Cystic Fibrosis And Its Impact On Fertility
Cystic Fibrosis (CF) is an inherited condition in which the body creates thick mucus that impairs breathing and digestion and leaves the body more susceptible to bacterial infections. The mutated cystic fibrosis gene is passed down in two copies one from each parent to the offspring .
Adults with cystic fibrosis have issues with their reproductive, digestive, and respiratory systems. When we talk about reproductive impairement in the context of cystic fibrosis, both men and women are effected.
Causes of Cystic Fibrosis
CFTR gene mutations cause cystic fibrosis. CFTR gene regulates chloride ion movement in and out of the cell. Sweat contains sodium chloride, a common salt made up of chloride. Additionally, chloride serves crucial roles in cells. For instance, chloride ions helps regulate tissue water flow, which is essential for developing thin, freely flowing mucus.
In patients with mutation in CFTR gene ,Chloride channels cannot control the movement of water and chloride ions across cell membranes.. As a result, mucus that is exceptionally thick and sticky is produced by cells that line the airways of the pancreas, lungs, and other organs. The airways and different ducts get blocked by this mucus, leading to the typical signs and symptoms of cystic fibrosis.
The severity of the illness is probably influenced by additional hereditary and environmental factors. For instance, mutations in genes other than CFTR may explain why some cystic fibrosis patients experience more severe symptoms than others. However, the majority of these genetic alterations are still unknown.
Fertility In Women With Cystic Fibrosis
Many women with CF have babies without undergoing any fertility treatment, and they can produce healthy, fertile eggs, so effective contraception is necessary if they are trying to avoid pregnancy. However, it is thought that women with CF are more likely to experience fertility problems than women who don’t have CF, due to:
• being more likely to experience irregular or absent periods if they are ill or very underweight, and
• having thicker vaginal mucus, which can make it harder for sperm to reach the egg.
Fertility issues in women with CF are treated in the same way as they are for women without the condition. There are various treatments available, including medications to boost egg production, intrauterine insemination (IUI) – a procedure that introduces sperm directly to the womb – or In vitro fertilisation (IVF) techniques.
There are some circumstances where a CF team may feel that a woman is medically unfit to become pregnant. This may be the case if she has:
•poor lung function
•respiratory failure
•pulmonary hypertension
•heart disease
•severe liver disease
Care During Pregnancy
During pregnancy, your metabolism increases and the heart and lungs work differently to accommodate the changes to your body. For some women with CF, particularly those with a low or unstable lung function, poor nutrition or low body weight, these changes can cause significant and irreversible health complications. For this reason, pregnant women with CF are monitored much more regularly than women without cystic fibrosis.
Fertility In Men With Cystic Fibrosis
Most men with cystic fibrosis (around 98 per cent) will suffer from infertility and, as a result, will not be able to father a child biologically without assistance from fertility specialists. This is because the tube that carries sperm from the testicles to the penis (called the vas deferens) is either missing or blocked. There’s nothing ‘wrong’ with the sperm, it just can’t get into the semen neither does it cause erectile dysfunction ( impotence).
However, it is possible for men with this CF-related problem to father biological children through fertility treatment.
Fertility Treatments
IVF
In vitro fertilisation (IVF) is the attempt to fertilise an egg with sperm outside the human body, ‘in glass’ (in vitro).
During IVF, an egg is removed from the woman's ovaries and fertilised with sperm in a laboratory. The fertilised egg, called an embryo, is then returned to the woman's womb to grow and develop.
The procedure can take place using a woman’s own eggs and her partner’s sperm, or eggs and/or sperm from donors.
Adoption and surrogacy
For some people, adoption is their first preference for creating a family, while others turn to adoption having not been able to conceive their own child.
The adoption process requires a series of suitability checks, including a health assessment. This assessment will be organised by the adoption agency, which is either part of the local authority or a voluntary organisation.
Surrogacy is another option. This involves another woman carrying and giving birth to a baby for a couple.
The Road Ahead!
Most aspects of life, including fertility, are impacted by cystic fibrosis. Therefore, it is important to consult a doctor, a fertility expert, or a genetic counsellor about the options if the individual has cystic fibrosis, and is thinking about having a child. In addition to it, third-party reproduction or adoption can be the greatest option if having a biological child is not the option. A counselor can assist the individuals in weighing the advantages and disadvantages of these choices.
