Asthma severity tied to need for fertility treatment
Published online March 6, 2025
Asthma, a chronic inflammatory airway condition, affects many women of reproductive age. While pregnancy outcome in women with asthma has been studied, less is known about asthma’s impact on fertility. This large-scale Danish study explores how asthma, especially when moderate to severe, may influence women’s likelihood of needing fertility treatment, aiming to inform both clinicians and patients planning for pregnancy.
In a nationwide cohort study published in The Journal of Allergy and Clinical Immunology: In Practice, Vejen Hansen et al. analysed data from 765,606 women born between 1976-1999, living in Denmark. Of these, 114,653 had asthma, identified by redemption of at least two asthma medication prescriptions within one year. The study followed participants for a median of 10.8 years to compare fertility outcomes, including fertility treatment use, live births, and pregnancy loss, between women with and without asthma. Asthma severity was assessed using prescription patterns aligned with Global Initiative for Asthma (GINA) treatment steps, and the influence of asthma-related factors such as exacerbation(s), age of onset, and use of inhaled rescue medication were evaluated. Age-specific analyses were conducted at age 35 to explore differences in fertility treatment use and reproductive outcomes.
Women with asthma were slightly more likely to undergo fertility treatment (5.6%) than those without asthma (5.0%). The risk increased with asthma severity: those in GINA steps 4-5 had a 59% higher risk of needing fertility treatment compared to women without asthma. Frequent asthma exacerbations also contributed to fertility treatment needs. Interestingly, excessive use of rescue medication was not linked to fertility treatment; this is a surprising finding, as it is typically regarded as a marker of poor asthma control. Despite the increased use of fertility treatment, live birth rates were nearly identical between groups, underscoring that while asthma may affect the path to conception, it does not seem to limit the ultimate likelihood of parenthood. The authors emphasised that clinicians should monitor asthma control and reduce exacerbation risk in women of reproductive age, especially those planning pregnancy or facing infertility.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.
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