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Braham I, Morisot A, Boukaïdi S, Perceval M, Durieu I, Rousset-Jablonski C, Hieronimus S, Leroy S, Chevalier N. The Prognosis of ART Is Not Altered in Cystic Fibrosis Women: A Case-Report Study. Front Endocrinol (Lausanne) 2022; 13:773753. [PMID: 35265034 PMCID: PMC8898889 DOI: 10.3389/fendo.2022.773753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
RESEARCH QUESTION Unlike in men, a very limited number of studies were focused on the specificity of ART management of cystic fibrosis (CF) in women. The purpose of this study was to determine the causes of infertility in patients, the appropriate ART treatment, and their prognosis in terms of pregnancy. DESIGN We conducted a multicentre analytical case-control study including CF women who were age-matched to non-CF women. We reported the causes of infertility, the ART management type and pregnancy outcomes. RESULTS 17 cases were compared to 34 controls. There was no significant difference between the groups concerning cause infertility. There was a non-statistically significant trend with a lower antral follicle count in CF compared to controls (19.5 versus 26.8, p=0.08). IUI seemed to be as successful as IVF/ICSI in CF as opposed to controls where the IVF/ICSI was the most effective (in CF group for HCG >100 UI/L: 38.8% vs. 36.8%, p=0.4175). There were more embryos obtained in CF than in controls (3.1 versus 1.6, p=0.02). The number of oocytes and embryos obtained and pregnancy outcomes remained similar between DF508 homozygous group and others CFTR mutations group. The results of ART procedures and pregnancy evolution were not influenced by FEV1. CONCLUSION In absence of any other pathology, IUI may be first option for CF women. If insemination fails, IVF with a low dose of gonadotropins may be more appropriate to prevent the risk of hyperstimulation syndrome. FEV1 and genetic do not seem to be contributing factors in the prognosis of ART.
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Affiliation(s)
- Inès Braham
- Université Côte d’Azur, CHU de Nice, Département d’Endocrinologie-Diabétologie et Reproduction, Nice, France
| | - Adeline Morisot
- Université Côte d’Azur, CHU de Nice, Département de Santé Publique, Nice, France
| | - Samir Boukaïdi
- Université Côte d’Azur, CHU de Nice, Centre d’aide médicale à la procréation, Nice, France
| | - Marie Perceval
- Hospices Civils de Lyon, CHU de Lyon, Centre de Ressources et de Compétences de la Mucoviscidose, Lyon, France
| | - Isabelle Durieu
- Hospices Civils de Lyon, CHU de Lyon, Centre de Ressources et de Compétences de la Mucoviscidose, Lyon, France
| | | | - Sylvie Hieronimus
- Université Côte d’Azur, CHU de Nice, Département d’Endocrinologie-Diabétologie et Reproduction, Nice, France
| | - Sylvie Leroy
- Université Côte d’Azur, CHU de Nice, Centre de Ressources et de Compétences de la Mucoviscidose, Nice, France
| | - Nicolas Chevalier
- Université Côte d’Azur, CHU de Nice, Département d’Endocrinologie-Diabétologie et Reproduction, Nice, France
- Université Côte d’Azur, Inserm U1065, C3M, Nice, France
- *Correspondence: Nicolas Chevalier,
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O'Connor KE, Goodwin DL, NeSmith A, Garcia B, Mingora C, Ladores SL, Rowe SM, Krick S, Solomon GM. Elexacafator/tezacaftor/ivacaftor resolves subfertility in females with CF: A two center case series. J Cyst Fibros 2021; 20:399-401. [PMID: 33353860 PMCID: PMC9101452 DOI: 10.1016/j.jcf.2020.12.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 11/18/2022]
Abstract
Infertility and subfertility are commonly faced by females with cystic fibrosis (FwCF) and resulting in decreased contraceptive use and increased utilization of reproductive technologies. Elexacaftor-tezacaftor-ivacaftor (ETI) is a CFTR modulator that affects common causes of subfertility. Two CF centers conducted a retrospective chart review on females with CF who were receiving ETI and became pregnant. We analyzed obstetrical-gynecological history, genotype, and clinical response to ETI therapy. Fourteen FwCF on ETI became pregnant. Half (7) of the FwCFs were previously attempting to conceive, but only three were using contraceptives. Four FwCF had a history of infertility; two were reconsidering use of reproductive technologies (IUI). Patients achieved conception at mean 8 weeks after initiating ETI. ETI may lessen CF-associated factors that affect fertility; however, its exact mechanism is unknown. This warrants counseling on contraceptive use and family planning prior to initiation of therapy and at routine intervals while utilizing ETI.
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Affiliation(s)
- Kate E O'Connor
- University of Alabama at Birmingham, 1900 University Blvd, THT 422, Birmingham, AL 35294, USA
| | - Dana L Goodwin
- University of Alabama at Birmingham, 1900 University Blvd, THT 422, Birmingham, AL 35294, USA
| | - Andrew NeSmith
- University of Alabama at Birmingham, 1900 University Blvd, THT 422, Birmingham, AL 35294, USA
| | - Bryan Garcia
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Sigrid L Ladores
- University of Alabama at Birmingham, 1900 University Blvd, THT 422, Birmingham, AL 35294, USA
| | - Steve M Rowe
- University of Alabama at Birmingham, 1900 University Blvd, THT 422, Birmingham, AL 35294, USA
| | - Stefanie Krick
- University of Alabama at Birmingham, 1900 University Blvd, THT 422, Birmingham, AL 35294, USA
| | - George M Solomon
- University of Alabama at Birmingham, 1900 University Blvd, THT 422, Birmingham, AL 35294, USA.
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Hernandez-Nieto C, Alkon-Meadows T, Lee J, Cacchione T, Iyune-Cojab E, Garza-Galvan M, Luna-Rojas M, Copperman AB, Sandler B. Expanded carrier screening for preconception reproductive risk assessment: Prevalence of carrier status in a Mexican population. Prenat Diagn 2020; 40:635-643. [PMID: 32003480 DOI: 10.1002/pd.5656] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 12/30/2019] [Accepted: 01/21/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Genetic carrier screening has the potential to identify couples at risk of having a child affected with an autosomal recessive or X-linked disorder. However, the current prevalence of carrier status for these conditions in developing countries is not well defined. This study assesses the prevalence of carrier status of selected genetic conditions utilizing an expanded, pan-ethnic genetic carrier screening panel (ECS) in a large population of Mexican patients. METHODS Retrospective chart review of all patients tested with a single ECS panel at an international infertility center from 2012 to 2018 were included, and the prevalence of positive carrier status in a Mexican population was evaluated. RESULTS Eight hundred five individuals were analyzed with ECS testing for 283 genetic conditions. Three hundred fifty-two carriers (43.7%) were identified with 503 pathogenic variants in 145 different genes. Seventeen of the 391 participating couples (4.34%) were identified as being at-risk couples. The most prevalent alleles found were associated with alpha thalassemia, cystic fibrosis, GJB2 nonsyndromic hearing loss, biotinidase deficiency, and familial Mediterranean fever. CONCLUSION Based on the prevalence and severity of Mendelian disorders, we recommend that couples who wish to conceive regardless of their ethnicity background explore carrier screening and genetic counseling prior to reproductive medical treatment.
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Affiliation(s)
- Carlos Hernandez-Nieto
- Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York, New York, USA.,Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York-Mexico, Mexico City, Mexico
| | - Tamar Alkon-Meadows
- Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York, New York, USA.,Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York-Mexico, Mexico City, Mexico
| | - Joseph Lee
- Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York, New York, USA
| | - Teresa Cacchione
- Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York, New York, USA
| | - Esther Iyune-Cojab
- Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York-Mexico, Mexico City, Mexico
| | - Maria Garza-Galvan
- Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York-Mexico, Mexico City, Mexico
| | - Martha Luna-Rojas
- Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York, New York, USA.,Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York-Mexico, Mexico City, Mexico
| | - Alan B Copperman
- Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York, New York, USA.,Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Sema4, A Mount Sinai Venture, Stamford CT, USA
| | - Benjamin Sandler
- Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York, New York, USA.,Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Reproductive Endocrinology and Infertility, Reproductive Medicine associates of New York-Mexico, Mexico City, Mexico
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Yeshua A, Lee JA, Witkin G, Copperman AB. Female Couples Undergoing IVF with Partner Eggs (Co-IVF): Pathways to Parenthood. LGBT Health 2015; 2:135-9. [DOI: 10.1089/lgbt.2014.0126] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Arielle Yeshua
- Reproductive Medicine Associates of New York, New York, New York
| | - Joseph A. Lee
- Reproductive Medicine Associates of New York, New York, New York
| | - Georgia Witkin
- Reproductive Medicine Associates of New York, New York, New York
- Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, New York
| | - Alan B. Copperman
- Reproductive Medicine Associates of New York, New York, New York
- Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, New York
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