Beyond The Lungs: Cystic Fibrosis, Infertility And Breakthroughs In Reproductive Technology
Cystic fibrosis has long been defined in the public imagination as a disease of the lungs, marked by relentless infections and the daily struggle to breathe.
Yet for thousands living with the condition, the challenges extend far beyond respiratory health. Infertility, particularly among men, remains one of the most overlooked consequences of cystic fibrosis, silently shaping the lives and futures of couples who dream of parenthood.
Today, however, advances in assisted reproductive technology are beginning to rewrite that narrative, offering hope where once there was despair.
This intersection of chronic illness, reproductive science and human resilience demands urgent attention, not only as a medical frontier but as a profound social issue that speaks to dignity, equity and the right to family life.
Women with Cystic fibrosis (CF) have thicker cervical mucus and can have ovulation issues due to poor nutrition. However, the majority of women with CF are fertile and can become pregnant if appropriate contraception is not used.
A majority of men (between 97 and 98 percent) with cystic fibrosis have a congenital bilateral absence of the vas deferens (CBAVD) – the ducts that carry sperm from the testes to the urethra – resulting in a lack of sperm in the semen.
The condition is called obstructive azoospermia and is a cause of infertility. Until recently, most men with cystic fibrosis could not father children. Assisted reproduction now makes fatherhood possible for these men.
Symptoms of CF
People with CF can have a variety of symptoms, including Very salty-tasting skin, persistent coughing, at times with phlegm, frequent lung infections including pneumonia or bronchitis, and wheezing or shortness of breath.
They also have chronic sinus infections, clubbing or enlargement of the fingertips and toes, rectal prolapse, and male infertility, among other issues.
Thicker Cervical Mucus
Women with cystic fibrosis have thicker cervical mucus due to abnormal cystic fibrosis transmembrane conductance regulator (CFTR) function. Thicker mucus can make it harder for sperm to successfully penetrate the cervix and can increase the amount of time it takes to become pregnant.
Cystic Fibrosis And Infertility
Most men with CF (97 to 98 percent) are infertile because of an absence of the sperm canal, known as the congenital bilateral absence of the vas deferens (CBAVD). The sperm never make it into the semen, making it impossible for them to reach and fertilize an egg through intercourse.
Impact Of Cystic Fibrosis On The Ovaries
Females with cystic fibrosis have been noted to have multicystic ovaries, much like those observed in Polycystic Ovarian Syndrome (PCOS). Reproductive tract effects of the CFTR mutation are believed to be present as early as the initiation of puberty, providing a mechanism for ovarian cyst formation.
Cystic Fibrosis, Infertile Couples And ART
While 97-98 percent of men with cystic fibrosis are infertile, they can still enjoy normal, healthy sex lives and have biological children with the help of assisted reproductive technology (ART).
Cystic Fibrosis And Pregnancy Outcomes
Pregnant women with cystic fibrosis who have poorer lung function at the beginning of pregnancy have a higher risk of having a premature or smaller baby.
Puberty And Menstruation
Poor nutrition, low body weight, and compromised lung function all affect the body’s ability to ovulate and menstruate regularly. For this reason, some women with CF may have absent or irregular periods associated with being underweight or malnourished.
Irregular Ovulation
Poor nutrition leading to irregular ovulation (the release of eggs from the uterus) can also contribute to fertility problems and is another reason some women with CF may have trouble conceiving.
Cystic Fibrosis And Infertility In Females
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.
Cystic Fibrosis And Childbirth
If only one of you is found to be a carrier, the chance that you will have a child with CF is very low, although not completely eliminated. If you are both carriers, each pregnancy will have a 1 in 4, or 25 percent chance of being affected with cystic fibrosis.
Pregnancy And Cystic Fibrosis
The sexual health issues that men and women with CF experience may mean extra medical procedures are needed to get pregnant. These may include medications to encourage ovulation, artificial insemination, or in vitro fertilisation.
Conclusion: It can take more time for women with cystic fibrosis to become pregnant than women without CF.
Most women with CF can become pregnant and achieve a normal pregnancy.
Your obstetrician should be able to help you understand your reproductive health to help you make the right family planning decisions.
Assisted Reproductive Technology
If you do have trouble conceiving, assisted reproductive technology (ART) techniques and alternate family-building options, such as adoption or surrogacy, are all viable options for starting a family.
Assisted reproductive technology (ART) is often a popular family-building option among people with cystic fibrosis.
With proper management, careful monitoring, and working closely with your care team and obstetric team, many women with cystic fibrosis can carry a child without significantly affecting their long-term health.
Dr Taiwo Orebamjo is an experienced Consultant Obstetrician and a medical administration expert from the Kingston Academy of Learning and Career College Canada. He is a post-graduate of the Royal College of Obstetricians and Gynaecologists, London. The Research Fellow in assisted conception at the St. George’s Teaching Hospital in Tooting London is also the Consultant Obstetrician &Gynaecologist, Medical Director, at Parklande Specialist Hospital & Lifeshore Fertility and IVF Clinic.