Acute pain crisis in a patient with sickle cell disease undergoing ovarian simulation for fertility preservation prior to curative stem cell transplantation: case report and literature review
- 211 Downloads
Hematopoietic stem cell transplantation (HSCT) is a cure for sickle cell disease (SCD) but frequently results in permanent sterility. The complications associated with oocyte cryopreservation and risks of future pregnancy are increased in SCD patients. This case report discusses risk reduction strategies and includes a literature review of pregnancy after HSCT.
A 23-year-old woman underwent ovarian stimulation for fertility preservation resulting in cancelation due to acute pain crisis. She underwent a successful oocyte retrieval after exchange transfusion to decrease her hemoglobin S to 30%. This is the second report of a pain crisis in a woman with SCD undergoing oocyte banking.
Women with SCD undergoing fertility preservation may be at increased risk of complications from ovarian stimulation. Risks in pregnancy after HSCT should also be considered before proceeding with fertility preservation.
KeywordsSickle cell disease Fertility preservation Pain crisis Stem cell transplantation
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Kato GJ, McGowan V, Machado RF, Little JA, Taylor J 6th, Morris CR, et al. Lactate dehydrogenase as a biomarker of hemolysis-associated nitric oxide resistance, priapism, leg ulceration, pulmonary hypertension, and death in patients with sickle cell disease. Blood. 2006;107(6):2279–85.CrossRefPubMedPubMedCentralGoogle Scholar
- 8.Practice Committees of American Society for Reproductive Medicine; Society for Assisted Reproductive Technology. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013;99:37–43.Google Scholar
- 9.Society for Assisted Reproductive Technology (SART) national summary report. https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=0. Accessed 12/29/16.
- 10.Practice Committees of American Society for Reproductive Medicine; Society for Assisted Reproductive Technology. Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril. 2013;100:1214–23.Google Scholar
- 22.Loren AW, Chow E, Jacobsohn DA, Gilleece M, Halter J, Joshi S, et al. Pregnancy after hematopoietic cell transplantation: a report from the late effects working committee of the Center for International Blood and Marrow Transplant Research (CIBMTR). Biol Blood Marrow Transplant. 2011;17(2):157–66.CrossRefPubMedGoogle Scholar
- 25.Provision of fertility services for women at increased risk of complications during fertility treatment or pregnancy: an Ethics Committee opinion. Fertil Steril. 2016; 106(6):1319–23.Google Scholar