Fertility Concerns and Access to Care for Stem Cell Transplant Candidates with Sickle Cell Disease.
Publication Title
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Document Type
Article
Publication Date
4-18-2020
Abstract
Sickle cell disease affects 100,000 Americans and causes significant psychiatric illness and poor quality of life in many domains including infertility. Hematopoietic cell transplant (HCT) is the only cure for sickle cell disease, but can have its own chronic toxicities, including psychiatric conditions such as depression and anxiety, and sterility in both men and women. There is scant literature on fertility or psychiatric outcomes for sickle cell disease patients receiving HCT, and none considering the additive ramifications of the stresses of sickle cell disease, transplant, and infertility. Financial toxicity is a significant concern for all patients receiving stem cell transplantation. Treatment for infertility is also very expensive and access to fertility services is variable in the United States, which adds to the medical and quality of life burden for this patient population. Here we review the relevant areas of sickle cell disease and infertility, sickle cell disease and psychiatric wellness, access to care, and infertility and quality of life. These data collectively suggest that the group of patients with sickle cell disease who undergo HCT, and experience infertility are at particularly high risk for poor quality of life, worsening psychiatric health, and poor access to adequate fertility treatment.
Clinical Institute
Women & Children
Specialty/Research Institute
Obstetrics & Gynecology
Specialty/Research Institute
Hematology
