RESUMO
BACKGROUND AND OBJECTIVE: Asthma is one of the most common chronic diseases among women of reproductive age, and previous studies have suggested a link between female asthma and infertility. The aim of the present review is to provide an update on current knowledge of the association between female asthma and/or atopy and a reduction in fertility, ie, number of offspring, time to pregnancy (TTP) and need for fertility treatment. METHODS: Systematic review performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guidelines. RESULTS: A total of 14 studies fulfilled the predefined criteria for inclusion in the present review. Six studies investigated the association between female asthma and/or atopy and number of offspring, of which one reported a positive, two a negative, and three no association. Three studies addressed the association between asthma and TTP and found that TTP was significantly prolonged in asthmatic women compared to non-asthmatic women. Five studies investigated subfertility and the need for fertility treatments of which two studies found a higher prevalence of infertility among women prescribed anti-asthma medication. One study found no difference in the number of fertility treatments of asthmatic women compared to non-asthmatic women, whereas three studies reported that female asthma was associated with significantly more fertility treatment compared to non-asthmatic women. CONCLUSION: Although the available evidence is conflicting, there is a clear trend toward an association between female asthma and a reduction in fertility, and by that a larger proportion requiring fertility treatment, even though female asthma might not negatively affect total number of offspring.
RESUMO
Asthma has been linked with prolonged time to pregnancy. Our aim was to explore a possible association between asthma and need for fertility treatment among women with live births.All women enrolled in the Management of Asthma during Pregnancy (MAP) programme at Hvidovre Hospital, Denmark were each matched with the next three consecutive women giving birth at Hvidovre Hospital. Information from the Danish National Assisted Reproductive Technology (ART) registry was cross-linked with the Danish Medical Birth registry to identify live births. The primary outcome of interest was births following fertility treatment.Our sample comprised pregnancies from asthmatic mothers (n=932, described as "cases") and non-asthmatic mothers (n=2757, described as "controls"), with 12% (n=114) and 8% (n=212), respectively, having had fertility treatment (OR 1.67, 95% CI 1.32-2.13; p<0.001). This association remained statistically significant after adjusting for confounders, including body mass index (OR 1.31, 95% CI 1.00-1.70; p=0.047). In women ≥35â years, 25% of cases (n=63) and 13% of controls (n=82) received fertility treatment (OR 2.12, 95% CI 1.47-3.07; p<0.001), which also remained statistically significant after adjusting for confounders (OR 1.65, 95% CI 1.11-2.46; p=0.013).A higher proportion of the births from asthmatic mothers involved fertility treatment compared to non-asthmatic mothers, not least among women aged ≥35â years.
