Article that link Beta-Thalassemia to fertility

Title: Living with Thalassemia

<http://cooleysanemia.org/updates/Pregnancy2.pdf> 

For many years, people assumed that the iron overload is seen in beta thalassemia patients is due to the frequent blood transfusion therapy (can give rise excess amount of iron-containing hemoglobin in the body) alone. However, recent studies have shown that patients with beta-thalassemia intermedia who has not undergo blood transfusion therapy have “higher-than-average” iron stores. For example the rate of iron uptake in the gut were 3 to 4 times higher than normal.

Besides the health problem that iron overload can cause, it can also affect the development of both male and female sex organ which in turn can affect the reproductive capabilities of a person with thalassemia. The article which we have choose to research on is based on the experiences and stories of individuals that has undergo careful interview by a panel of experts but has not been published in a medical journal.

Individuals with thalassemia may experience delayed puberty, due to the deficiency of hormones (testosterone and estrogen) necessary for sexual maturation cause by iron overload. Although many eventually would enter puberty, some do not reach sexual maturity and thus has a complication called “hypogonadism”. For females, those who never begin menses are said to have primary amenorrhea, while those who transiently have menses are said to have secondary amenorrhea. Delayed puberty, hypogonadism and amenorrhea are signs of hormone deficiency and hence may likely cause fertility problem.  For example, most affected males are not able to produce adequate amount of sperms and affected females do not ovulate.