Reproductive Health and Lung Disease

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General Information - PCD

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Reproductive Health in PCD
For individuals with primary ciliary dyskinesia (PCD), reproductive considerations fall into two main categories: 1) Achieving pregnancy and 2) Maintaining lung function during and after pregnancy.

Achieving Pregnancy
In PCD, genetic changes impact the structure and/or function of motile cilia—microscopic whiplike organelles responsible for keeping the airways clear. Proper cilia/flagella function is also critical for the movement of the cells of reproduction—the egg in females and the sperm tails in males. Impaired ciliary function can lead infertility/subfertility in individuals with PCD.

Assistive reproductive technologies (ART) can be very effective for PCD-related infertility/subfertility for both males and females.

Importantly, spontaneous conception can and does occur in PCD, so having PCD, in itself, is NOT a reliable form of birth control.


Managing Lung Health During Pregnancy and Post-Pregnancy
Many women with PCD have had successful pregnancies resulting in healthy children. For chronic lung diseases like PCD, lung outcomes during and post-pregnancy often depend on lung status at the time of conception. PCD lung disease can result in irreversible damage to airways (bronchiectasis) and loss of lung function. Damaged airways can harbor serious and difficult to treat bacteria. Additionally, the hormones of pregnancy may exacerbate underlying airway disease. Women with significant lung involvement may need to work very closely with their pulmonologist and obstetrician during pregnancy to find options for therapy and ensure optimal lung outcomes.

Treating underlying lung disease in PCD often requires daily, time-consuming therapies. Post-birth/post-adoption management of lung disease--for parents of any gender--can pose additional challenges, as self-care can decrease while caring for the needs of an infant resulting in increased symptoms and sometimes loss of lung function. Having a strong support system, including active engagement with one’s healthcare providers, allows new parents with underlying lung diseases time to care for their own lung health, and can be very helpful.

Although chronic lung diseases like PCD pose a diverse set of challenges in family planning, the issues of infertility/subfertility picture is not as limiting as once believed and lung health can be supported both during pregnancy and post-birth to support people in living full lives as parents with chronic lung disease.

Source:
Deepika Polineni, MD, MPH
Assistant Professor
Division of Pulmonary, Critical Care, and Sleep Medicine
University of Kansas Medical Center

Quick Facts About Reproductive Health and Lung Disease

  1. Imparied ciliary motility caused by PCD genetic defects impacts both the respiratory and reproductive systems, leading to infertility (inability to conceive spontaneously) and subfertility (delayed spontaneous conception) and loss of lung function.

  2. Sperm tails in males are affected by PCD genetic defects and males with PCD are often told they are infertile. Recent studies, however, indicate that this is not the case for about 25% of males with PCD who can conceive spontaneously.

  3. Women with PCD may experience infertility/subfertility or ectopic (tubal) pregnancy as the result of impaired ciliary motility in the Fallopian tubes. However, spontaneous conception is possible in women with PCD. Before becoming pregnant, women with PCD should discuss lung health with their pulmonary specialist.

  4. PCD does not cause sterility. Egg and sperm are both viable, but the mechanics of getting the sperm and egg where they need to be for fertilization can be impaired. This means that assistive reproductive technologies (ART) may be helpful for achieving pregnancy in PCD.