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.