatogenesis, puberty, testicular volume, gonadal hormones, iron chelators