Hydroxyurea has benefits for many patients with sickle cell disease. Hydroxyurea is given to patients with more severe sickle cell disease, and these patients often have other complications of sickle cell disease. One concern is its impact on fertility, especially when started in children.
Patient selection: sickle cell anemia, on hydroxyurea
Impact on semen parameters:
(1) often reversible oligospermia or azospermia
(2) reduced sperm motility
(3) higher percentage of abnormal morphologies
Risk factors for hydroxyurea effect:
(1) abnormal sperm parameters prior to starting hydroxyurea therapy
Additional factors impacting reproductive health:
(1) priapism
(2) erectile dysfunction
(3) hypogonadism (with low serum testosterone)
(4) testicular ischemia/infarction
A male patient with sickle cell disease should consider cryostorage of spermatozoa.
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