- Ovarian reserve, measured by anti-Müllerian hormone (AMH), is reduced in women with sickle cell disease (SCD).
Why this matters
- SCD is characterized by chronic hemolytic anemia, intermittent vaso-occlusive pain crises, and risk for multiorgan dysfunction.
- 300,000 children are born with SCD each year.
- AMH is a biomarker for ovarian reserve.
- Preconception counseling for women with SCD should discuss risk of decreased fertility at age >30 years.
- AMH levels were lower in patients with SCD compared with controls (7.6 vs 13.4 pmol/L; P=.01).
- AMH decreased with age in all women, but the decrease occurred at an earlier age in women with SCD.
- This decrease became more significant after age 30 years.
- In women ages 36-40 years, 55% of controls had low or negligible AMH compared with 90% of the SCD group (P=.043).
- Case-controlled cohort observational study.
- Women attending a hematology clinic with the diagnosis of stable SCD were identified (n=50) and compared with a control group consisting of women attending a reproductive medicine clinic (n=73); patients were further matched by age and ethnicity.
- AMH levels were drawn as a routine part of care and assessment.
- Funding: None.
- Small, heterogeneous cohort.