Human Reproduction, Vol. 16, No. 10, 2093-2097,
October 2001
© 2001 European Society of Human Reproduction and Embryology
Cystic fibrosis phenotype evaluation and paternity outcome in 50 males with congenital bilateral absence of vas deferens
1 Adult Cystic Fibrosis Care Centre, Centre Hospitalier Lyon-Sud, Pierre-Bénite Cédex, 2 Laboratoire de Biochimie Endocrinienne et Moléculaire, Hôpital Debrousse, Lyon Cédex, 3 Institut Rhonalpin pour l'étude de la reproduction, Bron, 4 Fédération d'Endocrinologie, Hôpital de L'Antiquaille and 5 Service de génétique, Hôtel-Dieu, Lyon, France
BACKGROUND: Most infertile males with congenital bilateral absence of vas deferens (CBAVD) carry mutations on the cystic fibrosis transmembrane conductance regulator gene and may express mild cystic fibrosis (CF) symptoms. Barriers to paternity for these men can now be overcome by assisted reproduction. Our aims were to investigate the CF-related phenotype and clinical outcome for 50 patients with CBAVD seen at a CF adult centre between 1992 and 1999. METHODS AND RESULTS: The investigation of the patients included screening for 22 CF mutations and identification of the poly-T variant of intron 8, sweat testing, clinical investigation for CF-related extra-genital manifestations, and genetic counselling. CFTR mutations were detected on 56 alleles of the 50 patients. A total of 15 (30%) was compound heterozygote and 26 (52%) heterozygote. In all, 38% of the patients had a positive sweat test. Four patients were diagnosed with typical CF not detected previously. Twenty-one patients became fathers following ICSI (eight cases), artificial insemination by donor or IVF with sperm donor (seven cases) or through adoption (six cases). A mail survey allowed the identification of CF-related clinical symptoms. Information on the occurrence of CF-related symptoms was obtained for 58.5% of patients: in the absence of initial symptoms, no new clinical signs were reported. CONCLUSION: Patients diagnosed with CBAVD need genetic counselling before assisted reproduction. Even when no wish for paternity is expressed, CF gene screening should be associated with at least a sweat test and clinical evaluation because of possible mild forms of CF disease. Medical follow-up did not reveal any new symptoms.
Key words: congenital bilateral absence of vas deferens/cystic fibrosis/outcome of paternity
6 To whom correspondence should be addressed at: Adult Cystic Fibrosis Care Centre, Department of Internal Medicine, Pavillon 1K, Centre Hospitalier Lyon-Sud, 69495 Pierre-Bénite Cédex, France. E-mail: isabelle.durieu{at}chu-lyon.fr
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