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.

PURPOSE: 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.

CASE: 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.

CONCLUSION(S): 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.