Effect of age on testicular function in adult males with sickle cell anemia.

OBJECTIVES

To determine the effect of age on testicular function and fertility profile of adult males with homozygous sickle cell disease.

DESIGN

A comparative cross-sectional study.

SETTING

A university teaching hospital in Nigeria.

PARTICIPANTS

Twenty-two adult males with homozygous sickle cell disease and 20 healthy adult males with normal hemoglobin genotype.

MAIN OUTCOME MEASURES: Seminal indexes, serum concentration of reproductive hormones, body mass index (BMI), testicular volume index, and span-height difference of patients with homozygous sickle cell disease and normal subjects were compared. Also significant differences were sought between two age groups among patients and control subjects: those < or = 25 years old and those > 25 years of age.

RESULTS

The mean BMI, testicular volume index, serum T concentration, and indexes of semen quality of the patients with homozygous sickle cell disease were significantly lower than the values for the control subjects. In contrast, there was no significant difference in the mean concentration of FSH, LH, PRL, and mean span-height difference between both groups. Also, although no significant age-related effect on serum T concentration, testicular volume index, and sperm density was found in the subjects 18 to 40 years of age with normal hemoglobin genotype, patients > 25 years old with homozygous sickle cell disease had significantly higher mean serum T concentration and mean testicular volume index than those < or = 25 years old; their sperm density was also substantially higher.

CONCLUSION

Fertility is impaired in adult males with homozygous sickle cell disease probably as a result of abnormal hypothalamic or pituitary function. There is a significant amelioration of the hypogonadism, abnormal sexual function, and poor semen profile with increasing age.