What You Should Know About Cystic Fibrosis And Male Infertility
While cystic fibrosis leads to a number of long-term respiratory challenges, one of its lesser-known complications is how it affects fertility. While most women with cystic fibrosis don't have difficulties, cystic fibrosis and male infertility is common. Here's what you need to know about causes and treatments that can help.
How does cystic fibrosis cause infertility in men?
The majority of men with cystic fibrosis are infertile. This is due to a structural condition called congenital bilateral absence of the vas deferens (CBAVD) that occurs in up to 98% of men with cystic fibrosis.
Typically, sperm develops in the testicles and moves into the epididymis, a tube attached to the testis. It’s function is to allow chemical changes to occur which promote sperm motility and storage until ejaculation occurs. The sperm travels from the epididymis through the vas deferens, a tube that transports sperm from the testicles to the ejaculatory duct. In men who have CBAVD, though, the vas deferens is completely blocked or altogether absent. This means that sperm is trapped in the testicles or the epididymis, thus never making it into the semen.
Even though the majority of men with cystic fibrosis are infertile, they are not sterile. Up to 90% of men with cystic fibrosis have healthy sperm. Assisted reproductive technologies (ART) can help many of these men conceive.
How to conceive with cystic fibrosis
If you have cystic fibrosis, the most important step is to work directly with your cystic fibrosis healthcare team and a fertility specialist to increase your chances of conceiving. You will also need additional support to balance your current cystic fibrosis therapies and any procedures or medications used for ART techniques.
For example, if you're considering a lung transplant, many anti-rejection medications can lead to birth defects. Because of this, many fertility clinics encourage you to freeze sperm before undergoing a transplant.
Cystic fibrosis is also a genetic disease. Your healthcare team will run genetic testing for your partner to see if they carry the gene as well. If so, they'll offer genetic counseling and can discuss other fertility options like surrogacy or donor sperm.
Can a man with cystic fibrosis have a baby?
Many men with cystic fibrosis can have biological children through ART techniques. Your fertility specialist will suggest the best approach after running fertility tests on you and your partner.
Most men with cystic fibrosis will start with an outpatient surgical procedure to retrieve sperm from either the epididymis or testicles. As noted, transplant medications as well as time spent blocked in the epididymis can damage sperm. Due to this, your doctor may advise you to retrieve sperm at a younger age—in your late teens or early 20s. Since sperm can be frozen and stored for up to ten years, this gives you the best chances for conceiving.
If you're ready to start, your fertility specialist will test your sperm for viability. If viable, your partner will generally undergo ovulation induction and then an egg retrieval procedure. A single viable sperm is injected directly into the egg. If fertilization leads to a healthy embryo, it will be transferred into the uterus.
This process is known as intracytoplasmic sperm injection (ICSI), a specialized form of in vitro fertilization (IVF).
Learn more about cystic fibrosis and male infertility
If you're struggling with cystic fibrosis and male infertility, there are treatments that can help you achieve a safe, healthy conception. A writer from the Cystic Fibrosis Foundation discusses how IVF personally helped him and his wife conceive (three healthy children!), as well as the specific challenges he faced with treatment.
If you're in Louisiana or our neighboring states, we'd love to help at The Fertility Institute. Our team of fertility specialists can coordinate your cystic fibrosis care with your healthcare team. Together, we're here to help you take the first step towards the family you’ve been dreaming of.
Contact us today to learn more about our cystic fibrosis and male infertility treatments.