Beta-thalassemia major and the role of oxidative stress on female fertility and infertility

Shirali, S.; Khodadi, E.
June 2014
Iranian Journal of Reproductive Medicine;Jun2014 Supplement, Vol. 12, p78
Academic Journal
Introduction: In beta-thalassemia major (BTM), iron overload is the joint outcome of multiple blood transfusions and an inappropriately increased iron absorption associated with ineffective erythropoiesis. The outpouring of catabolic iron that exceeds the ironcarrying capacity of transferrin results in the emergence of nontransferrin-bound iron (NTBI)and its redox active form, labile plasma iron (LPI), which catalyzes the formation of free radicals, resulting in oxidative stress (OS) and damage to mitochondria, lysosomes, membranes, proteins and DNA. Recent advancesin the management of BTM have significantly improved life expectancy and quality of life of BTM patients, with a consequent increase in their reproductive potential and desire to have children. However, endoerine complications due to haemosiderosis are still present in a significant number of patients worldwide usually cause hypogonadotropic hypogonadism (HH) and declining synthesis of LH and FSH. Materials and Methods: In this review we studied published papers on BTM and female fertility and also the role of OS in pathogenesis of infertility. Results: The levels of NTBI, LPI were increased antimullerian hormone (AMH), was mostly normal. The levels of FRAP were low and levels of AOPP and MDA were high in the nonchelated patients compared with the chelated patients. Conclusion: Infertility in women with BTM is assumed to be mainly caused by the direct or indirect effect of iron. The direct effect of iron is probably related to its direct deposition on the hypothalamic-pituitary axis and the female reproductive system and its indirect effect is mostly attributed to the iron-induced OS. Treatment with combination of antioxidants and iron chelators could neutralize the deleterious effects of OS, reverse endocrine complications and improve reproductive ability and fertility potential.


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