Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 9;2022(1):442-449.
doi: 10.1182/hematology.2022000382.

Incorporating gonadal health counseling into pediatric care of sickle cell patients

Lillian R Meacham  1   2 , Lydia H Pecker  3 , Beatrice Gee, Adrienne Mishkin  4   5
Affiliations

Incorporating gonadal health counseling into pediatric care of sickle cell patients

Lillian R Meacham et al. Hematology Am Soc Hematol Educ Program. .

Abstract

Discussions regarding gonadal function and possible disease or treatment-related ovarian or testicular dysfunction, sexual dysfunction, and possible future infertility can be challenging in the sickle cell disease (SCD) pediatric care setting. A construct that stratifies topics into those that are time sensitive and those that require reproductive care expertise vs address gonadal health as a part of normal SCD care may be helpful. Pediatric health care discussions of gonadal function/dysfunction for patients with SCD can include (1) time-sensitive fertility consults preceding the start of gonadotoxic therapy and (2) targeted discussions at key time points during normally scheduled hematology clinic visits. The former conversations are best led by individuals with expertise in the risk for treatment-related infertility and fertility preservation. The latter discussions can be incorporated into targeted regularly scheduled visits with hematologists. These topics can be addressed as a part of planned education in pediatric care for adolescents and incorporated into transition plans as young adults transfer care to adult providers. Although the topics of puberty and gonadal health can be uncomfortable and many complex interdisciplinary and ethical issues arise in this process, these discussions can be aided by the collaterals and teaching handouts presented in this article.

PubMed Disclaimer

Conflict of interest statement

Lillian R. Meacham: no competing financial interests to declare.

Lydia H. Pecker: Consultant for Global Blood Therapeutics.

Beatrice Gee: no competing financial interests to declare.

Adrienne Mishkin: no competing financial interests to declare.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Concepts to include in discussions about ovarian function. FSH, follicle-stimulating hormone; LH, luteinizing hormone.
Figure 2.
Figure 2.
Concepts to include in discussions about testicular function. FSH, follicle-stimulating hormone; LH, luteinizing hormone.
Figure 3.
Figure 3.
Tanner staging pubertal development.
Figure 4.
Figure 4.
Teaching sheets on female health to aid discussions with patients. FSH, follicle-stimulating hormone; LH, luteinizing hormone.
Figure 5.
Figure 5.
Teaching sheets on female health to aid discussions with patients (part 2). FSH, follicle-stimulating hormone; HU, hydroxyurea.
Figure 6.
Figure 6.
Teaching sheets on male health to aid discussions with patients. FSH, follicle-stimulating hormone; LH, luteinizing hormone.
Figure 7.
Figure 7.
Teaching sheets on male health to aid discussions with patients (part 2). HU, hydroxyurea.
See this image and copyright information in PMC

References

    1. Annon JS. The PLISSIT model: a proposed conceptual scheme for the behavioral treatment of sexual problems. J Sex Educ Ther. 1976;2(1):1-15. doi.org/10.1080/01614576.1976.11074483.
    1. Meacham LR, Williamson-Lewis R, Cherven BO, Effinger KE, Klosky JL, Gilleland-Marchak J. Educational intervention to address infertility-related knowledge gaps among adolescent and young adult survivors of childhood cancer. J Adolesc Young Adult Oncol. 2020;9(4):472-480. doi:10.1089/jayao.2019.0156. - DOI - PubMed
    1. Hibbert JM, Creary MS, Gee BE, Buchanan ID, Quarshie A, Hsu LL. Erythropoiesis and myocardial energy requirements contribute to the hypermetabolism of childhood sickle cell anemia. J Pediatr Gastroenterol Nutr. 2006;43(5):680-687. doi:10.1097/01.mpg.0000228120.44606.d6. - DOI - PMC - PubMed
    1. Nickel RS, Maher JY, Hsieh MH, Davis MF, Hsieh MM, Pecker LH. Fertility after curative therapy for sickle cell disease: a comprehensive review to guide care. J Clin Med. 2022;11(9):2318. doi:10.3390/jcm11092318. - DOI - PMC - PubMed
    1. Elchuri SV, Williamson Lewis R, Quarmyne MO, Haight AE, Cottrell HN, Meacham LR. Longitudinal description of gonadal function in sickle-cell patients treated with hematopoietic stem cell transplant using alkylator-based conditioning regimens. J Pediatr Hematol Oncol. 2020;42(7):e575-e582. doi:10.1097/MPH.0000000000001782. - DOI - PubMed