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Regularity of cycles and ovulatory pattern in young women with sickle cell anemia

PURPOSE: to evaluate the characteristics of the menstrual cycle and to identify the occurrence of ovulation in nulliparous young women with sickle cell anemia (SCA). METHODS: we conducted a case-control study including 26 nulliparous women of reproductive age, divided into two groups: "cases", consisting of 13 women with SCA, and "Control" Group, consisting of 13 healthy women with the same interval since menarche. The characteristics of the menstrual cycle were reported by the participants, who were also submitted to measurements of serum progesterone, basal body temperature curves and transabdominal ultrasound in three consecutive cycles (total: 78 cycles) in order to identify the occurrence of ovulation. The results were compared between groups using the nonparametric Mann-Whitney or Kruskal Wallis tests, and the differences were considered significant when p-value < 0.05. RESULTS: no significant difference was found in mean chronological age between the two groups (p = 0.2) in the pattern of the menstrual cycle when duration of flow (p = 0.4) and interval between cycles (p = 0.3) were compared. There was no difference between groups in age at menarche (p = 0.05). Mean hemoglobin value was 8.4 g/dL (± 0.9) in the group of women with SCA and 12.6 g/dL (± 0.8) in the control group (p < 0.01). The frequency of ovulatory cycles was similar for cases (76.9%) and controls (92.3%) (p = 0.5), with a predominance of individuals with three ovulatory cycles in the control group (84.6%) compared to 23.1% in the case group (p = 0.04). CONCLUSION: the findings justify the need for effective guidance for patients with SCA regarding sexual activity, the possibility of pregnancy and the alternatives for contraception.

Anemia, sickle cell; Menstrual cycle; Ovulation; Progesterone; Ultrasonography


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