Health Chronicle: Cystic Fibrosis and Procreation

Dr Lara Bilodeau

M.D., FRCPC

Pulmonologist

University Institute of Cardiology and Pneumology of Quebec Quebec Quebec (Quebec) Canada

Q: My partner and I are planning to have a child after my lung transplant. Since I am infertile and want to be the biological father of this child, I am very willing to have my sperm taken. Do you think it would be wise for the sample to be taken before the transplant? I was told that certain medications for transplant recipients can alter sperm quality and thus reduce my chances of procreation.

R: Over 98% of men with cystic fibrosis are infertile. The testicles have the capacity to produce sperm, but the channels that transport them (Vas deferens) are absent. Men who want to have children must choose one of the following options: adoption, artificial insemination with sperm from a donor, or even having their own sperm taken. For those who choose the third option, it is strongly recommended that their spouse be screened to find out if she is a carrier of a mutation that causes cystic fibrosis. Only the most frequent mutations are looked for during screening. If the spouse carries a faulty gene, the baby has a one in two chance of developing cystic fibrosis. If the spouse's screening does not show a mutation, the risk of the baby developing cystic fibrosis is low, but the baby will still be carrying a faulty gene.

There is very little data on male fertility after lung transplantation. Immunosuppressive drugs (which lower the immune system) used to avoid rejection can cause a lot of side effects, but it seems that they don't affect sperm. Therefore, sperm sampling prior to lung transplantation is not necessary.

‍