» Articles » PMID: 34063507

Fertility, Pregnancy and Lactation Considerations for Women with CF in the CFTR Modulator Era

Overview
Journal J Pers Med
Date 2021 Jun 2
PMID 34063507
Citations 11
Authors
Affiliations
Soon will be listed here.
Abstract

Cystic fibrosis (CF) is an autosomal recessive genetic disorder impacting approximately 80,000 people of all races and ethnicities world-wide. CF is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene which encodes a protein of the same name. Protein dysfunction results in abnormal chloride and bicarbonate transport in mucus membranes, including those in the respiratory, gastrointestinal and reproductive tracts. Abnormal anion transport causes viscous secretions at the site of involvement. The majority of people with CF succumb to respiratory failure following recurrent cycles of infection and inflammation in the airways. Historically, providers treated the signs and symptoms of CF, but since 2012, have been able to impact the basic defect for the subset of people with CF who have mutations that respond to the new class of drugs, CFTR protein modulators. With the improved health and longevity afforded by CFTR modulators, more women are interested in parenthood and are becoming pregnant. Furthermore, this class of drugs likely increases fertility in women with CF. However, the safety of CFTR modulators in pregnancy and lactation is only beginning to be established. We summarize available data on the impact of CFTR modulators on fertility, pregnancy and lactation in women with CF.

Citing Articles

Pulmonary nontuberculous mycobacterial infections among women with cystic fibrosis and non-cystic fibrosis bronchiectasis.

Gross J, Jones M, Buige A, Prevots D, Kasperbauer S Ther Adv Respir Dis. 2025; 19:17534666251323181.

PMID: 40071337 PMC: 11898043. DOI: 10.1177/17534666251323181.


Challenges of Preimplantation Genetic Counselling in the Context of Cystic Fibrosis and Other CFTR-Related Disorders: A Monocentric Experience in a Cohort of 92 Couples.

Sorrentino U, Menegazzo M, Gabbiato I, Calosci D, Zambon C, Zuccarello D Genes (Basel). 2024; 15(7).

PMID: 39062716 PMC: 11275312. DOI: 10.3390/genes15070937.


Ocular development after highly effective modulator treatment early in life.

Zhu Y, Li D, Reyes-Ortega F, Chinnery H, Schneider-Futschik E Front Pharmacol. 2023; 14:1265138.

PMID: 37795027 PMC: 10547496. DOI: 10.3389/fphar.2023.1265138.


Unplanned pregnancies following the introduction of elexacaftor/tezacaftor/ivacaftor therapy in women with cystic fibrosis.

Dacco V, Alicandro G, Trespidi L, Gramegna A, Blasi F Arch Gynecol Obstet. 2023; 308(5):1657-1659.

PMID: 37517074 DOI: 10.1007/s00404-023-07153-y.


Reproductive Counseling and Care in Cystic Fibrosis: A Multidisciplinary Approach for a New Therapeutic Era.

McGlynn J, DeCelie-Germana J, Kier C, Langfelder-Schwind E Life (Basel). 2023; 13(7).

PMID: 37511919 PMC: 10381247. DOI: 10.3390/life13071545.


References
1.
Cohen-Cymberknoh M, Gindi Reiss B, Reiter J, Lechtzin N, Melo J, Perez G . Baseline Cystic fibrosis disease severity has an adverse impact on pregnancy and infant outcomes, but does not impact disease progression. J Cyst Fibros. 2020; 20(3):388-394. DOI: 10.1016/j.jcf.2020.09.002. View

2.
Stead R, Hodson M, Batten J, Adams J, Jacobs H . Amenorrhoea in cystic fibrosis. Clin Endocrinol (Oxf). 1987; 26(2):187-95. DOI: 10.1111/j.1365-2265.1987.tb00776.x. View

3.
Fortner C, Seguin J, Kay D . Normal pancreatic function and false-negative CF newborn screen in a child born to a mother taking CFTR modulator therapy during pregnancy. J Cyst Fibros. 2021; 20(5):835-836. DOI: 10.1016/j.jcf.2021.03.018. View

4.
Edenborough F . Women with cystic fibrosis and their potential for reproduction. Thorax. 2001; 56(8):649-55. PMC: 1746112. DOI: 10.1136/thorax.56.8.649. View

5.
Taylor-Cousar J, Munck A, McKone E, van der Ent C, Moeller A, Simard C . Tezacaftor-Ivacaftor in Patients with Cystic Fibrosis Homozygous for Phe508del. N Engl J Med. 2017; 377(21):2013-2023. DOI: 10.1056/NEJMoa1709846. View