Reproductive health in males with cystic fibrosis: knowledge, attitudes, and experiences of patients and parents.

ABSTRACT

PIP: Reproductive and sexual health issues are often neglected in work with patients with chronic, life-limiting diseases. Aberrant development of Wolffian duct derivatives generally leads to infertility in men with cystic fibrosis. The reproductive health-related knowledge, attitudes, and experiences of adolescent and adult males with cystic fibrosis were investigated in a descriptive study conducted at the Children's Hospital Cystic Fibrosis Clinic in Boston, Massachusetts (US). Enrolled were 10 adolescents 14-17 years old (mean age, 16 years) and 40 adult men 18-53 years old (mean age, 29 years). 90% of adults, 60% of adolescents, and 50% of parents of adolescent patients were aware of the risk of infertility associated with cystic fibrosis. The average age at which the adult men first learned of this risk was 16 years. A health care provider was the source of this knowledge for 48% of adults and 83% of adolescents. 90% of adult men reported no major distress upon first hearing of the likelihood of infertility during adolescence; however, the emotional significance of possible infertility increased over time for 30%. 20% confused infertility with impotence. 30% of adult men had requested semen analyses and all were azoospermic. There was agreement among respondents that 14 years of age is an appropriate time for health care providers to initiate discussions about the impact of cystic fibrosis on reproductive health. Semen analysis is important to offer all men with cystic fibrosis, providing it is coupled with counseling if azoospermia is confirmed.