Marriage and Fertility of Patients with Beta Thalassemia Major : A Single Center Experience from Southwest Turkey

Introduction:

Infertility and hypogonadotropic hypogonadism are still a significant problem due to iron overload in patients with beta thalassemia major (BTM). In our study, we aim to evaluate the marriage and fertility status of the patients with BTM.

Material and Method:

Adult patients living in Denizli with BTM were included in the study. All of the patients were receiving iron chelator therapy and transfusion regularly. In routine follow up all patients were consulted to the endocrinology. The files of the patients were examined retrospectively. We recorded all datas from the files as age, gender, marriage, divorce or have a child.

Results:

In our study, 82 adult patients with BTM were included. The median age was 26 (Min:18, max:45 years). 43.9% (n:36) of the patients were male and 56.1% (n:46) were female. The median ferritin level was 1352 (304-5464). 47.5% (n:39) of the patients had undergone splenectomy. The rate of hypogonadism was 40.2 % (n:33), hypothyroidism was 17% (n:14), hypoparathyroidism was 8.5% (n:7) and diabetes mellitus was 9.7% (n:8) in the patients.The marriage rate was 25.6% (n:21, 10 men, 11 women). The mean age of marriage was 26 years (18-32 years). The duration of mean marriage duration was 3.4 years (3 months - 6 years). There were no couples with both partners with BTM. 1 marriage was between a couple with BTM and sickle cell anemia. The number of divorced patients with BTM was 2.4% (n:2). There was no significant difference between in terms of ferritin levels between married and single patients. We found that the rate of marriage rate was higher in cases without hypogonadism and it was statistically significant (p<0.001). Only 2 patients of married had hypogonadism (2/21). There was no spontaneous miscarriage in the patients. The number of patients who had a child was 12.1% (n: 10, 4 men and 6 women). The mean of the children was 1.4. The patients having 2 or more children was 4.8% (n: 4).

Discussion: In our country, all couples are scanned for the presence of BTM routinely. Although the tests are easy and accessible, births of babies with BTM are still reported today. Whereas, if the patients with BTM are managed correctly and iron load is reduced, they can marry, start a family and have a healthy child. Unfurtunately, patients with BTM still have not only metabolic problems but also social problems.

No relevant conflicts of interest to declare.