Fertility and Pregnancy in Women with Transfusion-Dependent Thalassemia

Hematol Oncol Clin North Am. 2018 Apr;32(2):297-315. doi: 10.1016/j.hoc.2017.11.004.

Abstract

As more women with transfusion-dependent thalassemia are seeking pregnancy, ensuring the best outcomes for both the mother and baby requires concerted, collaborative efforts between practitioners and the family. Proactive counseling, early fertility evaluation, recent developments in reproductive technology, and optimal management of iron overload, have resulted in more successful pregnancies and the birth of healthy newborns. With advances in technology for prenatal screening and increased awareness to perform screening for hemoglobinopathies, healthy pregnancy outcomes have become the expectation. Topics that require further study include management that allows fertility preservation, improved non-invasive prenatal diagnosis methods for affected fetuses, the use of chelation therapy during pregnancy, and indications for and duration of anticoagulation.

Keywords: Fertility; Iron chelation; NIPT; Pregnancy; Thalassemia major.

Publication types

  • Review

MeSH terms

  • Blood Transfusion
  • Disease Management
  • Female
  • Fertility*
  • Humans
  • Iron / metabolism
  • Iron Overload / diagnosis
  • Iron Overload / drug therapy
  • Iron Overload / etiology
  • Iron Overload / metabolism
  • Perinatal Care
  • Pregnancy
  • Pregnancy Complications, Hematologic*
  • Pregnancy Outcome
  • Pregnancy Rate
  • Prenatal Diagnosis
  • Thalassemia / diagnosis
  • Thalassemia / metabolism
  • Thalassemia / physiopathology*
  • Thalassemia / therapy

Substances

  • Iron