Hydroxyurea treatment does not affect ovarian reserve in female patients, according to a new study, meaning the impact of the treatment on fertility may not be as bad as first thought.
The Swiss study has found no reduction in primordial follicles among girls and young women receiving the treatment for sickle cell disease (SCD).
The findings come from a study of samples from patients who had ovarian tissue cryopreserved before undergoing haematopoietic stem cell transplants. Researchers took the opportunity to directly examine the ovarian tissue to see what impact hydroxyurea treatment has on ovarian follicle number.
Among 76 patients, 35 had been treated with hydroxyurea and 50 had not gone through puberty. The median age of the patients was 10.2 at the time of ovarian tissue cryopreservation.
The researchers found no significant difference in the density of primordial follicles between patients who had been treated with hydroxyurea and those who had not, after adjusting for age.
They did however find that hydroxyurea-treated girls and women had reduced density of growing follicles compared to untreated patients. Writing in Blood Advances, the researchers argue that this indicates hydroxyurea affects the developmental process of follicles, but not their quantity.
Study leader Dr Tamara Diesch-Furlanetto, of the University Children’s Hospital, Basel, Switzerland, said: “Many female patients with sickle cell disease avoid hydroxyurea due to concerns about fertility. However, they should be more confident in hydroxyurea as a therapy. It reduces vaso-occlusive crises and hospitalisation rates, increasing their quality of life, and, according to the data from this study, doesn’t impact fertility.
“Individuals living with sickle cell disease should still consider preserving ovarian tissue before [haematopoietic stem cell transplant], but it’s not obligatory if they are just being treated with hydroxyurea. This is the first time we can say, after examining histological tissue, that hydroxyurea doesn’t impact ovarian reserve.”
Source:
Diesch-Furlanetto T, Sanchez C, Atkinson A, Pondarre C, Dhedin N, Neven B, Arnaud C, Kamdem A, Pirenne F, Lenaour G, Brocheriou I, Terris B, Bernaudin F, Dalle JH, Poirot C. (2024) “Impact of Hydroxyurea on follicle density in patients with sickle cell disease.” Blood Advances, 18 July 2024, doi: 10.1182/bloodadvances.2023011536.
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