Marital status and paternity in patients with Transfusion- Dependent Thalassemia (TDT) and Non Transfusion-Dependent Thalassemia (NTDT): an ICET - A survey in different countries

Marital status and paternity in patients with Transfusion- Dependent Thalassemia (TDT) and Non Transfusion-Dependent Thalassemia (NTDT): an ICET - A survey in different countries

Authors

  • Vincenzo De Sanctis Quisisana Hospital, Ferrara
  • Ashraf T Soliman Department of Pediatrics, Division of Endocrinology, Alexandria University Children’s Hospital, Alexandria, Egypt
  • Ihab El-Hakim Department of Pediatrics, Ain Shams University, Cairo, Egypt
  • Soteroula Christou Archbishop Makarios III, Thalassemia Center, Nicosia, Cyprus
  • Demetris Mariannis Royal Lancaster Infirmary, United Kingdom
  • Mehran Karimi Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Vassilis Ladis Thalassemia Unit, Division of Pediatric Hematology-Oncology. First Department of Pediatrics, University of Athens, "Agia Sofia" Children's Hospital, Athens, Greece
  • Antonis Kattamis Thalassemia Unit, Division of Pediatric Hematology-Oncology. First Department of Pediatrics, University of Athens, "Agia Sofia" Children's Hospital, Athens, Greece
  • Shahina Daar Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman
  • Mohamed Yassin National Center for Cancer Care and Research, Medical Oncology Hematology Section HMC, Doha, Qatar
  • Duran Canatan Director of Thalassemia Diagnosis Center of Mediterranean Blood Diseases Foundation, Antalya, Turkey
  • Maria Concetta Galati Department of Pediatric Haematoncology, Thalassaemia and Prenatal Diagnosis Regional Center, Pugliese-Ciaccio Hospital, Catanzaro, Italy
  • Giuseppe Raiola Department of Paediatrics, Pugliese-Ciaccio Hospital, Catanzaro, Italy
  • Saveria Campisi U.O.S.D. Thalassemia, Umberto 1° Hospital, Siracusa, Italy
  • Shruti Kakkar Department of Pediatrics, Dayanand Medical College & Hospital Ludhiana, Ludhiana, India
  • Valeria Kaleva Varna Expert Center for Coagulopathies and Rare Anemias,Varna, Bulgaria
  • Forough Saki Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Andreas Ellinides Medical Student, European University Cyprus School of Medicine, Cyprus
  • Giorgos Pikis Archbishop Makarios III Hospital, Cyprus
  • Constantinos Christodoulides Archbishop Makarios III Hospital, Cyprus
  • Mohamed Abdulla National Center for Cancer Care and Research, Medical Oncology Hematology Section HMC, Doha, Qatar
  • Salvatore Di Maio Emeritus Director in Pediatrics, Children’s Hospital “Santobono-Pausilipon”, Naples, Italy
  • Charalambos Theodoridis Endocrinology Clinic, Kyriakou" Children's Hospital, Athens, Greece
  • Heba Elsedfy Department of Pediatrics, Ain Shams University, Cairo, Egypt
  • Christos Kattamis First Department of Pediatrics,”Aghia Sophia “Children Hospital,University of Athens, Athens, Greece

Keywords:

Thalassemia, marital status, treatment, comorbidities, endocrine complications, iron overload, chelation therapy

Abstract

Background: More than five decades ago, thalassemia major (TDT) was fatal in the first decade of life. Survival and quality of life have improved progressively thanks to the implementation of a significant advance in diagnostic and therapeutic methods, consisting mainly of a frequent transfusion program combined with intensive chelation therapy. Improvement also includes imaging methods used to measure liver and cardiac iron overload. Improved survival has led to a growing number of adults requiring specialised care and counselling for specific life events, such as sexual maturity and acquisition of a family. Aims of the study: The main aim is to present the results of a survey on the marital and paternity status in a large population of adult males with TDT and NTDT living in countries with a high prevalence of thalassemia and a review of current literature using a systematic search for published studies. Results: Ten out of 16 Thalassemia Centres (62.5%) of the ICET-A Network, treating a total of 966 male patients, aged above 18 years with β- thalassemias (738 TDT and 228 NTDT), participated in the study. Of the 966 patients, 240 (24.8%) were married or lived with partners, and 726 (75.2%) unmarried. The mean age at marriage was 29.7 ± 0.3 years. Of 240 patients, 184 (76.6%) had children within the first two years of marriage (2.1 ± 0.1 years, median 2 years, range 1.8 - 2.3 years). The average number of children was 1.32 ± 0.06 (1.27 ± 0.07 in TDT patients and 1.47 ± 0.15 in NTDT patients; p: >0.05). Whatever the modality of conception, 184 patients (76.6%) had one or two children and 1 NTDT patient had 6 children. Nine (4.8%) births were twins. Of 184 patients, 150 (81.5%) had natural conception, 23 (12.5%) required induction of spermatogenesis with gonadotropins (hCG and hMG), 8 (4.3%) needed intracytoplasmic sperm injection (ICSI) and 3 adopted a child. 39 patients with TDT and NTDT asked for medical help as they were unable to father naturally: 7 TDT patients (17.9%) were azoospermic, 17 (37.7%) [13 with TDT and 4 with NTDT] had dysspermia and 15 (33.3%) [13 with TDT and 2 with NTDT] had other “general medical and non-medical conditions”. Conclusions: Our study provides detailed information in a novel area where there are few contemporary data. Understanding the aspects of male reproductive health is important for physicians involved in the care of men with thalassemias to convey the message that prospects for fatherhood are potentially good due to progressive improvements in treatment regimens and supportive care.

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Published

06-09-2019

Issue

Section

ORIGINAL ARTICLES

How to Cite

1.
De Sanctis V, Soliman AT, El-Hakim I, Christou S, Mariannis D, Karimi M, et al. Marital status and paternity in patients with Transfusion- Dependent Thalassemia (TDT) and Non Transfusion-Dependent Thalassemia (NTDT): an ICET - A survey in different countries. Acta Biomed [Internet]. 2019 Sep. 6 [cited 2024 Jul. 22];90(3):225-37. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/8586