The number of people suffering from asthma is growing. It’s estimated that one in 12 people (25 million) in the US now suffer from the illness compared with one in 14 in 2001. Among the serious side effects it can cause, there has been concern for some time about the impact asthma has on pregnant women and those trying to conceive.
A new study has now shown that women taking the wrong type of asthma medication are much more likely to be affected by fertility problems. The study was based on over 5000 women in their first pregnancies across the UK, Ireland, New Zealand and Australia. The pregnant women were asked about their medical history, whether they were asthma sufferers and which type of medication they used if they were.
Although there was no difference in fertility found in women who used long acting preventer drugs like steroids, those taking short acting reliever drugs, or beta agonists, took an average of 20% longer to conceive. It also found that these women were 30% more likely to take over a year to conceive, which is the threshold for infertility.
Dr Luke Grzeskowiak, of the Robinson Research Institute at Adelaide University, said this discovery could massively reduce the number of asthmatics finding they need fertility treatment. He said: “This study shows 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. Asthma is known to increase the risk of complications in pregnancy including the potentially fatal condition pre-eclampsia.”
The researchers also found that by using steroids, the majority of women who took part in the study were able to conceive as quickly as non-asthmatics. Prof Grzeskowiak added: “Five to 10 percent of all women around the world have asthma and it is one of the most common chronic medical conditions in women of reproductive age.”
“Several studies have identified a link between asthma and female infertility, but the impact of asthma treatments on fertility has been unclear. Studying the effect of asthma treatments in women who are pregnant or trying to get pregnant is important as women often express concerns about exposing their unborn babies to potentially harmful effects of medications.”
Overall, it was found that 10% of the participants had asthma, and overall these women took longer to get pregnant. However, when they were split into groups of different treatment types, it was found that beta-agonists seemed to be the cause of fertility problems – even after other factors like age and weight were taken into account.
Dr Grzeskowiak, a pharmacist, said his results are good news for asthmatic women. They show that using preventative treatments like corticosteroids seem to have no impact on fertility as was previously believed. He said: “There is plenty of evidence maternal asthma has a negative impact on the health of pregnant mothers and their babies and so our general advice is women should take steps to get their asthma under control before trying to conceive.
“What we don’t yet know is exactly how asthma or asthma treatments lead to fertility problems. As well as affecting the lungs, asthma could cause inflammation elsewhere is the body, including the uterus. It could also affect the health of eggs in the ovaries. Inhaled corticosteroids suppress the immune system, whereas short-acting asthma treatments do not alter immune function. In women who are only using relievers it’s possible that, while their asthma symptoms may improve, inflammation may still be present in the lungs and other organs in the body.”
As a result of these new findings, the researchers plan to carry out further studies to help improve the fertility outcomes for pregnant women with asthma. Professor Mina Gaga, president of the European Respiratory Society and medical director of the respiratory department of Athens Chest Hospital, said: “Asthma is a common condition but in the majority of cases it can be well-controlled with the right medicines.”
She added: “Women who are trying to conceive and women who are already pregnant are naturally concerned about the effects of their medicines, although there are large studies showing that asthma medications are safe, in fact safer than not taking medication. This large study provides reassurance that using preventers, which include inhaled corticosteroids and long-acting bronchodilators, to prevent asthma symptoms helps asthmatic women be as fertile as non-asthmatic women, while intermittent treatment with short acting relievers is associated with reduced fertility.”