Infertility and its management in men with cystic fibrosis: review of literature and clinical practices in the UK.

Cystic fibrosis (CF) is the most common life-shortening autosomal recessive disorder of Caucasians. Most of the men with CF (>95%) have congenital bilateral absence of vas deferens (CBAVD), which makes them infertile. However, with advances in assisted reproductive techniques, it is now potentially possible for these patients to father their own biological children. Spermatozoa may be retrieved from either the epididymis or the testes and combined in vitro with oocytes retrieved from the female partner. Epididymal sperm may be collected either by microsurgical or percutaneous epididymal sperm aspiration. It is important to remember that when assisted reproductive techniques are used for such patients, there is the inevitability of transmitting a mutated cystic fibrosis transmembrane (CFTR) gene, which increases the risk of producing an affected child and can have serious long-term implications. It is therefore mandatory to offer genetic counselling to the men with CF (and CBAVD) and their partners before carrying out assisted reproductive techniques. In the literature, there are a very few studies on fertility treatment of these men. However, even though the reported number of live births in men with CF is small, given the current technology, there are definitely more opportunities for these men to become parents.