Introduction: Sickle cell disease is the most common autosomal recessive genetic haemoglobinopathy in the world. Progress in its management has significantly increased the life expectancy of patients with sickle cell disease, exposing them to age-related complications, including fertility problems. Assessment of ovarian reserve is a key test for estimating fertility potential in women with sickle cell disease. The aim of this study was to determine the ovarian reserve of women with sickle cell disease by measuring antimüllerian hormone and counting antral follicles and identify the associated factors. Material and Methods: This was a cross-sectional analytical study conducted from 5 April to 31 October 2024 in Kisangani, Democratic Republic of the Congo. It enrolled 268 women, categorised into four groups according to their haemoglobin status and the absence or presence of sickle cell crises: HbAA, asymptomatic HbAS (HbASa), symptomatic HbAS (HbASs) and HbSS. Participants with HbAA were grouped with HbASa to form the control group and those with HbSS were grouped with HbASs to form the patient groups. Results: The mean age at menarche was significantly later in the patients in the control group (P-value < 0.001), 15.5 years vs. 13 years. 5.1% of participants in the control group had low AMH levels compared with 22.5% of patients. 2.8% in the control group had a low NFA compared with 53.9% among patients. 1.7% in the control group had a DOR, compared with 20.2% among patients. Ovarian reserve was associated with BMI (P-value = 0.008), number of vaso-occlusive crises (P-value = 0.013), number of haemolytic crises (P-value = 0.006) and Hb level (P-value = 0.009). Conclusion: Sickle cell disease leads to a decrease in ovarian reserve (ORR). This DOR is associated with low BMI, multiple vaso-occlusive and haemolytic crises, low haemoglobin levels and the use of non-steroidal anti-inflammatory drugs.
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