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Clinical Investigations: CYSTIC FIBROSIS |

Fertility in Men With Cystic Fibrosis*: An Update on Current Surgical Practices and Outcomes

Theresa J. McCallum, MD; Jeff M. Milunsky, MD; Donna L. Cunningham, BS, MT; Doria H. Harris, PhD; Thomas A. Maher, BS; Robert D. Oates, MD
Author and Funding Information

*From the Department of Urology (Drs. McCallum and Oates), and the Center for Human Genetics (Dr. Milunsky and Mr. Maher), Boston University School of Medicine, Boston; Reproductive Science Center of Boston (Ms. Cunningham), Waltham, MA; and Boston IVF (Dr. Harris), Brookline, MA.

Correspondence to: Robert D. Oates, MD, DOB Suite 606, 720 Harrison Ave, Boston, MA 02118-2334; e-mail: robert.oates@BMC.org



Chest. 2000;118(4):1059-1062. doi:10.1378/chest.118.4.1059
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Background: Men with cystic fibrosis (CF) have bilateral absence of the vas deferens causing an obstructive azoospermia that is not amenable to surgical correction. Advances in the field of reproductive medicine allow for the procurement of viable sperm and facilitate fertilization and pregnancy in couples where the man has CF.

Objectives: To describe patient anatomy and semen characteristics and to determine the pregnancy rates of couples in whom the male partner has CF and who have undergone microsurgical epididymal sperm aspiration coupled with in vitro technology, specifically intracytoplasmic sperm injection (ICSI).

Design: Retrospective analysis.

Setting: Clinical department of urology and two reproductive medicine units.

Patients: Thirteen married men with CF who were referred for infertility.

Interventions: History, physical examination, semen analysis, transrectal and renal ultrasonography, CF mutation analysis, and microsurgical sperm aspiration coupled with ICSI.

Results: All 13 men had low-volume azoospermia, absent vasa, and aplasia/hypoplasia of the seminal vesicles. CF mutation analysis was carried out in 11 of 13 men, and 9 of 11 were ΔF508 homozygous. Eight men underwent microsurgical sperm aspiration, and their partners underwent one or more cycles of ICSI. Five couples (62.5%) achieved a pregnancy, with four couples delivering (three sets of twins and one singleton).

Conclusions: CF in men is accompanied by bilateral vasal aplasia. The resultant obstructive azoospermia can be treated quite successfully with a combination of sperm aspiration and ICSI. It is important for physicians involved in the care of men with CF to convey the message that prospects for fatherhood are excellent with current technology.

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