IVF and Cystic Fibrosis

Question

Dear expert team,

I have had cystic fibrosis and diabetes for 29 years, and also chronic staphylococcus colonization (no MRSA).

Since my husband and I cannot have children, we chose the path of artificial insemination (in vitro fertilizatin, IVF).

Before the hormone treatment I had inpatient i.v. therapy in order to stabilize the lungs.

During the hormone treatment as well as after implanting the eggs, my health worsened significantly (fever, infections) so that I needed antibiotics. My condition improved only after I had lost the embryos again. At the second attempt, the same thing happened again.

Are you aware of a connection between IVF (specifically of hormone treatment before IVF) and deteriorating health in the context of CF?

Many thanks and kind regards.

Answer

Hello,

Assistant Professor Dr. Doris Staab at Berlin University Hospital (Head, Christiane Herzog CF Center) has provided the following answer:

“I have not had a case like this before; we have treated a number of patients with pregnancies after IVF. Theroetically, it is possible that hormones have a proinflammatory effect [i.e., promoting inflammations], (which, after all is a topic discussed as a reason for the worse prognosis for girls after puberty), but I cannot really explain such an extent. One would need to talk to an IVF specialist about the frequency of such reactions even independent of CF.”

Furthermore, Dr. Daniela d’Alquen screened the literature and found the following information that could also be of interest to you:

“Since the hormones used for stimulation in IVF are closely related both structurally and biologically to the hormones that are produced by the placenta during pregnancy (esp. beta HCG), it could be possible that pregnant women with CF suffer from the problems described here as well. The international guidelines for the treatment of pregnant CF patients (Edenborough et al. 2008 in the Journal of Cystic Fibrosis 7 S2-S32 "Guidelines for the management of pregnancy in women with cystic fibrosis") only deal with the general question whether pregnancy has a negative effect on the progression for the mother. This cannot be determined clearly from the data. The paper only states that the mother’s outcome depends primarily on the status of her lung disease and could possibly be predictable, depending on the severity of the lung disease before pregnancy, although there are women with an unexpectedly bad progression during pregnancy. The paper does not refer to the causes for this, but hormonal influences are conceivable here, of course.”

Kind regards
Annette Pfalz for ECORN-CF

28.02.2012