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

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)525-529
Number of pages5
JournalJournal of Cystic Fibrosis
Volume18
Issue number4
DOIs
Publication statusPublished - Jul 1 2019

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Exocrine Pancreatic Insufficiency
Infertility
Lung
Body Mass Index
Female Infertility
Pregnancy
Coitus
Israel
Sputum
Nutritional Status
Spain
Italy
France
Fertility
Multivariate Analysis
Retrospective Studies
Mutation

Keywords

  • Adult
  • Cystic fibrosis
  • Female
  • Fertility

ASJC Scopus subject areas

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

Cite this

Shteinberg, M., Lulu, A. B., Downey, D. G., Blumenfeld, Z., Rousset-Jablonski, C., Perceval, M., ... Cohen-Cymberknoh, M. (2019). Failure to conceive in women with CF is associated with pancreatic insufficiency and advancing age. Journal of Cystic Fibrosis, 18(4), 525-529. https://doi.org/10.1016/j.jcf.2018.10.009

Failure to conceive in women with CF is associated with pancreatic insufficiency and advancing age. / Shteinberg, Michal; Lulu, Adi Ben; Downey, Damian G.; Blumenfeld, Zeev; Rousset-Jablonski, Christine; Perceval, Marie; Colombo, Alessandra; Stein, Nili; Livnat, Galit; Gur, Michal; Bentur, Lea; Mussaffi, Huda; Blau, Hannah; Sarouk, Ifat; Dagan, Adi; Kerem, Eitan; Aviram, Micha; Picard, Elie; Aliberti, Stefano; Álvarez, Antonio; Perez-Miranda, Javier; Polverino, Eva; Durieu, Isabelle; Stuart Elborn, J.; Cohen-Cymberknoh, Malena.

In: Journal of Cystic Fibrosis, Vol. 18, No. 4, 01.07.2019, p. 525-529.

Research output: Contribution to journalArticle

Shteinberg, M, Lulu, AB, Downey, DG, 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, Álvarez, A, Perez-Miranda, J, Polverino, E, Durieu, I, Stuart Elborn, J & Cohen-Cymberknoh, M 2019, 'Failure to conceive in women with CF is associated with pancreatic insufficiency and advancing age', Journal of Cystic Fibrosis, vol. 18, no. 4, pp. 525-529. https://doi.org/10.1016/j.jcf.2018.10.009
Shteinberg M, Lulu AB, Downey DG, Blumenfeld Z, Rousset-Jablonski C, Perceval M et al. Failure to conceive in women with CF is associated with pancreatic insufficiency and advancing age. Journal of Cystic Fibrosis. 2019 Jul 1;18(4):525-529. https://doi.org/10.1016/j.jcf.2018.10.009
Shteinberg, Michal ; Lulu, Adi Ben ; Downey, Damian G. ; Blumenfeld, Zeev ; Rousset-Jablonski, Christine ; Perceval, Marie ; Colombo, Alessandra ; Stein, Nili ; Livnat, Galit ; Gur, Michal ; Bentur, Lea ; Mussaffi, Huda ; Blau, Hannah ; Sarouk, Ifat ; Dagan, Adi ; Kerem, Eitan ; Aviram, Micha ; Picard, Elie ; Aliberti, Stefano ; Álvarez, Antonio ; Perez-Miranda, Javier ; Polverino, Eva ; Durieu, Isabelle ; Stuart Elborn, J. ; Cohen-Cymberknoh, Malena. / Failure to conceive in women with CF is associated with pancreatic insufficiency and advancing age. In: Journal of Cystic Fibrosis. 2019 ; Vol. 18, No. 4. pp. 525-529.
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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.",
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AU - Shteinberg, Michal

AU - Lulu, Adi Ben

AU - Downey, Damian G.

AU - Blumenfeld, Zeev

AU - Rousset-Jablonski, Christine

AU - Perceval, Marie

AU - Colombo, Alessandra

AU - Stein, Nili

AU - Livnat, Galit

AU - Gur, Michal

AU - Bentur, Lea

AU - Mussaffi, Huda

AU - Blau, Hannah

AU - Sarouk, Ifat

AU - Dagan, Adi

AU - Kerem, Eitan

AU - Aviram, Micha

AU - Picard, Elie

AU - Aliberti, Stefano

AU - Álvarez, Antonio

AU - Perez-Miranda, Javier

AU - Polverino, Eva

AU - Durieu, Isabelle

AU - Stuart Elborn, J.

AU - Cohen-Cymberknoh, Malena

PY - 2019/7/1

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N2 - 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.

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KW - Adult

KW - Cystic fibrosis

KW - Female

KW - Fertility

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