Supervisors info:
Μαρία Παπαϊωάννου, Αναπληρώτρια Καθηγήτρια, Τμήμα Ιατρικής, Αριστοτέλειο Πανεπιστήμιο Θεσσαλονίκης
Δημήτριος Γ. Γουλής, Αναπληρωτής Καθηγητής, Τμήμα Ιατρικής, Αριστοτέλειο Πανεπιστήμιο Θεσσαλονίκης
Θεόδωρος Θεοδωρίδης, Αναπληρωτής Καθηγητής, Τμήμα Ιατρικής, Αριστοτέλειο Πανεπιστήμιο Θεσσαλονίκης
Summary:
With continuous developments in the management of β-Thalassemia, there has been a marked improvement in patient survival and quality of life. Meanwhile, with the better understanding of assisted reproductive technology (ART), there is a substantial increase in the ability of these patients to acquire a family.
This particular study records the data on the fertility of 45 women with homozygous β-thalassemia monitored at the Thalassemia Unit of the AHEPA University Hospital of Thessaloniki. These data relate to menstruation, hormonal status, attempts to achieve pregnancy with various methods of conception, and the results of these efforts. Then, we describe the methods of conception and childbirth, as well as the progression and outcome of pregnancy taking into account the transfusions carried out, iron load and chelation therapy in women with successful pregnancy. In particular, 31 of the 45 women underwent pregnancy. In 26 of these 31, 45 pregnancies were achieved. Two of the 26 women had automatic miscarriage and remained childless. The remaining 5 women also remain childless. The partners of two of them had unhealthy sperm and one of them had thrombophilia while the other three had failed attempts. Seven out of 45 pregnancies were preceded by ovulation induction by gonadotrophin administration. In five cases, in vitro fertilization (IVF) was carried out while in 9 intrauterine insemination. Finally, twenty-four pregnancies were achieved automatically. A smooth progression was seen in 32 of the 45 pregnancies (71.1%). Of the 32 pregnancies, a childbirth of 34 infants was achieved, six of which were derived from twin pregnancies, one from triple pregnancy and one from quadruplet pregnancy. Of the newborns, twenty two (64.7%) were full-term and twelve (35.3%) preterm. The caesarean section was the primary method of delivery.
In conclusion, pregnancy in homozygous β-Thalassemia is feasible with appropriate supportive treatment. However, it must be considered as a high risk pregnancy for both the mother and the fetus. The favorable outcomes of pregnancy are the result of continuous monitoring and management by a team of β-Thalassemia experts both before and during pregnancy and postpartum.
Keywords:
Homozygous, β-Thalassemia, Major, Fertility, Pregnancy
