TO THE EDITOR:

Information about whether sickle cell anemia (SCA) and its treatments affect female fertility is needed.1 Diminished ovarian reserve (DOR) describes low egg supply, is considered irreversible in women with cancer,2 and is a risk factor for recurrent pregnancy loss,3 miscarriage,4 and infertility.5 Women with SCA (>30 years old) have higher rates of DOR than age-matched controls.6-8 In a study of 10- to 21-year-old females with SCA, DOR occurred in 24% (8 of 33) of the hydroxyurea-treated subjects and none of the 14 untreated subjects.9 In cancer, DOR before chemotherapy is a risk factor for posttreatment infertility10 and an indication for fertility preservation.11 Fertility preservation for pre- and postpubescent females12,13 before gonadotoxic treatment is a care standard and offered to individuals with SCA before curative therapies.14,15 Fertility...

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