Successful pregnancy and birth after IVF in a woman with cystic fibrosis: Case Report

Abstract

As survival increases, patients with cystic fibrosis (CF) are often confronted with reproductive issues. Initial reports gave conflicting advice regarding the outcome of pregnancy in CF. However a recent large longitudinal study of pregnancies in CF women suggested that pregnancy has little impact on morbidity or mortality. Reduced fertility in CF women has been described, possibly due to thickened cervical mucus, and intrauterine insemination (IUI) has been used to overcome this. We report the first woman with CF, to our knowledge, to be successfully treated with IVF after repeated failed attempts at IUI.

Pregnancy and cystic fibrosis: Approach to contemporary management

“…clomiphene) and in vitro fertilization (IVF) have been successfully used to assist women with CF to achieve pregnancy, depending on the likely mechanism of infertility. 43 Despite this, studies of knowledge of reproductive potential demonstrate that many young women with CF may not be aware (or fully aware) of the risk of pregnancy following unprotected intercourse. 44 A key role of the CF team is to ensure all young women with CF are aware that pregnancy can and does occur.…”

Cystic Fibrosis and Infertility

“…The absence of obvious anatomical abnormalities in the female reproductive tract -except for thick and tenacious cervical mucus with altered water and electrolyte content (Kopito et al, 1973) -has led to the general belief that abnormal mucus contributes to the reduced fertility of CF women by acting as a barrier to sperm passage (Chan et al, 2009). However, repeated and unsuccessful attempts with intrauterine insemination were also reported (Epelboin et al, 2001;Rodgers et al, 2000), suggesting that further abnormalities (such as inadequate fluid control throughout the rest of the reproductive tract) could also contribute to infertility in humans (Hodges et al, 2008).…”

“…Successful outcomes can be achieved for both the CF mother and the child with careful patient assessment, combined with the integration of a multidisciplinary team, composed of the CF physician, the fertility specialist and the obstetrician (CF Foundation Patient registry 2009: Annual data report, 2011). Close follow-up of the maternal and foetal condition, along with careful monitoring of ventilation, immunology, diabetes, glucose tolerance and nutrition is important since all these parameters may be adversely affected in a CF pregnancy (Barak et al, 2005;Rodgers et al, 2000).…”

Infertility and abnormal cervical mucus in two sisters who are compound heterozygotes for the cystic fibrosis (CF) ΔF508 and R117H/7T mutations

“…Previous case reports have described infertility caused by a cervical mucus factor in patients with CF (10,(12)(13)(14). In cases of infertility, IUI has been performed to successfully bypass the cervical mucus.…”