Abstract
BACKGROUND: The vast majority of men with CF (mwCF) are infertile. Improvements in assisted reproductive technology (ART) have made it possible for these patients to become biological fathers. METHODS: Data were examined for all male CF patients attending a large adult CF center over a 23-year period. Azoospermia was confirmed via laboratory analysis of semen and was defined as complete absence of sperm in the ejaculate. Outcome of surgical sperm retrieval (SSR) procedure, post SSR complications, success rate of intracytoplasmic sperm injection (ICSI) and embryo transfer and subsequent live births were evaluated. RESULTS: Seventy-one mwCF with proven azoospermia were referred to fertility services over the study period. Mean (SD) percentage predicted forced expiratory volume in 1 second (ppFEV(1)) 67.86 ( ± 25.3), body mass index (BMI) 24.3 ( ± 3.7) kg/m(2). Seventy (98.5%) of these men underwent and had successful SSR. 67/71 (94%) couples proceeded to have ICSI post SSR. 11 couples had failed egg fertilisation, implantation, or early miscarriage. 56/67 couples (84%) went on to have live births. To date 10/71 (14%) mwCF referred for fertility treatment have died. Mean ppFEV(1) and BMI of mwCF who survived was higher than those who died; FEV(1) 72.8% ( ± 23.4) versus 38% ( ± 12.0) (p < 0.001), BMI 25.0 ( ± 3.5) kg/m(2) versus 20.3 ( ± 2.2) kg/mg(2) (p < 0.001). CONCLUSION: This is the largest study to investigate success rate of fertility treatment in mwCF and demonstrates that fertility treatment is successful in greater than 75% of patients referred. Clinical status and prognosis remain important factors when considering referral to fertility services.