Researchers recently highlighted the importance of offering reproductive health counseling to adolescents with cystic fibrosis (CF) in a letter to the editor of the journal Pediatric Pulmonology. 

Advances in CF therapeutics mean that more patients with CF are living to an age at which reproductive health and goals matter. 

Studies suggest that females receiving CF transmembrane conductance regulator modulator therapy have improved fertility, likely due to better cervical mucus consistency and vaginal pH. These improvements are important for healthcare providers to be aware of because misconceptions among patients with CF regarding fertility remain, a lack of advice regarding proper nutrition and health goals can impede fertility, and patients with CF are more likely to engage in risky sexual behavior if this subject is not discussed. 

Current attitudes about sex education among adolescents lean toward equipping them with accurate, actionable medical advice. However, studies indicate that less than one-half of those with CF receive counseling about their reproductive health. 

Read more about CF etiology 

“Given these findings, we were concerned about a low frequency of these discussions within our own cystic fibrosis center,” the authors wrote. 

Because of this concern, they initiated a study regarding whether reproductive health was adequately discussed among adolescents with CF who were patients at the University of Iowa Stead Family Children’s Hospital Cystic Fibrosis Clinic. A single reviewer was tasked with assessing the documentation on discussions related to fertility, contraception, and the safety of CF therapies during pregnancy. Electronic health records of adolescent patients with CF (n=112) were assessed for the purpose of the study. 

Of the 112 patients reviewed, only 20 received counseling on sexual health, 19 received counseling on contraception, and 8 received counseling on fertility. In addition, the authors reported that referral rates for reproductive health were low; of the 41 referrals to an endocrinologist by a pediatric pulmonary provider, none were on topics related to sexual or reproductive health. 

“Our results confirm there is a need for improvement within our clinic to ensure that all people with cystic fibrosis receive appropriate counseling on reproductive health, fertility, contraception, and pregnancy‐related topics,” the authors concluded. 


Flynn H, Wright B, Larson Ode K. Assessing the occurrence of reproductive health counseling in adolescents with cystic fibrosisPediatr Pulmonol. 2022;10.1002/ppul.26196. doi:10.1002/ppul.26196