A recent study presented at the 25th European Society for Human Reproduction and Embryology in Amsterdam revealed that women with cystic fibrosis (CF) can successfully conceive through fertility treatments without long-term adverse effects on their children or themselves. Historically, CF was associated with early mortality, often before individuals reached their teens. However, with advancements in medical care, many people with CF are now living longer lives and even starting families. This is no longer an uncommon scenario.
Despite these advances, women with CF still face significant fertility challenges. The condition can lead to infertility due to factors such as thick cervical mucus, which can hinder natural conception. To better understand and address these issues, researchers conducted a comprehensive study evaluating infertile women with CF. The study included 24 women who were treated at Hôpital Cochin Saint Vincent de Paul between 1998 and 2008. After initial health assessments, three women withdrew from the study due to other medical concerns, while six remained under evaluation. The remaining 15 underwent various fertility treatments.
Dr. Sylvie Epelboin, the lead researcher and an obstetrician coordinating the Paris-based ART-CF network, emphasized that while CF can interfere with natural conception, assisted reproductive technologies like intrauterine insemination (IUI) and in vitro fertilization (IVF) offer effective solutions. Success depends on the woman’s overall health, particularly lung function and nutritional status. Some women may face serious complications, including the need for lung transplants or even death, but with proper care, many can have healthy pregnancies.
Of the 15 women who received treatment, 13 became pregnant, resulting in 17 pregnancies, 12 live births, two ongoing pregnancies, and three miscarriages. Most of the mothers delivered vaginally, with only one requiring a cesarean section. While half of them developed gestational diabetes and experienced mild lung function decline, all mothers remained in good health throughout their pregnancies. Newborns were born at an average of 37 weeks, with most weighing between 1910 grams and 3500 grams. Only four infants were considered low birth weight, and none fell below the 1500-gram threshold.
Out of the 12 live births, five babies were breastfed, and all children—seven girls and five boys—are currently healthy. At the age of ten, they show no signs of developmental delays or major health issues. Dr. Epelboin expressed optimism about the findings, stating that assisted reproductive technology offers a safe and promising option for women with CF, both for themselves and their children.
She also highlighted that similar approaches apply to men with CF who may require intracytoplasmic sperm injection (ICSI) to achieve successful pregnancies. However, she stressed the importance of a multidisciplinary team approach, including careful pre-pregnancy evaluations, medical, genetic, and ethical counseling, and close monitoring during pregnancy.
Multiple pregnancies can pose additional risks, especially for women with CF, due to the strain on the heart, lungs, and overall health. Therefore, achieving a single, healthy pregnancy is often preferred. Women with CF are also more likely to develop diabetes due to pancreatic involvement, making it essential to manage blood sugar levels before and during pregnancy.
Through collaboration with experts like Dr. Dominique Hubert, a pulmonologist, and the broader ART-CF network, Dr. Epelboin continues to track CF mothers, their partners, and their children. She aims to explore the social and ethical implications of raising children in families where the mother has CF, as well as the expectations and needs of these families regarding medical interventions and quality of life.
“This long-term follow-up is crucial to ensure that our initial findings remain positive and to provide better support for future patients,†she said. “With continued research and care, we are confident that more women with CF will be able to build healthy, fulfilling families.â€
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