Microcytic hypochromic anemia means that your body has too few red blood cells and these cells are smaller and paler than usual. This happens because of low levels of hemoglobin, a protein in red blood cells that helps transport oxygen around the body.
This article has been verified by a medical professional
Anemia is a widespread condition: according to the World Health Organization, almost 25% of the global population has anemia. Women of reproductive age are more likely to become anemic. Microcytic hypochromic anemia can mean that you have another type of anemia or a medical condition that needs treatment.
Impact of microcytic hypochromic anemia on fertility
This form of anemia is usually due to an iron deficiency, which has been proven to reduce fertility. Too little iron in the body can interfere with ovulation and increase the risk of miscarriage, low birth weight, and preterm labor. Copper deficiency, another potential cause for microcytic hypochromic anemia, is also associated with miscarriage and infertility.
A low flow of oxygen to the ovaries due to reduced hemoglobin in the blood can lower egg quality, which can cause problems with fertilization and implantation and lead to miscarriage. Thalassemia is associated with infertility, higher rates of miscarriage, and premature labor. During pregnancy, severe anemia can increase the chance of developing high blood pressure.
Potential causes of microcytic hypochromic anemia
Possible causes for this form of anemia include:
- Iron deficiency anemia (the most common cause)
- Thalassemias (blood disorders that impact your body’s ability to produce red blood cells and hemoglobin)
- Sideroblastic anemia (a rare blood disorder that decreases normal red blood cell production in the bone marrow)
- Copper deficiency
- Excess zinc
- Lead poisoning
Symptoms of microcytic hypochromic anemia
Signs of microcytic hypochromic anemia can be mild and get worse over time. Symptoms can include:
- Fatigue
- Weakness
- Dizziness
- Pale skin
- Rapid heartbeat
- Dry skin
- Easy bruising
- Shortness of breath
Diagnosis of microcytic hypochromic anemia
Healthcare providers diagnose microcytic hypochromic anemia with a variety of lab tests. A complete blood count (CBC) provides information about your levels of hemoglobin and other components of your blood. In a blood smear, a provider will examine your blood cells under a microscope. Finally, a reticulocyte count informs if your bone marrow makes enough healthy red blood cells.
You may be referred to a hematologist (a blood disorder specialist) for further testing to determine what is behind your microcytic hypochromic anemia. If you have stomach pain, you may be referred to a gastroenterologist who might do imaging tests to look at your abdomen, such as an ultrasound, CT scan, and an upper GI endoscopy.
Treatment to improve fertility
Your therapy regimen will depend on what is behind your anemia. If you have an iron deficiency, you may be prescribed iron supplements. Evidence shows that taking iron supplements significantly decreases the risk of ovulatory infertility. Iron supplements aren’t recommended for people receiving blood transfusions.
The following are iron-rich foods that you can incorporate more of into your diet if you have a deficiency:
- Beans
- Lentils
- Beef
- Turkey
- Liver
- Shrimp
- Dark leafy greens
- Dried fruits like raisins and apricots
- Fortified grains like bread and cereal
Vitamin C helps your body absorb iron better. Foods rich in this vitamin include:
- Citrus fruits
- Bell peppers
- Broccoli
- Berries
- Kale
- Brussels sprouts
Treatment for thalassemia depends on how severe the condition is – people may need blood transfusions to increase the amount of hemoglobin in the body. Regular blood transfusions can cause a build-up of iron. To counteract this, doctors can prescribe chelation therapy, a medicine to remove excess iron (chelation therapy will most likely pause during pregnancy). Studies show that women receiving blood transfusions for thalassemia can conceive naturally or with the help of assisted reproductive technology (ART) and, with the supervision of a multidisciplinary team of doctors, have a safe pregnancy.
This article has been verified by a medical professional
- Everything You Need to Know About Microcytic Anemia. Healthline. Accessed 25 November 2022.
- Chaudhry HS and Kasarla MR: Microcytic Hypochromic Anemia. StatPearls [Internet]. 2022.
- Microcytic Anemia. Cleveland Clinic. Accessed 25 November 2022.
- Chavarro JE et al.: Iron intake and risk of ovulatory infertility. Obstet Gynecol. 2006;108(5):1145-52.
- Skalnaya MG et al.: Serum levels of copper, iron, and manganese in women with pregnancy, miscarriage, and primary infertility. Journal of Trace Elements in Medicine and Biology. 2019;56:124-130.
- Akinci B et al.: Fertility in Patients with Thalassemia and Outcome of Pregnancies: A Turkish Experience. Turk J Haematol. 2019;36(4):272-277.
- Thalassemia – Diagnosis & treatment. Mayo Clinic. Accessed 02 December 2022.
- Thalessemia: Complications and Treatment. Centers for Disease Control and Prevention. Accessed 02 December 2022.
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