Sexual development and fertility of Jamaican female patients with homozygous sickle cell disease

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Abstract
Results of a questionnaire study of 91 Jamaican patients with homozygous sickle cell (SS) disease and 59 Jamaican control subjects of similar socioeconomic status indicated a mean delay of 2.3 yr in age at menarche and of 3.9 yr in age at 1st pregnancy in SS disease. The mean interval between 1st sexual exposure and pregnancy was similar in the 2 groups. The delay in age at 1st pregnancy in SS disease resulted partly from the delay in puberty, but it also resulted from a further delay in 1st sexual exposure, with a mean interval between menarche and 1st sexual exposure of 2.6 and 4.4 yr in control subjects and patients, respectively. Physical and social factors that related to this delay were reflected in the higher prevalence of casual unions in patients; this finding implied lesser sexual exposure. Although the similar interval between 1st sexual exposure and pregnancy did not suggest a lesser fertility in patients with SS disease, the number of infants born to patients with SS disease was less at all ages compared with Jamaican standards. This might reflect lesser fertility subsequent to the 1st pregnancy.

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