Effect of hydroxyurea exposure before puberty on sperm parameters in males with sickle cell disease

Blood. 2021 Feb 11;137(6):826-829. doi: 10.1182/blood.2020006270.


Sperm parameters are known to be impaired in men with sickle cell disease (SCD). Although treatment with hydroxyurea (HU) has an impact on sperm quality, sperm preservation is impossible before puberty. This study's primary objective was to analyze and compare sperm parameters in male patients with SCD exposed (or not) to HU before puberty. Twenty-six sperm samples from 15 patients (median age, 17 years; range, 16-23) treated with HU during childhood were compared with 46 samples from 23 HU-naïve patients (20 years; 16-24). The median age at HU initiation was 6 years (1-14 years), the median duration of HU treatment was 4 years (0.5-10), and the mean dose of HU was 22.4 ± 3.7 mg/kg per day. Although we observed substantial quantitative and qualitative semen abnormalities in all patients, there were no significant differences in semen volume, sperm concentration, total sperm count, or spermatozoa motility, morphology, and vitality between the HU-exposed and HU-naïve groups. At the time of the semen analysis, 100% of the patients in the HU-exposed group and 52% of the patients in the HU-naïve group received transfusion therapy. The specific effect of HU on spermatogenesis in very young infants and the putative value of transfusion for reversing the toxicity of HU warrant further investigation.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Acute Chest Syndrome / epidemiology
  • Acute Chest Syndrome / etiology
  • Adolescent
  • Age Factors
  • Anemia, Sickle Cell / complications
  • Anemia, Sickle Cell / drug therapy*
  • Anemia, Sickle Cell / physiopathology
  • Anemia, Sickle Cell / therapy
  • Antisickling Agents / administration & dosage
  • Antisickling Agents / adverse effects*
  • Antisickling Agents / therapeutic use
  • Arterial Occlusive Diseases / epidemiology
  • Arterial Occlusive Diseases / etiology
  • Blood Transfusion
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Humans
  • Hydroxyurea / administration & dosage
  • Hydroxyurea / adverse effects*
  • Hydroxyurea / therapeutic use
  • Infant
  • Infertility, Male / chemically induced*
  • Male
  • Puberty*
  • Sperm Count
  • Sperm Motility / drug effects
  • Spermatogenesis / drug effects*
  • Spermatozoa / drug effects*
  • Young Adult


  • Antisickling Agents
  • Hydroxyurea