Prenatal recommendations and fertility

Key message

  • Best possible asthma control, using appropriate pharmacotherapy, is recommended for women trying to conceive.

Reported observations show that monotherapy with SABA is associated with decreased fertility, whereas asthma therapy with ICS with or without add-on LABA, is not (Grzeskowiak et al. 2018).  This suggests that controller medications may play a role not only in improving asthma control but may also lead to a reduction in the associated systemic inflammation that may be the driver of impaired fertility. This is supported by a smaller observational study showing that women treated for severe asthma with add-on biological therapy, presumably targeting both the local and systemic inflammation, experienced an improvement in fertility (Ozden et al. 2021).

However, there is not full consensus as a recent study by Crowe et al. found only a limited association between a history of asthma or use of asthma medication and fecundability. Their findings, however, indicated a reduction in fecundability in women with adult-onset asthma (Crowe et al. 2020).

Despite conflicting data, it seems very likely that the best possible asthma control may reverse the negative effect of asthma on fertility (Grzeskowiak et al. 2018). However, further research is needed, concerning the importance of asthma control and fertility outcomes.