How Cystic Fibrosis Affects Fertility

Among the parts of the body negatively affected by cystic fibrosis is the urogenital system, which involves the urinary system and the genitals. In fact, the vast majority of men with cystic fibrosis — up to 98 percent — will be infertile as a result of this disease. The fertility of women can be affected as well, but not to the same extent and not for the same reasons as men.

Fertility issues are common in women with cystic fibrosis. One study in mice found signs of cystic fibrosis that included disrupted ovulation and smaller uteri and ovaries. Due to poor lung function and poor nutrition, cystic fibrosis can cause low body weight. Also, in adult women, it can disrupt normal ovulation and cause irregular periods or even an absence of menstruation. Infertility can occur as well through the medications used to combat the disease. Fungal infections are also seen since the medications tend to disrupt the healthy flora in the vagina.

In men, sperm count and motility can be affected by poor lung function, low body weight, and poor nutrition. However, this is not the main cause in men with cystic fibrosis.

Mutation in the CFTR gene can cause cystic fibrosis. The development of the seminal vesicle, ejaculatory duct, vas deferens, and epididymis are all affected. In some men, the vas deferens is entirely absent; this is known as congenital bilateral absence of vas deferens. Thus, no sperm can be transported outside the body, so the man cannot make a woman pregnant. This is called clinical infertility. Almost ten percent of men with cystic fibrosis are not able to produce sperm.

To assist men lacking a vas deferens in fertilizing women, multiple assisted reproductive technologies have been developed. Three such methods are:

• Microsurgical epididymal sperm aspiration: To extract sperm from the epididymal tubes, tiny aspirations are made using an operating microscope. This is the most advanced and most effective technique, although it is very expensive and requires precise skill.
• Percutaneous epididymal sperm aspiration: To collect the sperm, a tiny needle is used. This method is similar to the above therapy.
• Testicular sperm extraction: The sperms are acquired by removing small amounts of tissues from the testicles.

Cystic fibrosis is a hereditary disease. If both partners have cystic fibrosis, the risk of their child developing it as well is high. However, if only one partner has it, the chance is less. Some may even carry the gene without having the disease, so each partner should undergo testing for cystic fibrosis. This will help to determine the risk associated with the child.

Cystic fibrosis may not result in infertility; some men remain fertile. There is a chance of pregnancy even if you did not have your fertility tested and you are sexually active.

In men and women, cystic fibrosis, along with other issues, may cause fertility problems. In women, a possible side effect of the disease is reduced fertility. However, the link is much stronger and more direct in men. In the majority of male cases of cystic fibrosis, the vas deferens is absent.

To induce pregnancy with one’s partner, sperm can be harvested through various methods, such as in vitro fertilization. However, caution should be taken with any resulting children in order to assess their risk of cystic fibrosis.