Effect of iron overload on impaired fertility in male patients with transfusion-dependent beta-thalassemia
Journal
Pediatric Research
Journal Volume
83
Journal Issue
3
Pages
655-661
Date Issued
2018
Author(s)
Abstract
BackgroundTo investigate the fertility of male patients with transfusion-dependent beta-thalassemia, and to use magnetic resonance imaging (MRI) as a novel method to assess the iron overload status of testis in such patients.MethodsTwenty-one male patients with transfusion-dependent beta-thalassemia and five normal male controls enrolled in this study. Hormonal profiles, iron levels, MRI testicular dimension, MRI T2 values, parameters for sperm quality, and sperm DNA fragmentation (SDF) of participants were measured.ResultsThe MRI T2 values of the testis were significantly lower in transfusion-dependent beta-thalassemia patients than in normal controls (P=0.027), and they correlated to serum ferritin levels in all enrolled subjects (R 2 =0.258, P=0.008). There were significantly lower sperm concentrations (P=0.037), a lower percentage of sperm with normal morphology (P=0.001), and a higher percentage of SDF (P=0.009) in transfusion-dependent beta-thalassemia patients without hypogonadotropic hypogonadism and with spontaneous spermatogenesis compared with normal controls. The percentage of SDF was significantly correlated with serum ferritin levels in transfusion-dependent beta-thalassemia male patients with spontaneous spermatogenesis (R 2 =0.48, P=0.009).ConclusionOur study is the first demonstration of iron deposition in the testis of patients with transfusion-dependent beta-thalassemia based on imaging, and such findings might explain the high prevalence of impaired fertility in above patients with normal pituitary function. Copyright ? 2018 International Pediatric Research Foundation, Inc.
SDGs
Other Subjects
deferasirox; deferiprone; deferoxamine; estradiol; ferritin; follitropin; gonadorelin; hemoglobin; inhibin B; luteinizing hormone; prolactin; testosterone; ferritin; follitropin; iron; reactive oxygen metabolite; adult; Article; beta thalassemia; clinical article; controlled study; diabetes mellitus; DNA fragmentation; erythrocyte transfusion; ferritin blood level; hemoglobin blood level; hepatitis C; human; hypogonadotropic hypogonadism; hypophysis function; iron chelation; iron overload; male; male fertility; male infertility; nuclear magnetic resonance imaging; priority journal; sperm quality; spermatogenesis; spermatozoon; spermatozoon density; testis; testis size; beta thalassemia; blood; blood transfusion; blood transfusion reaction; cardiac muscle; case control study; complication; diagnostic imaging; iron overload; liver; male infertility; metabolism; pathology; young adult; Adult; beta-Thalassemia; Blood Transfusion; Case-Control Studies; Ferritins; Follicle Stimulating Hormone; Humans; Infertility, Male; Iron; Iron Overload; Liver; Magnetic Resonance Imaging; Male; Myocardium; Reactive Oxygen Species; Spermatozoa; Testis; Transfusion Reaction; Young Adult
Type
journal article