EFFECT OF AGE ON TESTICULAR FUNCTION IN ADULT MALES WITH SICKLE-CELL-ANEMIA

Objectives: To determine the effect of age on testicular function and fertility profile of adult males with homozygous sickle cell disease. Design: A comparative cross-sectional study. Setting: A university tea ching hospital in Nigeria. Participants: Twenty-two adult males with h omozygous sickle cell disease and 20 healthy adult males with normal h emoglobin genotype. Main Outcome Measures: Seminal indexes, serum conc entration of reproductive hormones, body mass index (BMI), testicular volume index, and span-height difference of patients with homozygous s ickle cell disease and normal subjects were compared. Also significant differences were sought between two age groups among patients and con trol subjects: those less than or equal to 25 years old and those > 25 years of age. Results: The mean BMI, testicular volume index, serum T concentration, and indexes of semen quality of the patients with homo zygous sickle cell disease were significantly lower than the values fo r the control subjects. In contrast, there was no significant differen ce in the mean concentration of FSH, LH, PRL, and mean span-height dif ference between both groups. Also, although no significant age-related effect on serum T concentration, testicular volume index, and sperm d ensity was found in the subjects 18 to 40 years of age with normal hem oglobin genotype, patients > 25 years old with homozygous sickle cell disease had significantly higher mean serum T concentration and mean t esticular volume index than those less than or equal to 25 years old; their sperm density was also substantially higher. Conclusion: Fertili ty is impaired in adult males with homozygous sickle cell disease prob ably as a result of abnormal hypothalamic or pituitary function. There is a significant amelioration of the hypogonadism, abnormal sexual fu nction, and poor semen profile with increasing age.