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ular menses. Among those who became pregnant, conception was spontaneous in 7, all of whom had regular menses. Nine pregnancies were achieved following gonadotrophin-induced ovulation, while intrauterine insemination was performed in 3 cases. Two patients developed gestational The life expectancy and quality of life of patients with thalassemia has significantly increased over the last few years due to an improvement in the management of a transfusional approach and iron chelation therapy. Despite these advances, hypogonadotropic hypogonadism is still a common problem [1] that has been associated with increased fetal and maternal complications during pregnancy [2] . As only a few studies have described the evolution of pregnancy in subjects with beta-thalassemia major when managed according to the most recent recommendations [3–5] , the present study investigated the methods of conception and the mode of delivery as well as the course and outcome of pregnancy in a cohort of 46 patients in North Sardinia during the period between 2001 and 2017. All patients provided informed consent and the study was approved by the local ethics committee. As shown in Figure 1 , 19 pregnancies occurred in 15 women with thalassemia major. The mean age at the time of the first pregnancy was 33 years (range 28–38). Of these, 4 were being treated with deferasirox, 6 with deferoxamine, 2 with deferiprone, and 3 with deferoxamine plus deferiprone. Chelation therapy was discontinued in all pregnancies. Three patients had primary amenorrhea, 1 had secondary amenorrhea, and 1 had oligomenorrhea, while 10 patients had basically regReceived: August 17, 2017 Accepted after revision: August 20, 2017 Published online: October 10, 2017