Does Ovulation Induction Affect Anemia in Mediterranean Anemia Patients?

Will the ovulation induction medications used for in vitro fertilization affect the severity of Mediterranean anemia?

Dear Doctor, I am a carrier of thalassemia.
In my blood test report on August 8, both MCV and MCH were normal.
Now, in order to undergo assisted reproduction for pregnancy, my doctor has advised me to take two iron-containing prenatal vitamins and folic acid daily to prevent insufficient blood volume during pregnancy.
However, in the blood test report on August 18, all values, including MCV and MCH, were in the red, indicating a significant deterioration in just ten days.
Could this change in blood values over the ten days be caused by the ovulation induction injections? My reproductive specialist has advised me to see a doctor to determine the issue.
Should I consult a hematologist or an obstetrician-gynecologist? Thank you for your assistance.

Xiao Fang, 40~49 year old female. Ask Date: 2015/09/04

Dr. He Dongjin reply Cardiology

Hello, it is recommended that you consult a hematologist.
For pregnant women, a specialized iron-containing multivitamin of 2 capsules plus folic acid is suggested.
The supplements for the general public do not help with Mediterranean anemia.
You are not deficient in iron or folic acid.
Additionally, relevant literature does not mention that ovulation induction injections cause anemia; it may be that your pre-existing Mediterranean anemia condition has changed.
It is advisable to follow up with your hematologist for further evaluation.
Changhua Hospital cares about your health.

Reply Date: 2015/09/04

More Info

Ovulation induction can indeed have an impact on anemia, particularly in patients with Mediterranean anemia, also known as thalassemia. In your case, it is essential to understand the relationship between your condition and the treatments you are undergoing, especially since you are preparing for artificial reproduction.

Mediterranean anemia is characterized by a reduced production of hemoglobin, which can lead to anemia. Patients with this condition often have normal MCV (mean corpuscular volume) and MCH (mean corpuscular hemoglobin) levels, but they can experience fluctuations in their blood parameters due to various factors, including medications and dietary changes.

When you began taking iron supplements and prenatal vitamins, it was intended to support your body’s increased demands during pregnancy. However, the introduction of these supplements can sometimes lead to an increase in iron levels, which may not be well-tolerated by individuals with thalassemia. Excess iron can accumulate in the body and lead to complications, including organ damage. This could explain why your blood test results showed a decline in MCV and MCH, as well as other parameters.

The use of ovulation induction medications, such as gonadotropins or other hormonal treatments, can also affect your blood parameters. These medications can lead to changes in fluid balance, blood volume, and even the production of red blood cells. If your body is under stress from hormonal changes, it may not respond well to the additional iron and vitamins, leading to the deterioration in your blood counts that you observed.

Given your situation, it is advisable to consult with both a hematologist and your reproductive endocrinologist. The hematologist can assess your blood parameters in detail and determine if the changes are related to your Mediterranean anemia or if they are a result of the supplements and medications. They can also provide guidance on managing your iron levels and ensuring that you are not at risk for iron overload.

On the other hand, your reproductive endocrinologist can evaluate how the ovulation induction process is affecting your overall health and whether any adjustments to your treatment plan are necessary. They may also consider alternative approaches to support your fertility without compromising your health.

In summary, while ovulation induction can influence anemia in Mediterranean anemia patients, the specific changes in your blood parameters could be multifactorial, involving both the supplements you are taking and the hormonal treatments. It is crucial to work closely with your healthcare providers to monitor your condition and adjust your treatment plan as needed to ensure both your health and your fertility goals are met.

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