OVARIAN RESERVE IN POST-MENARCHAL FEMALES WITH SICKLE CELL ANEMIA

患有镰状细胞性贫血的初潮后女性的卵巢储备

• 批准号: 10493883
• 负责人: Lydia Pecker
• 金额: $ 5.4万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-09 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10493883
• 关键词: Affect; Age; Age-Months; Biological Markers; Biometry; Cessation of life; Clinical; Contraceptive methods; Cross-Sectional Studies; Data; Data Collection; Decision Making; Epidemiology; Evaluation; Female; Fertility; Goals; Hematologist; Hemolytic Anemia; Knowledge; Laboratories; Longevity; Measures; Methodology; Ovary; Patient Care; Patients; Pharmaceutical Preparations; Pregnancy; Principal Investigator; Qualitative Research; Reproductive Biology; Reproductive Health; Reproductive Medicine; Research; Research Design; Research Methodology; Risk; Sickle Cell Anemia; Training; Woman; diminished ovarian reserve; disease phenotype; experience; girls; hydroxyurea; hypoxic ischemic injury; multiorgan injury; ovarian reserve; oxidative damage; patient oriented; preference; programs; reproductive; treatment choice

ABSTRACT Reproductive health decisions for women with sickle cell anemia (SCA) a congenital hemolytic anemia that causes multi-organ injury and early death, are limited by a lack of data to inform contraception choices, pregnancy management or fertility risks. In SCA, the ovaries may be injured by oxidative and hypoxic-ischemic injury. Hydroxyurea (HU), a medication used to treat SCA as early as 9 months of age, may affect fertility negatively. In a study evaluating ovarian reserve in girls with SCA treated with HU, 8 of 33 HU-treated subjects had diminished ovarian reserve, which was associated with older age and longer duration of HU use. This data supports that ovarian reserve is compromised in some patients, but the contributions of SCA, SCA complications or SCA treatments are unknown. To optimize SCA patient care and to better understand this reproductive biology, carefully designed studies of ovarian reserve that assess disease phenotype and treatment are needed. The goal of this research is to conduct a methodologically rigorous evaluation of ovarian reserve in women with SCA to assess whether SCA or its treatments are associated with diminished ovarian reserve. This evidence will help clinicians manage patients considering the risks of untreated SCA against the known and theorized risks of SCA therapies. The proposed study will investigate whether clinical features of SCA or its primary treatment, hydroxyurea, are associated with ovarian reserve in SCA by conducting (1) a cross-sectional study that entails primary data collection of measures of ovarian reserve in women with SCA and matched controls, and (2) a study of whether HU treatment, clinical and laboratory biomarkers of SCA are associated with reduced ovarian reserve. As this information will be incorporated into patient-centered decision making, we will also (3) explore patient knowledge, experiences and preferences about fertility and SCA therapies. This research, critical for understanding the effects of SCA and HU on ovarian reserve in women with SCA, will develop the principal investigator through advanced training in epidemiology and biostatistics, qualitative research methods and reproductive medicine and SCA. Few hematologists have this kind of expertise and the principal investigator will be poised to build an independent research program at the forefront of reproductive health in SCA.

抽象的 镰状细胞贫血（SCA）的生殖健康决定（SCA）一种先天性溶血性贫血 导致多器官损伤和早期死亡，受到缺乏数据为避孕选择的数据的限制， 怀孕管理或生育风险。在SCA中，卵巢可能因氧化和缺氧缺血而受伤 受伤。羟基脲（HU）是一种用来治疗SCA的药物，最早为9个月大，可能会影响生育能力 负面。在一项评估HU SCA女孩的卵巢储备的研究中，33名HU治疗受试者中有8个 卵巢储备减少了，这与年龄较大的人HU使用持续时间有关。这个数据 支持某些患者的卵巢储备受到损害，但是SCA，SCA的贡献 并发症或SCA治疗尚不清楚。 为了优化SCA患者护理并更好地了解这种生殖生物学，仔细设计了 需要评估疾病表型和治疗的卵巢储备。这项研究的目的是 对SCA女性的卵巢储备进行方法论严格评估，以评估SCA是否是否 或其治疗方法与卵巢储备的减少有关。这些证据将帮助临床医生管理 考虑未经治疗的SCA风险，以抗知SCA疗法的已知和理论风险。 拟议的研究将研究SCA或其主要治疗的临床特征，羟基脲是否是 通过（1）横截面研究需要主要数据，与SCA中的卵巢储备相关 SCA和匹配控制的女性中卵巢储备的措施收集，（2）研究 HU治疗，SCA的临床和实验室生物标志物是否与卵巢储备减少有关。 由于这些信息将被纳入以患者为中心的决策中，我们还将（3）探索患者 关于生育和SCA疗法的知识，经验和偏好。 这项研究对于了解SCA和HU对SCA女性卵巢储备的影响至关重要，将会 通过流行病学和生物统计学的高级培训来开发主要研究者 研究方法和生殖医学和SCA。很少有血液学家拥有这种专业知识， 首席研究人员将有望在生殖的最前沿建立一个独立的研究计划 SCA的健康状况。