Female cystic fibrosis mutation carriers and assisted reproductive technology Does carrier status affect reproductive outcomes

Female cystic fibrosis (CF) carrier status does not appear to impact the chance of achieving pregnancy with assisted reproductive technology (ART). Further research is needed to investigate whether positive CF carrier status affects fertility in a non-ART context.

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Authors

Teresa Ann VanWort, B.A., Joseph A. Lee, B.A., Hrishikesh Karvir, Ph.D., Michael C. Whitehouse, B.A., Piraye Yurttas Beim, Ph.D., Alan B. Copperman, M.D.

Volume 102, Issue 5, Pages 1324–1330

Abstract

Objective:

To evaluate the association between female cystic fibrosis (CF) carrier status and in vitro fertilization (IVF) response and outcomes. The presence of cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations in male carriers has been associated with infertility, yet possible adverse effects on the ovarian function and reproductive outcomes of female carriers have not been studied to date.

Design:

Retrospective cohort study.

Setting:

Private academic, clinical reproductive center.

Patient(s):

Females <40 years of age who were screened for CFTR mutations and received IVF treatment between July 2002 and March 2013. Intervention(s):

Patients initiated controlled ovarian hyperstimulation with frequent monitoring, vaginal oocyte retrieval, fertilization, embryo transfer, and a pregnancy test. Various measures of IVF stimulation response and cycle outcome were evaluated for both carriers and noncarriers.

Main Outcome Measure(s):

Analysis was performed by logistic regression and Poisson regression.

Result(s):

IVF cycles (n = 199) from CFTR mutation carrier patients (n = 112) were analyzed. No significant differences in outcome were noted when carriers of different mutation loci were compared in aggregate with the noncarrier group (n = 6,420 cycles from 3,555 patients). Significant differences were noted for some metrics when the carriers were grouped by mutation loci.

Conclusion(s):

Overall, no significant differences in stimulation response and cycle outcome were noted between female CFTR mutation carriers and noncarriers. Further research is needed to investigate whether the differences noted between specific CFTR mutation loci are clinically relevant and whether CFTR mutations may impact reproductive outcomes outside the context of assisted reproductive technologies.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)01861-5/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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