Comparative study of hypogonadism in beta-thalassemia intermedia patients with and without hydroxyurea

We aimed at evaluating the effect of long-term use of hydroxyurea (HU) on gonad function in patients with beta-thalassemia intermedia (beta-TI) in Iran.

Seventy-five beta-TI patients aged ≥11 years, mean serum ferritin level of <1000 ng/dL in the recent 5 years, and taking HU with a dose of 8-15 mg per kg body weight per day for at least 5 years were randomly selected during 2010 in southern Iran. Thirty-one beta-TI patients without HU were considered as a control group. Serum levels of prolactin, luteinizing hormone, follicle-stimulating hormone, testosterone, and estradiol were measured. An expert endocrinologist examined all participants and reviewed their hormonal profile.

The mean age of the participants was 22.7 ± 5.1 years (age range of 12-41 years). Overall, 10 patients with hypogonadotropic hypogonadism were detected including seven patients (9.3%) with HU and three patients (9.7%) without HU. The difference between the two groups was not statistically significant (P = 0.605).

It appears that long-term use of HU at a dose of 8-15 mg per kg body weight per day has no effect on gonad function in beta-TI patients. However, further prospective studies and large clinical trials are needed to confirm this subject.