TY - JOUR
T1 - Failure to conceive in women with CF is associated with pancreatic insufficiency and advancing age
AU - Shteinberg, Michal
AU - Lulu, Adi Ben
AU - Downey, Damian G.
AU - Blumenfeld, Zeev
AU - Rousset-Jablonski, Christine
AU - Perceval, Marie
AU - Colombo, Alessandra
AU - Stein, Nili
AU - Livnat, Galit
AU - Gur, Michal
AU - Bentur, Lea
AU - Mussaffi, Huda
AU - Blau, Hannah
AU - Sarouk, Ifat
AU - Dagan, Adi
AU - Kerem, Eitan
AU - Aviram, Micha
AU - Picard, Elie
AU - Aliberti, Stefano
AU - Álvarez, Antonio
AU - Perez-Miranda, Javier
AU - Polverino, Eva
AU - Durieu, Isabelle
AU - Stuart Elborn, J.
AU - Cohen-Cymberknoh, Malena
N1 - Publisher Copyright:
© 2018 European Cystic Fibrosis Society.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Objective: The causes of subfertility in women with CF though multifactorial are not well described. Our aim in this study was to determine the prevalence and factors associated with female subfertility among women with CF. Methods: A retrospective multinational study from 11 CF centers in 5 countries (Israel, France, Spain, Italy, UK) including women with CF was undertaken. Sub/infertility was defined as not achieving a spontaneous pregnancy after one year of unprotected sexual intercourse. Data including genetics, pancreatic insufficiency (PI), prevalence of diabetes (CFRD), lung function, nutritional status measured by body mass index (BMI), sputum bacterial colonization, and rate of pulmonary exacerbations were collected from patients' files. Results: Out of 605 women, 241 attempted pregnancy. Of these, 84 (35%) had subfertility, and 67 of them eventually became pregnant. Females attempting conception were older but had better pulmonary function and nutrition compared to those who did not. In a multivariate analysis, PI (OR 1.9 [1.03–3.5], p =.04) and older age (OR 3.9 [2.1–7.3] p <.0001) were associated with subfertility. Lung function, BMI, CFRD, Presence of two class I-III mutations and number of exacerbations in the year prior to fertility attempts were not associated with subfertility. Conclusions: The prevalence of subfertility among women with CF (35%) is higher than the expected 5–15% subfertility in the general population. Older age and pancreatic insufficiency are associated with subfertility in women with CF.
AB - Objective: The causes of subfertility in women with CF though multifactorial are not well described. Our aim in this study was to determine the prevalence and factors associated with female subfertility among women with CF. Methods: A retrospective multinational study from 11 CF centers in 5 countries (Israel, France, Spain, Italy, UK) including women with CF was undertaken. Sub/infertility was defined as not achieving a spontaneous pregnancy after one year of unprotected sexual intercourse. Data including genetics, pancreatic insufficiency (PI), prevalence of diabetes (CFRD), lung function, nutritional status measured by body mass index (BMI), sputum bacterial colonization, and rate of pulmonary exacerbations were collected from patients' files. Results: Out of 605 women, 241 attempted pregnancy. Of these, 84 (35%) had subfertility, and 67 of them eventually became pregnant. Females attempting conception were older but had better pulmonary function and nutrition compared to those who did not. In a multivariate analysis, PI (OR 1.9 [1.03–3.5], p =.04) and older age (OR 3.9 [2.1–7.3] p <.0001) were associated with subfertility. Lung function, BMI, CFRD, Presence of two class I-III mutations and number of exacerbations in the year prior to fertility attempts were not associated with subfertility. Conclusions: The prevalence of subfertility among women with CF (35%) is higher than the expected 5–15% subfertility in the general population. Older age and pancreatic insufficiency are associated with subfertility in women with CF.
KW - Adult
KW - Cystic fibrosis
KW - Female
KW - Fertility
UR - http://www.scopus.com/inward/record.url?scp=85055187529&partnerID=8YFLogxK
U2 - 10.1016/j.jcf.2018.10.009
DO - 10.1016/j.jcf.2018.10.009
M3 - Article
C2 - 30366850
AN - SCOPUS:85055187529
SN - 1569-1993
VL - 18
SP - 525
EP - 529
JO - Journal of Cystic Fibrosis
JF - Journal of Cystic Fibrosis
IS - 4
ER -
