SynthesisPloS one2024
Effects of hydroxyurea on fertility in male and female sickle cell disease patients. A systemic review and meta-analysis.
Synthesis in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Reproductive function and sperm parameters in men with sickle cell disease: a systematic review.Asian journal of andrology · 2026Pooled it
- Growth and puberty in African children with sickle cell anemia treated with hydroxyurea.Blood advances · 2026Trial
- Identifying potential factors influencing family-building perspectives in adults with SCD.Journal of assisted reproduction and genetics · 2026Article
- Fertility preservation in 2026: current landscape in Europe and the United States for children and adolescents undergoing hematopoietic stem cell transplantation-recommendations on behalf of the Westhafen Intercontinental Group.Bone marrow transplantation · 2026Review
- Fertility Preservation in 2026: Current Landscape in Europe and the United States for Children and Adolescents Undergoing Hematopoietic Stem Cell Transplantation - Recommendations on Behalf of the Westhafen Intercontinental Group.Transplantation and cellular therapy · 2026Review
- Sex and gender differences in responses to antianemic therapies: biological mechanisms and clinical implications.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- Sickle Cell Disease and Male Infertility: Pathophysiological Mechanisms, Clinical Manifestations, and Fertility Preservation Strategies-A Narrative Review.Life (Basel, Switzerland) · 2026Review
- Experiences of family building counseling and perceptions of reproductive technology among adults with sickle cell disease.PloS one · 2026Article
- The right patient, the right treatment: tailoring sickle cell disease care.Hematology. American Society of Hematology. Education Program · 2025Review
- Impact of sickle cell anaemia on reproductive health: a narrative review.Reproductive health · 2025Review
- Topics of Interest in Women With Myeloproliferative Neoplasms.American journal of hematology · 2025Review
- CureSCi Metadata Catalog-Finding and harmonizing studies for secondary analysis of hydroxyurea discontinuation in sickle cell disease.PloS one · 2025Article
- The Current Role of Hydroxyurea in the Treatment of Sickle Cell Anemia.Journal of clinical medicine · 2024Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence 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.
methodsThis 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.
resultsFour 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< 0.001), which continued following treatment cessation (MD = -20.09 million/mL; 95% CI: [-38.78, -1.40]; P = 0.04). HU treatment also led to lower total sperm counts (MD = -105.87 million; 95% CI: [-140.61, -71.13]; P< 0.001) which persisted after treatment (MD = -53.05 million; 95% CI: [-104.96, -1.14]; P = 0.05). Sperm volume, initial forward motility and morphology were unaffected by HU treatment. In females, HU treatment decreased the mean AMH levels 1.83 (95% CI [1.42, 2.56]. A total of 18.2.% patients treated with HU showed reduced ovarian reserves. INTERPRETATION &
conclusionsThis systemic review and meta-analysis suggest that the use of HU for SCD impacts seminal fluid parameters in males and can diminish AMH levels and ovarian reserves in females.
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