**3. Fertility in women with cystic fibrosis**

Although most men with CF have significant anatomical abnormalities of the reproductive tract, most CF women have an anatomically normal reproductive tract and may be able to conceive spontaneously, but in literature it is reported that only slightly more than half of them have spontaneous pregnancies. The fertility problems in CF female are multifactorial: the main cause would be the difficult transport of sperm through the female reproductive tract, secondary to thick secretions; but certainly also the underlying medical conditions (especially lung function and nutritional status) have a major impact on fertility in these patients. The improved health and longevity of CF women naturally leads to an increased number of CF women who become or desire to become pregnant.

The first reported successful pregnancy in a CF woman was in 1960 [16], and in 1966 13 pregnancies in 10 different patients were reported [17]. These early reports were discouraging. However, with aggressive management of infections and significant improvement in pulmo‐ nary and nutritional interventions, pregnancies today are well tolerated in CF, especially in women with mild to moderate disease [18, 19]. The North American CF Registry reported in 2007 that 3–4% of CF women over 17 years old become pregnant each year [20].
