Skip to main content
PMC home page
Thorax logoLink to Thorax
. 2005 Apr;60(4):326–330. doi: 10.1136/thx.2004.027599

A survey of sexual and reproductive health in men with cystic fibrosis: new challenges for adolescent and adult services

S Sawyer 1, B Farrant 1, B Cerritelli 1, J Wilson 1
PMCID: PMC1747378  PMID: 15790989

Abstract

Background: Improved survival dramatically alters the consequences of adult co-morbidities in men with cystic fibrosis (CF) such as male infertility. Few studies have systematically addressed the impact of sexual and reproductive health issues in these men or considered the implications for healthcare delivery.

Method: A descriptive cohort study was undertaken using a sexual and reproductive health survey of men from a large adult CF centre, including men with lung transplantation.

Results: The mean (SD) age of the 94 men (response rate 75%) was 30.5 (7.6) years. 94% knew that men with CF had reduced fertility. Men first heard about infertility later than desired (p<0.001) and only 53% heard from their preferred source. Men who were told about infertility when older were more likely to be upset than those told earlier (p<0.01). 53% of men had undergone semen analysis: 68% of men who had not been tested wanted semen analysis. 73% believed semen analysis should occur before 18, but the youngest age of testing was 24 years. In adolescence, one in three men had assumed they did not need to use condoms and one in 10 had confused infertility with impotence. 66% of men wanted more information on reproductive options and 84% wanted children. Seventeen men were parents by natural conception (n = 1), micro-epididymal sperm aspiration (n = 6), donor sperm (n = 9), and through step children (n = 1).

Conclusions: Men with CF desire more sexual and reproductive health information. Earlier discussion of sexual and reproductive health is indicated in paediatric settings, and semen analysis should be routinely offered. In adult services greater discussion of reproductive health options is indicated.

Full Text

The Full Text of this article is available as a PDF (95.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baker P. The international men's health movement. BMJ. 2001 Nov 3;323(7320):1014–1015. doi: 10.1136/bmj.323.7320.1014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Courtenay W. H. Constructions of masculinity and their influence on men's well-being: a theory of gender and health. Soc Sci Med. 2000 May;50(10):1385–1401. doi: 10.1016/s0277-9536(99)00390-1. [DOI] [PubMed] [Google Scholar]
  3. Denning C. R., Sommers S. C., Quigley H. J., Jr Infertility in male patients with cystic fibrosis. Pediatrics. 1968 Jan;41(1):7–17. [PubMed] [Google Scholar]
  4. Doull I. J. Recent advances in cystic fibrosis. Arch Dis Child. 2001 Jul;85(1):62–66. doi: 10.1136/adc.85.1.62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dreyfus D. H., Bethel R., Gelfand E. W. Cystic fibrosis 3849+10kb C > T mutation associated with severe pulmonary disease and male fertility. Am J Respir Crit Care Med. 1996 Feb;153(2):858–860. doi: 10.1164/ajrccm.153.2.8564145. [DOI] [PubMed] [Google Scholar]
  6. Fair A., Griffiths K., Osman L. M. Attitudes to fertility issues among adults with cystic fibrosis in Scotland. The Collaborative Group of Scottish Adult CF Centres. Thorax. 2000 Aug;55(8):672–677. doi: 10.1136/thorax.55.8.672. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hall Robert H. Promoting men's health. Aust Fam Physician. 2003 Jun;32(6):401–407. [PubMed] [Google Scholar]
  8. Hames A., Beesley J., Nelson R. Cystic fibrosis: what do patients know, and what else would they like to know? Respir Med. 1991 Sep;85(5):389–392. doi: 10.1016/s0954-6111(06)80183-6. [DOI] [PubMed] [Google Scholar]
  9. Hull S. C., Kass N. E. Adults with cystic fibrosis and (in)fertility: how has the health care system responded? J Androl. 2000 Nov-Dec;21(6):809–813. [PMC free article] [PubMed] [Google Scholar]
  10. Kaplan E., Shwachman H., Perlmutter A. D., Rule A., Khaw K. T., Holsclaw D. S. Reproductive failure in males with cystic fibrosis. N Engl J Med. 1968 Jul 11;279(2):65–69. doi: 10.1056/NEJM196807112790203. [DOI] [PubMed] [Google Scholar]
  11. Landing B. H., Wells T. R., Wang C. I. Abnormality of the epididymis and vas deferens in cystic fibrosis. Arch Pathol. 1969 Dec;88(6):569–580. [PubMed] [Google Scholar]
  12. Lyon Angela, Bilton Diana. Fertility issues in cystic fibrosis. Paediatr Respir Rev. 2002 Sep;3(3):236–240. doi: 10.1016/s1526-0542(02)00184-7. [DOI] [PubMed] [Google Scholar]
  13. Madge S. L., Carr S. B. Reproductive health in males with cystic fibrosis: knowledge, attitudes, and experience of patients and parents. Pediatr Pulmonol. 1999 Apr;27(4):293–293. doi: 10.1002/(sici)1099-0496(199904)27:4<293::aid-ppul13>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  14. McCallum T. J., Milunsky J. M., Cunningham D. L., Harris D. H., Maher T. A., Oates R. D. Fertility in men with cystic fibrosis: an update on current surgical practices and outcomes. Chest. 2000 Oct;118(4):1059–1062. doi: 10.1378/chest.118.4.1059. [DOI] [PubMed] [Google Scholar]
  15. Nixon G. M., Glazner J. A., Martin J. M., Sawyer S. M. Female sexual health care in cystic fibrosis. Arch Dis Child. 2003 Mar;88(3):265–266. doi: 10.1136/adc.88.3.265. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Nolan T., Desmond K., Herlich R., Hardy S. Knowledge of cystic fibrosis in patients and their parents. Pediatrics. 1986 Feb;77(2):229–235. [PubMed] [Google Scholar]
  17. Phelan P. D., Allan J. L., Landau L. I., Barnes G. L. Improved survival of patients with cystic fibrosis. Med J Aust. 1979 Apr 7;1(7):261–263. doi: 10.5694/j.1326-5377.1979.tb112071.x. [DOI] [PubMed] [Google Scholar]
  18. Rosenlund B., Sjöblom P., Dimitrakopoulos A., Hillensjö T. Epididymal and testicular sperm for intracytoplasmic sperm injection in the treatment of obstructive azoospermia. Acta Obstet Gynecol Scand. 1997 Feb;76(2):135–139. doi: 10.3109/00016349709050069. [DOI] [PubMed] [Google Scholar]
  19. Sawyer S. M. Reproductive health in young people with cystic fibrosis. Curr Opin Pediatr. 1995 Aug;7(4):376–380. doi: 10.1097/00008480-199508000-00006. [DOI] [PubMed] [Google Scholar]
  20. Sawyer S. M., Tully M. A., Colin A. A. Reproductive and sexual health in males with cystic fibrosis: a case for health professional education and training. J Adolesc Health. 2001 Jan;28(1):36–40. doi: 10.1016/s1054-139x(00)00172-5. [DOI] [PubMed] [Google Scholar]
  21. Sawyer S. M., Tully M. A., Dovey M. E., Colin A. A. Reproductive health in males with cystic fibrosis: knowledge, attitudes, and experiences of patients and parents. Pediatr Pulmonol. 1998 Apr;25(4):226–230. doi: 10.1002/(sici)1099-0496(199804)25:4<226::aid-ppul2>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  22. Stern R. C., Doershuk C. F., Drumm M. L. 3849+10 kb C-->T mutation and disease severity in cystic fibrosis. Lancet. 1995 Jul 29;346(8970):274–276. doi: 10.1016/s0140-6736(95)92165-6. [DOI] [PubMed] [Google Scholar]
  23. Thickett K. M., Stableforth D. E., Davies R. E., Smith E., Edenborough F. P. Awareness of infertility in men with cystic fibrosis. Fertil Steril. 2001 Aug;76(2):407–408. doi: 10.1016/s0015-0282(01)01880-5. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES