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Pregnancy and CF

Question
I want to ask whether a person with CF can deliver a healthy child, and what is the percentage of success to get pregnant in CF women. Thank you!
Answer
Dear Mrs,

Patients with CF, women or men - can have a healthy child. It is difficult to speak in percentages. Rate percentage of success to become pregnant in CF patients is very difficult. Only part of patients with CF decided to have a child. Many CF patients don´t try to get pregnant (for fear of the disease in the child, or for the inherited possibility of their disease). In general, however, it can be stated that women with CF have no reduced fertility and should have similar rates of success of getting pregnant as women not suffering from CF (assumed, that they have no other underlying gynecologic problems). In CF women, there are hints at an increased rate of miscarriage and prenatal delivery, but in general, pregnancy is well tolerated by women in good health with good outcomes for the baby.

It is always appropriate to investigate genetically both partners who intend to have a child before conception. If one partner has genetically confirmed disease, and in the other healthy partner, no mutation can be detected, with a high probability, their common child will not suffer from CF but be a carrier of CF gene (inherited from the mother). As with the genetic test, however, a carriership of the healthy partner can not be excluded with 100% security (as the test do usually cover the 30 most frequent mutations but not all possible ones), there remains a small risk that the healthy partner still is a carrier and could inherit with a probability of 50% this mutation to the child. In dependence on the used genetic test, the risk to get a child with CF for a couple with a CF mother and a partner with no found mutations ranges from 1:330 to 1:982. In this case, prenatal diagnosis would not help further to obtain data about CF recurrence risk (as the same genetic test is used for this that has already been used to search for mutations in the father) and is therefore not recommended.

Things are different in the case of a couple with a CF mother and were the genetic test revealed a carriership of the healthy father. Here, the probability to become a child with CF is 50%. In this case and in the case the partner's genotype is unkown and cannot be tested, prenatal diagnosis is recommended to dtermine the genotype of the fetus.

During pregnancy the patient with CF should be frequently monitored by a specialist. In the event that a woman with confirmed CF has a problem to get pregnant, the gynecologist in the CF center provides information on possible solutions of this problem, always in collaboration with urologists.
It is a very personal issue, therefore is appropriate to seek the assistance of regional experts.
Best regards, Branko Takáč and D. d'Alquen

13.12.2011