Fertility, Pregnancy and Lactation Considerations for Women with CF in the CFTR Modulator Era
Abstract
:1. Introduction
2. Fertility
2.1. Possible Causes of Infertility in Women with CF
2.2. Unexpected Pregnancies and Improved Fertility with Modulators
2.3. Fertility Case Example
3. Pregnancy
3.1. History of Pregnancy in Women with CF
3.2. Pregnancy Case Example
3.3. Data from Animal Reproductive Models Following CFTR Modulator Administration
3.4. Data in Pregnant Women Exposed to CFTR Modulators during Pregnancy
3.5. Considerations for Infants Exposed to CFTR Modulators during Pregnancy
4. Lactation
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Impaired Fertility | Genotoxicity | Teratogenicity | Neonatal Cataracts | Presence in Breast Milk | |
---|---|---|---|---|---|
Ivacaftor | Yes at toxic human doses | None | At maternally toxic doses: ↓ fetal body weight; no impact on survival or organogenesis | Cataracts observed at all doses administered to juvenile rats | Yes * |
Lumacaftor | No | None | No | When using combination therapy (i.e., LUM/IVA), see IVA | Yes * |
Tezacaftor | No | None | At maternally toxic doses: ↓ fetal body weight, early development delay in pinna detachment/eye opening; no impact on survival or organogenesis | When using combination therapy (i.e., TEZ/IVA), see IVA | Yes |
Elexacaftor | Yes at toxic human doses | None | At maternally toxic doses: ↓ fetal body weight; no impact on survival or organogenesis | When using combination therapy (i.e., ELX/TEZ/IVA), see IVA | Yes |
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Jain, R.; Taylor-Cousar, J.L. Fertility, Pregnancy and Lactation Considerations for Women with CF in the CFTR Modulator Era. J. Pers. Med. 2021, 11, 418. https://doi.org/10.3390/jpm11050418
Jain R, Taylor-Cousar JL. Fertility, Pregnancy and Lactation Considerations for Women with CF in the CFTR Modulator Era. Journal of Personalized Medicine. 2021; 11(5):418. https://doi.org/10.3390/jpm11050418
Chicago/Turabian StyleJain, Raksha, and Jennifer L. Taylor-Cousar. 2021. "Fertility, Pregnancy and Lactation Considerations for Women with CF in the CFTR Modulator Era" Journal of Personalized Medicine 11, no. 5: 418. https://doi.org/10.3390/jpm11050418