Failure to conceive in women with CF is associated with pancreatic insufficiency and advancing age

Michal Shteinberg*, Adi Ben Lulu, Damian G. Downey, Zeev Blumenfeld, Christine Rousset-Jablonski, Marie Perceval, Alessandra Colombo, Nili Stein, Galit Livnat, Michal Gur, Lea Bentur, Huda Mussaffi, Hannah Blau, Ifat Sarouk, Adi Dagan, Eitan Kerem, Micha Aviram, Elie Picard, Stefano Aliberti, Antonio ÁlvarezJavier Perez Miranda, Eva Polverino, Isabelle Durieu, J. Stuart Elborn, Malena Cohen-Cymberknoh

*Corresponding author for this work

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Pages (from-to)1-7
JournalJournal of Cystic Fibrosis
Early online date23 Oct 2018
DOIs
Publication statusEarly online date - 23 Oct 2018

Keywords

  • Adult
  • Cystic fibrosis
  • Female
  • Fertility

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

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    Shteinberg, M., Lulu, A. B., Downey, D. G., Blumenfeld, Z., Rousset-Jablonski, C., Perceval, M., Colombo, A., Stein, N., Livnat, G., Gur, M., Bentur, L., Mussaffi, H., Blau, H., Sarouk, I., Dagan, A., Kerem, E., Aviram, M., Picard, E., Aliberti, S., ... Cohen-Cymberknoh, M. (2018). Failure to conceive in women with CF is associated with pancreatic insufficiency and advancing age. Journal of Cystic Fibrosis, 1-7. https://doi.org/10.1016/j.jcf.2018.10.009