Myocardial iron is strongly associated with reproductive function in beta-thalassemic women under chelation therapy

Objective: To evaluate gynaecological features of a group of transfusion dependent beta-thalassemic women and to analyze their re- productive function with the morpho-functional features of genital female tract. Materials and Methods: Cross-sectional study in a Uni- versity Hospital and Tertiary Care Center. Fifty-nine transfusion-dependent beta-thalassemic women in reproductive age, were divided into two groups: to group A were assigned women with spontaneous menarche (n=44), while to group B were allocated patients with inducted menarche. Data on demographic characteristics, iron overload in liver and heart (evaluated with T2∗ RMN method), chelation therapy, and reproductive function were collected. Difference in demographic characteristics, chelation therapy, iron status, and repro- ductive function between groups were assessed, together with correlation analysis of iron overload. Results: Patients in group B had a worse reproductive function and a higher myocardial iron overload, than patients in group A. Moreover multivariate logistic regression showed a significant correlation between uterine biometry, FSH, E2, parity and hearth iron T2∗HSIV, but not with liver iron. Conclu- sion: The present data shows that myocardial iron loading could be putative of prolonged and severe iron overload in the female geni- tal tract, impairing fertility and reproductive function in patients affected with beta-thalassemia major under chelation therapy.