Fertility Preservation in a Female Adolescent with a Hemoglobinopathy

A 16-year-old female with a history of β-thalassemia presented to our Reproductive Endocrinology and Infertility (REI) clinic prior to undergoing hematopoietic stem cell transplantation (HSCT). Her gynecologic history was significant for spontaneous menarche at age 13 years and regular monthly menses. She was not sexually active but did use tampons. Her history was otherwise significant for mild asthma and a history of depression for which she saw a therapist but was not prescribed medications. She was able to tolerate a transvaginal ultrasound, which revealed a normal-sized uterus and an antral follicle count of 12. Laboratory results were notable for an anti-Mullerian hormone (AMH) level of 3.41 ng/mL. She was counseled that the preconditioning regimens used prior to HSCT could lead to premature ovarian insufficiency and therefore she should consider fertility preservation. She was counseled about preservation options and elected to undergo oocyte cryopreservation.