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    Assessment of the ovarian reserve in patients with Beta-thalassemia major; A prospective longitudinal study
    (Galenos Publishing House, 2023) Özcan, Aykut; Gülseren, Varol; Özcan, Esin; Toz, Emrah; Turan, Volkan
    Objective: Repeated blood transfusions in women with Beta-thalassemia major (BTM) may lead to iron overload and increase oxidative stress and consequently resulting in ovarian damage. We aimed to evaluate the alterations in the ovarian reserve of transfusion-dependent BTM patients over a time period of one year and compared the anti-mullerian hormone (AMH) levels between women with BTM and healthy population. Material and methods: This longitudinal prospective study was conducted in 41 women with transfusion-dependent BTM at the tertiary hospital. The hospital database between 1996 to 2021 was screened for women diagnosed with BTM. Anti-mullerian hormone levels were assessed at baseline and one year later. Results: Twenty-five (60.9%) of the patients had amenorrhea while 16 (39.1%) were observed to have normal cycles. The mean AMH values of all women were 2.7±1.8 ng/mL at the initial measurement which was significantly lower compared to age related AMH (mean 4.0±0.4 ng/mL) nomogram of healthy population (P= 0.001). The baseline AMH values of the patients with amenorrhea were found to be lower than the patients with normal menstrual cycles (2.1±1.8 vs 3.6±1.5 ng/mL, P= 0.009). After a one-year follow-up, there was a trend towards to a decrease in AMH levels of the patients with normal menstrual cycles. Conclusion: Serum AMH values is decreased in patients with transfusion-dependent BTM. It would be beneficial to inform all patients about possible effects of repeated blood transfusions on fertility.