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: 10055022
• 负责人: Lydia Pecker
• 金额: $ 19.69万
• 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 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10055022
• 关键词: Address; Adhesions; Adult; Affect; Age; Age-Months; Age-Years; Antral; Award; Biological Markers; Biometry; Blood Vessels; Case-Control Studies; Cessation of life; Characteristics; Child; Clinic; Clinical; Contraceptive methods; Cross-Sectional Studies; Data; Data Collection; Decision Making; Development; Disease; Epidemiology; Estradiol; Evaluation; Extramural Activities; Female; Fertility; Focus Groups; Follicle Stimulating Hormone; Funding; Genotype; Goals; Hematologist; Hemoglobin; Hemolytic Anemia; Hormones; Hypoxia; Knowledge; Laboratories; Longevity; Longitudinal Studies; Measures; Mentors; Mentorship; Methodology; Multicenter Studies; Nursery Schools; Organ; Ovarian; Ovary; Participant; Patient Care; Patients; Pharmaceutical Preparations; Physicians; Pilot Projects; Placebos; Positioning Attribute; Pregnancy; Preparation; Principal Investigator; Qualitative Methods; Qualitative Research; Race; Randomized; Records; Reproductive Biology; Reproductive Health; Reproductive Medicine; Research; Research Design; Research Methodology; Resources; Risk; Sampling; Sickle Cell; Sickle Cell Anemia; Surveys; Training; Ultrasonography; Uncertain Risk; Woman; Work; cohort; diminished ovarian reserve; disease phenotype; experience; female fertility; fertility preservation; girls; hydroxyurea; infertility treatment; inflammatory marker; insight; ischemic injury; mullerian-inhibiting hormone; multiorgan injury; organ injury; ovarian reserve; oxidative damage; patient oriented; patient population; preference; programs; prospective; reproductive; skills; sperm cell; tool; treatment choice; willingness; young adult

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 镰状细胞性贫血（SCA）的生殖健康决定先天性溶血 导致多器官损伤和提早死亡的贫血受到缺乏数据的限制 避孕选择，妊娠管理或生育风险。在SCA中，卵巢可能是 因氧化和缺氧缺血性损伤而受伤。羟基脲（HU），一种用于治疗的药物 SCA早在9个月大时就可能对生育能力产生负面影响。在评估卵巢的研究中 在接受HU治疗的SCA的女孩中，有33名HU处理的受试者中有8位卵巢 储备，与年龄较大的HU使用持续时间有关。此数据支持 某些患者的卵巢储备被妥协，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 需要对卵巢储备的研究，以评估疾病表型和治疗。 这项研究的目的是对卵巢储备进行方法论严格的评估 在患有SCA的女性中，可以评估SCA或其治疗方法是否与减少有关 卵巢储备。这些证据将帮助临床医生管理患者考虑的风险 未经治疗的SCA针对已知和理论上的SC​​A疗法风险。 拟议的研究将研究SCA或其主要治疗的临床特征， 羟基脲与SCA中的卵巢储备有关（1）横截面 SCA女性的卵巢储备量度收集的主要数据收集 和匹配的对照，以及（2）研究HU治疗，临床和实验室是否 SCA的生物标志物与减少卵巢储备有关。因为这个信息将是 并入以患者为中心的决策中，我们还将（3）探索患者知识， 关于生育和SCA疗法的经验和偏好。 这项研究对于了解SCA和HU对卵巢储备的影响至关重要 患有SCA的妇女将通过高级培训来开发主要调查员 流行病学和生物统计学，定性研究方法和生殖医学以及 SCA。很少有血液学家拥有这种专业知识，主要研究人员将得到准备 在SCA生殖健康的最前沿建立一个独立的研究计划。