Abstract
BackgroundInfertility is a major problem in sickle cell disease patients, especially in males. In addition to low serum testosterone, other abnormalities involving the accessory sex organs, such as the seminal vesicles and the prostate gland, as well as marked decrease in ejaculate volume may be observed in male HbSS patients. Hence, the need to study the role of sex hormones as a cause of infertility in male HbSS patients.MethodsAn unmatched case-control study was performed using seventy-five consenting subjects from Lagos University Teaching Hospital. These included 47 patients with haemoglobin phenotype SS from the Sickle cell clinic and 28 volunteered medical students and members of staff with haemoglobin phenotype AA. Demographic data were obtained using a self-administered questionnaire. A total of 5 mls of blood was collected from each subject between 9.00 am & 11.am, and assayed for serum testosterone concentration.ResultsThe concentrations of serum testosterone in HbSS patients ranged from 0.2 to 4.3 ng/ml with a mean of 1.28 ± 0.72 ng/ml whilst the values in HbAA controls ranged from 1.2 to 6.9 ng/ml with a mean of 2.63 ± 1.04 ng/ml. Seven (25.0%) of the 28 controls had serum testosterone concentration lower than the quoted reference (normal) range whereas 44 (93.6%) of the 47 HbSS subjects had serum testosterone concentration lower than the reference range.ConclusionOverall, subjects with HbSS have significantly lower mean serum testosterone than HbAA controls.
Highlights
Infertility is a major problem in sickle cell disease patients, especially in males
Homozygous sickle cell disease is a genetic disorder caused by a point mutation in the beta globin gene, which results in the substitution of valine for glutamine [1]
Oligospermia due to local ischaemia caused by sickling phenomenon and tissue hypoxia have been reported in sickle cell disease patients [7]
Summary
Infertility is a major problem in sickle cell disease patients, especially in males. In addition to low serum testosterone, other abnormalities involving the accessory sex organs, such as the seminal vesicles and the prostate gland, as well as marked decrease in ejaculate volume may be observed in male HbSS patients. The need to study the role of sex hormones as a cause of infertility in male HbSS patients. Infertility in Sickle cell disease Infertility is a known complication in males with sickle cell disease This has been attributed to relative primary gonadal failure, impotence, and priapism, delayed or Oligospermia due to local ischaemia caused by sickling phenomenon and tissue hypoxia have been reported in sickle cell disease patients [7]. Hypopituitarism reported in HbSS disease, results from intravascular thrombosis and pituitary infarction [8]. Sickle cell disease is associated with high folate demand. This with zinc deficiencies have been implicated in pituitary and primary gonadal dysfunction [9]
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