Asthma and Infertility: A Prospective Case-Control Study on Pregnancy and Live Birth Rates in Women With Asthma Undergoing Assisted Reproduction

哮喘与不孕症:一项关于接受辅助生殖治疗的哮喘女性妊娠率和活产率的前瞻性病例对照研究

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Abstract

BACKGROUND: Previous studies have suggested a negative impact of asthma on fertility, and it has been hypothesized that the underlying inflammation is playing an important role. However, available data are scarce and mostly refer to women conceiving naturally. With this study, we wished to investigate whether asthma affects the outcomes of medically assisted reproduction or not. METHODS: We conducted a prospective cohort study of 809 women, with (N = 213) or without asthma (N = 596), undergoing fertility treatment between 2009 and 2019 at one academic-based reproductive medicine center. Treatment outcome measures included clinical pregnancy rate (CPR) and live birth rate (LBR) per stimulation cycle, per oocyte pickup, and per embryo transfer, among women undergoing in vitro fertilization treatment, and LBR among women treated by intrauterine insemination. Odds ratios and 95% confidence intervals were estimated using multivariable generalized estimating equation models. RESULTS: No significant differences were found in CPR or LBR between women with asthma and women without asthma undergoing in vitro fertilization (N = 694) or intrauterine insemination (N = 45). In women with asthma, the adjusted odds ratio of clinical pregnancy per embryo transfer for all cycles was 0.91 (95% CI, 0.71-1.16), and the adjusted odds ratio of live birth per embryo transfer for all cycles was 0.90 (95% CI, 0.70-1.16). The adjusted odds ratio of live birth per performed intrauterine insemination was 1.42 (95% CI, 0.63-3.21) in women with asthma. CONCLUSIONS: Infertile women with asthma undergoing medically assisted reproductive treatment have a similar chance of achieving clinical pregnancy and live childbirth when compared to infertile women without asthma.

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