Macrocytic hyperchromic anemia

Macrocytic hyperchromic anemia means that your bone marrow produces unusually large and dark red blood cells. These cells don’t have the nutrients they need to transport oxygen around the body. It occurs when the body doesn’t have a sufficient supply of essential nutrients or can’t absorb the nutrients as well as it should.

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Impact on fertility

A low supply of oxygen to the ovaries decreases the quality of your eggs. This can lead to problems with fertilization and implantation. It can also cause miscarriage.

Potential causes of Macrocytic hyperchromic anemia

Macrocytic hyperchromic anemia can be caused by:

• Vitamin B12 deficiency
• Folic acid deficiency 
• Hypothyroidism (underactive thyroid)
• Liver disease
• Excess alcohol consumption
• Myelodysplastic syndrome (a group of disorders affecting the bone marrow)
• Medications

Symptoms of Macrocytic hyperchromic anemia

Signs of anemia include:

• Fatigue
• Weakness
• Pale skin
• Dizziness
• Rapid heartbeat
• Shortness of breath
• Easy bruising

With this form of anemia, you may also experience changes to your mood and memory or feel tingling in your arms and legs.

Diagnosis

Doctors diagnose macrocytic hyperchromic anemia through a variety of lab tests. A complete blood count (CBC) shows your red blood cell count and function. Additional tests include a peripheral blood smear, which healthcare providers use to analyze blood cells under a microscope, and the reticulocyte count, which shows if your bone marrow makes enough healthy red blood cells.

Your doctor may order additional tests to find the cause of your anemia, like tests for thyroid hormones, vitamin B12 levels, and signs of liver problems.

Treatment to improve fertility

Most cases of macrocytic hyperchromic anemia are due to high alcohol consumption. If this is the case for you, know that no amount of alcohol is safe for a growing baby. So it’s recommended that all women trying to conceive cut out alcohol entirely. Once you do that, your anemia will resolve itself quite quickly.

If your anemia is due to a deficiency of vitamin B12 or folic acid (or a problem preventing your body from effectively absorbing these nutrients), your doctor will likely prescribe supplements. Having a healthy level of these nutrients is vital for fertility and a successful pregnancy. 

Foods high in vitamin B12 include meat, dairy, eggs, and fish, as well as cereals and nondairy milk fortified with vitamin B12. Folate-rich foods include leafy greens, broccoli, brussels sprouts, citrus fruits, lentils, nuts, seeds, and asparagus. 

In case your anemia is because of an underlying health condition, your doctor will treat the root cause. For example, hypothyroidism is treated with medication that replaces the missing thyroid hormones – and it greatly improves fertility!

This article has been verified by a medical professional

• Macrocytic Anemia. Cleveland Clinic. Accessed 05 December 2022.
• Moore CA and Adil A: Macrocytic Anemia. StatPearls [Internet]. 2022.
• Heertum KV and Rossi B: Alcohol and fertility: how much is too much? Fertil Res Prac. 2017;3:10.