Hydroxyurea and Fertility

Manal has recently asked about this topic and I know others need to know this, so I made it a point to find out at the conference. I posed the question "does hydroxyurea cause fertility problems?" to Dr Vichinsky and he told me that in males it does lower, but does not eliminate sperm count, and that this reduction is also reversible with cessation of the drug.

I do not feel this is enough reason to interrupt hydroxyurea therapy in a patient.



(As always, I worked very hard at this conference and found answers to most of the questions I posed).

Thank you Andy a million for your concern and efforts, as usual and always we depend on you in our journey with thal 


But Andy does this apply with patients who have started before puberty???

What i read was that it will lower the counts in patients who started the treatment when they were already adults (so they expierenced having normal counts).
But in male children who started the treatment before puberty it may lead to not producing any sperms  (as they have never had normal counts in the first place)

So the difference here is the time of starting the hydroxy?? Is this right Andy or it is not studies in that way

manal

Hi Manal,

No. They have not observed this in pre-pubescent boys. There is a definite drop but not an elimination of sperm cells and as I mentioned, it is reversible. I can also guarantee that your son will not be on hydroxyurea for life. I doubt he will be on it 10 years from now. Several new drugs are in the works that have a much better effect on Hb levels and the Hemaquest trial is now in stage 2 (so no data is yet available) and it is looking very promising. At present, I can make an informed guess that we will see an Hb increase of as much as 3 points (possibly more) using this drug, which would bring your son up to minor status. Have patience (everyone).

Thanks Andy for your re-assuring and comforting reply . I was really so heavy hearted from the time i read about this. It is an awful feeling  knowing that you might be giving your children something that might harm them in the future, but now i am releaved. Thanks again Andy for taking the time to investigate this issue, 

I will follow your advise and be more patient and i am sure the future will be more promising in all the areas of thal management. Hoping too that Haemaquest would soon release any of their findings, wish them all the luck

manal