Although some people with cystic fibrosis have difficulty getting pregnant, it is still possible to conceive. They are also at a higher risk of complications, including gestational diabetes and low infant birth weight.
Cystic fibrosis (CF) affects both male and female fertility. While some people are able to get pregnant naturally, others need to use fertility treatments, such as in vitro fertilization (IVF).
Having CF presents unique challenges and can impact both a birthing parent’s and an infant’s health. Therefore, navigating the complexities of pregnancy requires careful planning and medical support.
This article explores factors affecting those pregnant while living with cystic fibrosis, including potential risks and tips for a safe and successful pregnancy.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
CF can negatively impact the fertility of both males and females. This means that females may have a harder time getting pregnant, and males may have more difficulty getting a partner pregnant.
Many females with CF produce healthy eggs and are able to conceive without fertility treatment. However, they may find it a bit harder to get pregnant than people without CF.
First, there is a greater probability that women with CF experience irregular or absent menstrual cycles due to illness or low body weight. Secondly, CF causes thicker cervical mucus, which can prevent sperm from reaching an egg.
Over 98% of men with CF have fertility issues due to a problem with sperm transportation. A defect or absence of the vas deferens, which is the tube that transports sperm to the urethra, means that semen may not contain sperm.
While getting pregnant may be more difficult for someone with CF than without, many people with the condition are able to get pregnant either naturally or with the assistance of fertility treatments.
Adhering to specific pregnancy guidelines can help those with CF have a healthy and successful pregnancy. The following recommendations aim to optimize parental and fetal health:
- Pre-pregnancy planning: Before becoming pregnant, a person should consult their healthcare team to discuss potential risks and necessary steps to improve their health.
- Lung function: Ideally, forced expiratory volume (FEV1) should measure 50% or more before becoming pregnant. There is a link between lower FEV1 values and a higher risk of complications.
- Regular prenatal care: These appointments allow a healthcare team to monitor the person’s lung function, nutritional status, and any pregnancy issues, such as gestational diabetes. They also help the person develop a detailed birth plan.
- Medication management: A person should work with their healthcare team to review current medications and ensure they are safe during pregnancy and postpartum.
- Nutritional support: Maintaining proper nutrition during pregnancy is crucial. People may need additional caloric intake, vitamin supplementation, and support from a dietitian to meet the increased nutritional demands of pregnancy.
- Postpartum care: After giving birth, a person should continue to receive close medical supervision to monitor their recovery, lung function, and overall health, as well as the infant’s health.
Being pregnant while living with CF presents several risks and complications that can affect both the birthing parent and the baby.
- Respiratory complications: The increased respiratory demands of pregnancy can affect lung function and increase the risk of infections.
- Nutritional challenges: CF makes it difficult to maintain optimal nutrition. Therefore, a person may require dietary support to meet the increased nutritional demands of pregnancy.
- Gestational diabetes: Women with CF are more likely to develop gestational diabetes during pregnancy. This can lead to complications, such as high birth weight, premature birth, and respiratory distress in the newborn.
- Preterm labor and delivery: CF increases the risk of preterm labor and delivery, which can cause respiratory distress, underdeveloped organs, and long-term health issues for the newborn.
- Low birth weight: Infants may have lower birth weights due to maternal malnutrition or other pregnancy complications. Low birth weight can lead to difficulties with feeding, slower growth, and increased susceptibility to infections.
- Complications related to medications: Some medications that manage CF may not be safe during pregnancy.
If a person with CF is pregnant, their healthcare team will conduct regular testing and assessments to ensure both the individual and fetus are healthy.
These may include:
- lung function tests
- Burkholderia cepacia infection testing
- nutritional status
- liver and kidney function testing
- mental health screening
- gestational diabetes monitoring
A person may also have tests to see if they have passed CF to the baby.
The two prenatal tests that can show if a baby is likely to have CF:
- Chorionic villus sampling (CVS): This involves taking a sample of placental tissue between the 10th and 13th weeks of pregnancy.
- Amniocentesis: This involves taking a sample of amniotic fluid surrounding the baby between the 15th and 20th weeks of pregnancy.
Extra care during pregnancy ensures the best possible outcome. While a person should always consult a doctor first, they may find it helpful to consider the following tips:
- Attend regular prenatal appointments: Regular checkups allow for appropriate health monitoring and management of existing health issues.
- Maintain proper nutrition: If eating enough is challenging, consider drinking nutritional supplements. A person should consult their healthcare team for personalized recommendations.
- Consider vitamin and mineral supplements: Ask a healthcare professional if they recommend vitamin and mineral supplements during pregnancy.
- Stay active with gentle exercise: Engage in regular, low-impact activities, such as walking or swimming.
- Care for mental health: Address any emotional concerns by asking for support from friends, family, and mental health professionals, if needed.
A person may find it helpful to ask the following questions when discussing pregnancy with a doctor:
- How will CF affect my pregnancy and my baby’s health?
- Are there any specific tests or screenings I should have before trying to conceive or during my pregnancy?
- How often should I schedule prenatal appointments with my CF healthcare team and my obstetrician?
- Are there any medications that I should stop taking or adjust during pregnancy?
- What is the recommended nutritional plan to ensure I meet the increased demands of pregnancy?
- How will my CF affect my ability to breastfeed?
Although it can be more difficult to get pregnant, people with CF can conceive both naturally and with the help of fertility treatments. People can have successful pregnancies and births by working closely with and following the guidance of a healthcare team.
Prioritizing proper nutrition, engaging in gentle exercise, managing existing health conditions, and attending regular prenatal visits are essential for a healthy pregnancy.
Remember to ask questions, seek support, and stay informed throughout the process to ensure the best possible outcome.