Fertility of women with cystic fibrosis: a French survey

Tournier, A.; Murris, M.; Prévotat, A.; Fanton, Annlyse; Bettiol, Célia; Parinaud, Jean

doi:10.1016/j.rbmo.2019.04.128

Cited by 8 publications

(9 citation statements)

References 33 publications

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“…A recent study ( 10 ) has shown reduced fertility in CF patients compared to the general population (37% of infertility versus 10 to 24%). Those women are usually referred to ART centres but few data are available in the literature concerning the prognosis of ART procedures in such women.…”

Section: Discussionmentioning

confidence: 99%

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The Prognosis of ART Is Not Altered in Cystic Fibrosis Women: A Case-Report Study

et al. 2022

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Research QuestionUnlike in men, a very limited number of studies were focused on the specificity of ART management of cystic fibrosis (CF) in women. The purpose of this study was to determine the causes of infertility in patients, the appropriate ART treatment, and their prognosis in terms of pregnancy.DesignWe conducted a multicentre analytical case-control study including CF women who were age-matched to non-CF women. We reported the causes of infertility, the ART management type and pregnancy outcomes.Results17 cases were compared to 34 controls. There was no significant difference between the groups concerning cause infertility. There was a non-statistically significant trend with a lower antral follicle count in CF compared to controls (19.5 versus 26.8, p=0.08). IUI seemed to be as successful as IVF/ICSI in CF as opposed to controls where the IVF/ICSI was the most effective (in CF group for HCG >100 UI/L: 38.8% vs. 36.8%, p=0.4175). There were more embryos obtained in CF than in controls (3.1 versus 1.6, p=0.02). The number of oocytes and embryos obtained and pregnancy outcomes remained similar between DF508 homozygous group and others CFTR mutations group. The results of ART procedures and pregnancy evolution were not influenced by FEV1. ConclusionIn absence of any other pathology, IUI may be first option for CF women. If insemination fails, IVF with a low dose of gonadotropins may be more appropriate to prevent the risk of hyperstimulation syndrome. FEV1 and genetic do not seem to be contributing factors in the prognosis of ART.

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Section: Discussionmentioning

confidence: 99%

“…Regarding CF in women, recent studies ( 10 , 11 ) have estimated the rate of hypofertility to be around 35-40% while it was only 10% in the overall European population. The primary hypothesis of this subfertility was related to cervical mucus being thicker and as a result acting as a barrier to the passage of the sperm ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

The Prognosis of ART Is Not Altered in Cystic Fibrosis Women: A Case-Report Study

et al. 2022

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“…Some data show a reported prevalence of infertility or subfertility of approximately 20–35%, which is potentially 10–20% higher than that in the general population [ 12 , 13 , 14 ]. In a multicenter French study, median time to conception in women with CF was reported as 12 months [ 15 ]. Unlike men with CF who are almost always azoospermic, due to congenital bilateral absence of the vas deferens [ 16 ], the structural anatomy of the reproductive system of women with CF is similar to that of women without CF.…”

Section: Fertilitymentioning

confidence: 99%

Fertility, Pregnancy and Lactation Considerations for Women with CF in the CFTR Modulator Era

Jain

Taylor‐Cousar

2021

JPM

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Cystic fibrosis (CF) is an autosomal recessive genetic disorder impacting approximately 80,000 people of all races and ethnicities world-wide. CF is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene which encodes a protein of the same name. Protein dysfunction results in abnormal chloride and bicarbonate transport in mucus membranes, including those in the respiratory, gastrointestinal and reproductive tracts. Abnormal anion transport causes viscous secretions at the site of involvement. The majority of people with CF succumb to respiratory failure following recurrent cycles of infection and inflammation in the airways. Historically, providers treated the signs and symptoms of CF, but since 2012, have been able to impact the basic defect for the subset of people with CF who have mutations that respond to the new class of drugs, CFTR protein modulators. With the improved health and longevity afforded by CFTR modulators, more women are interested in parenthood and are becoming pregnant. Furthermore, this class of drugs likely increases fertility in women with CF. However, the safety of CFTR modulators in pregnancy and lactation is only beginning to be established. We summarize available data on the impact of CFTR modulators on fertility, pregnancy and lactation in women with CF.

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“…Women with CF are usually fertile. [130][131][132] However, there is some evidence to suggest that CFTR dysfunction and the effect on mucus secretion and content may slightly reduce fertility. 130 CFTR is expressed in the epithelial cells of the urogenital tract, and there is an important interaction between sperm penetration, mucus, and mucociliary movement of eggs and subsequent fertilized zygote in the early stages of pregnancy.…”

Section: Fertility and Pregnancymentioning

confidence: 99%

“…Subfertility is also impacted by poor nutrition, reduced lung function, and chronic infection. 131 This probably has more impact on fertility than underlying CFTR dysfunction. A recent study shows a relationship with pancreatic sufficiency, which is a surrogate for residual function mutations, better nutritional state, and preserved lung function.…”

Section: Fertility and Pregnancymentioning

confidence: 99%

Adult Care in Cystic Fibrosis

Elborn

2019

Semin Respir Crit Care Med

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Cystic fibrosis (CF) is now more common in adults than children in countries with well-developed health care systems. The number of adults continues to increase and will further increase if the new cystic fibrosis transmembrane conductance regulator (CFTR) modulators are disease modifying. Most of the complex morbidity and almost all the mortality of CF occur in adults and will increasingly follow this pattern even with new effective modulator therapies. Maintaining good quality of life including social functioning and maximizing survival for adults are the key priorities. This requires a highly knowledgeable and adaptable multidisciplinary team, which, though focused on maintaining lung health, requires an increasing range of other disciplines and specialties to maximize well-being. Changes in health care systems will require current models of care to adapt to provide care for the large number of adult patients. With increasing survival and age, many are likely to have both CF morbidities and additional diseases of aging. New models are needed for health care delivery for this expanding population with complex medical conditions.

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Fertility of women with cystic fibrosis: a French survey

Cited by 8 publications

References 33 publications

The Prognosis of ART Is Not Altered in Cystic Fibrosis Women: A Case-Report Study

The Prognosis of ART Is Not Altered in Cystic Fibrosis Women: A Case-Report Study

Fertility, Pregnancy and Lactation Considerations for Women with CF in the CFTR Modulator Era

Adult Care in Cystic Fibrosis

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