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Unplanned pregnancies following the introduction of elexacaftor/tezacaftor/ivacaftor therapy in women with cystic fibrosis

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Abstract

Cystic fibrosis (CF) causes infertility and subfertility due to various factors, including altered cervical mucus, delayed puberty, and hormonal imbalances. With the introduction of the CFTR modulator therapy elexacaftor-tezacaftor-ivacaftor, we have observed an increase in unplanned pregnancies among women undergoing ETI treatment in our CF center, despite repeated recommendations for strict fertility monitoring. It appears that these pregnancies are more likely attributed to reduced attention to the possibility of conception rather than contraceptive failure. The perception of subfertility developed by women with CF over time, before the era of modulators, can influence their long-term habits and lead to the underuse of contraceptive methods. While further research is needed to fully understand the effects of ETI on fertility, healthcare providers should be attentive to the fertility concerns of women with CF, particularly those treated with modulators in adulthood.

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Funding

This research received no financial support. The content of this article is solely the responsibility of the authors.

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Authors and Affiliations

  1. Cystic Fibrosis Center, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy

    Valeria Daccò & Gianfranco Alicandro

  2. Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

    Gianfranco Alicandro, Andrea Gramegna & Francesco Arturo Blasi

  3. Obstetrics and Gynaecology Department, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy

    Laura Trespidi

  4. Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy

    Andrea Gramegna & Francesco Arturo Blasi

Authors
  1. Valeria Daccò
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  2. Gianfranco Alicandro
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  3. Laura Trespidi
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  4. Andrea Gramegna
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  5. Francesco Arturo Blasi
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Contributions

Conceptualization: VD; Methodology: VD; Writing—original draft preparation: VD; Writing—review and editing: VD, GA, AG, FAB, LT; Supervision: VD.

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Correspondence to Valeria Daccò.

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Daccò, V., Alicandro, G., Trespidi, L. et al. Unplanned pregnancies following the introduction of elexacaftor/tezacaftor/ivacaftor therapy in women with cystic fibrosis. Arch Gynecol Obstet 308, 1657–1659 (2023). https://doi.org/10.1007/s00404-023-07153-y

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  • DOI: https://doi.org/10.1007/s00404-023-07153-y

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