Abstract
Reproductive changes such as impaired fertility and adverse pregnancy outcomes have been related to female asthma. We recently found that time to pregnancy is prolonged in asthmatic females especially in women with moderate to severe asthma and in those above 30 years of age. Despite their reproductive difficulties the asthmatics ultimately conceived just as many biological children as healthy throughout their reproductive lives. This knowledge therefore raises questions about how asthma affects fertility pathophysiologically. The purpose of this review is to describe the existing knowledge in this field and suggest hypotheses of causal relationships, which may form the basis for future studies in this field. The aim is, in particular, in the literature to examine whether there is any evidence to suggest that the systemic inflammation that characterizes asthma, can affect fertility. The issue is potentially clinically important for asthmatic, infertile individuals and society because treatment of the general systemic inflammation associated with the asthmatic disease combined with hormone stimulation might be the optimal target for an effective infertility therapy, possibly decreasing the need for in vitro fertilization.
Highlights
We have recently, in a retrospective registry-based study, demonstrated that asthma significantly prolongs time to pregnancy (TTP) and fertility (21,6% versus 27% OR: 1.31 P = 0.009), whereas allergy was not related to TTP [1]
We recently found that time to pregnancy is prolonged in asthmatic females especially in women with moderate to severe asthma and in those above 30 years of age
We showed that untreated asthmatics had a significantly increased risk of prolonged TTP compared with healthy individuals (30.5 versus 21.6%, OR = 1.79, P = 0.004), while asthmatics receiving any kind of treatment for asthma tended to have a shorter TTP than untreated asthmatics (23.8 versus 30.5%, OR = 1.40, P = 0.134) indicating that an untreated systemic inflammation could have a negative effect on fertility
Summary
We showed that untreated asthmatics had a significantly increased risk of prolonged TTP compared with healthy individuals (30.5 versus 21.6%, OR = 1.79, P = 0.004), while asthmatics receiving any kind of treatment for asthma tended to have a shorter TTP than untreated asthmatics (23.8 versus 30.5%, OR = 1.40, P = 0.134) indicating that an untreated systemic inflammation could have a negative effect on fertility. These findings are to our knowledge new and of highly clinical relevance given that a large proportion of asthmatic patients are young and in the reproductive age. They reported that a greater number of women undergoing IVF treatment were using antiasthmatic drugs
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