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Hum. Reprod. Advance Access published online on January 23, 2006
Human Reproduction, doi:10.1093/humrep/dei453
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received July 15, 2005
Revised November 8, 2005
Accepted November 17, 2005

Article

Results of assisted reproductive technique in men with cystic fibrosis

Dominique Hubert 1, Catherine Patrat 2, Juliette Guibert 3, Nicolas Thiounn 4, Thierry Bienvenu 5, Géraldine Viot 6, Pierre Jouannet 2, and Sylvie Epelboin 7 *

1 Centre de Ressources et de Compétences pour la Mucoviscidose - Service de Pneumologie, Assistance Publique Hôpitaux de Paris, Paris, France
2 Histologie-Embryologie-Biologie de la Reproduction, Assistance Publique Hôpitaux de Paris, Paris, France
3 Service de Gynécologie-Obstétrique et Médecine de la Reproduction Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
4 Service d’Urologie, Assistance Publique Hôpitaux de Paris, Paris, France
5 Biochimie et Génétique Moléculaire, Assistance Publique Hôpitaux de Paris, Paris, France
6 Génétique Médicale, Assistance Publique Hôpitaux de Paris, Paris, France
7 Service de Gynécologie-Obstétrique et Médecine de la Reproduction Saint Vincent de Paul, Groupe Hospitalier Cochin Saint Vincent de Paul, Assistance Publique Hôpitaux de Paris, Paris, France

* To whom correspondence should be addressed.
Sylvie Epelboin, E-mail: s.epelboin{at}svp.aphp.fr


  Abstract

BACKGROUND: Sterility in men with cystic fibrosis (CF) raises the question of the use of assisted reproductive techniques (ART). A multidisciplinary network including adult CF centre and reproductive medicine units was set up to answer requests for ART. METHODS: This retrospective study included 25 men with CF between 1994 and 2004. Clinical status, semen analysis, CF mutations analysis and artificial insemination by donor (AID) or ICSI after surgical retrieval of sperm were monitored. RESULTS: All CF men had azoospermia. Two chose AID first (one delivery); 23 chose ICSI. Sperm were surgically retrieved in 21 cases, and ICSI was performed in 19. Pregnancies occurred in 12 of these 19 couples (63%) (two ectopic pregnancies, two spontaneous abortions, one termination of pregnancy for poly-malformed twins and 11 single deliveries in nine couples). Two couples tried AID after ICSI failed; one had twins. Another adopted a child, and two had a spontaneous pregnancy. After a follow-up of 4.1±2.3 years, two patients died, two underwent lung transplantation and 21 remained stable. CONCLUSION: ART can help men with CF to become a father, but their health status and short survival need careful counselling and multidisciplinary medical care.

Keywords: assisted reproductive techniques/cystic fibrosis/ethical issues/ICSI.
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