Women with asthma may suffer loss of fertility from using short-acting relievers – but not from use of preventers, according to the findings of a major study reported today.
The team, led by Dr Luke Grzeskowiak from the University of Adelaide, Australia, explain that asthma affects 8% to 13% of pregnancies and is linked to significant perinatal illness and even a raised risk of death, but its impact on fertility are unclear.
They examined the effect of asthma and asthma medication use on fertility by analysing figures on 5,617 women from Australia, New Zealand, Ireland and the UK. Of these women, 19.7% had diagnosed asthma.
Compared with non-asthmatics, patients taking intermittent reliever medications had a 15% reduced chance of conceiving – whereas no difference was observed for former patients or the group of current patients using inhaled corticosteroids with or without long-acting beta-agonists.
The researchers write in the European Respiratory Journal today (15 February) that: "We show that asthma is associated with reduced fertility but the greatest impact is among women with current asthma receiving intermittent reliever treatment.
"The lack of associations with inhaled corticosteroids with or without long-acting beta-agonists suggests that preventer medications may play a protective role in improving asthma control and reducing associated systemic inflammation which may drive impaired fertility.
"This is important as women and health care professionals express concerns regarding the safety of preventer medications such as inhaled corticosteroids during pregnancy. These concerns lead to poor adherence and discontinuation of asthma medications during pregnancy, with negative impacts on asthma control and pregnancy outcomes."
Dr Grzeskowiak comments: "This study shows that women using short-acting asthma relievers take longer to get pregnant. On the other hand, continued use of long-acting asthma preventers to control asthma seems to protect fertility and reduce the time it takes women with asthma to become pregnant. This could lead to a reduction in the need for fertility treatments."
Grzeskowiak, L. E. et al. Asthma treatment impacts time to pregnancy: evidence from the international SCOPE study. European Respiratory Journal 15 February 2018; doi: 10.1183/13993003.02035-2017 [abstract]
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