Does infertility of CF men change?

Question

Dear expert team,

CF men are in 98% of cases infertile, this is what I read. What is the reason for this? Can the infertility change? I myself got tested 10 years ago at a specialist for urology with the result, that I was infertile. As my girl-friend (non CF) does not use a contraceptive coil anymore: do I have to do a testing at the urologist again? We are both in the mid 30ties and do not want a child.
Many thanks in advance for the answer and help,

M.

Answer

Dear M.,

your information about male infertility in CF is correct. CF men are in 95% of cases infertile. The infertility stays for the whole life. However, inhere it is important to know, that the production of spermatozoa (semen) is in general totally normal. That means, that the testes are producing functioning (or only of limited motility) spermatozoa, these can however not be transported to the outside because of an interruption of the spermatic duct (aplasia of the ductus deferens). This means, that male CF patients can nevertheless become fathers. In these cases, spermatozoa are taken out of the testes in case there is the wish to have children and an in vitro fertilization is done (intracytoplasmatic sperm injection). Hereby the spermatozoa have to be injected in vitro (in the test tube outside the body) into the egg cell.
However, if thought the other way round, in spite of a proven azoospermia in a CF patient, it can not be excluded 100% that spermatozoa reach the outside via the normal way and that it can come naturally to a fertilization of an egg cell. This is however very improbable. Probably the usage of a condome for contraception can give you the needed security.
I hope to have helped with my remarks and stay with my best regards,
Yours
Dr. med. Christina Smaczny

03.11.2014