The relationship between female asthma and fertility.

Introduction: Asthma and fertility represent two health-related challenges for women of reproductive age. Women with asthma experience prolonged time to pregnancy and an increased likelihood of requiring fertility treatment, with age, severity of asthma and uncontrolled asthma being important factors, compared to women without asthma, suggesting complex interplay between asthma and fertility.

Areas covered: While evidence on the association between asthma and pregnancy loss is conflicting, pregnancy itself is associated with additional risks of maternal and fetal complications, including preeclampsia, preterm birth, and low birth weight. However, well-controlled asthma reduces these risks, underscoring the critical importance of proper management according to generally accepted asthma treatment guidelines.Age influences not only fertility but also the control of asthma during pregnancy, an increasing age correlates with a higher likelihood of uncontrolled asthma and exacerbations during pregnancy. Although systemic corticosteroid exposure during first trimester may be associated with risks, the consequences of uncontrolled asthma and hypoxemia pose greater threats to fetal well-being and should therefore be administered according to guidelines if required.

Expert opinion: This review explores the relationship between asthma, fertility and pregnancy outcomes, emphasizing the importance of asthma control and medication adherence. Practical recommendations are provided for women with asthma planning pregnancy, along with proposed future research directions to improve understanding and care in this population. In conclusion, women with asthma should be encouraged to plan pregnancies earlier in life, given the impact of age on fertility and asthma-related risks. While some may experience pregnancy loss, asthma does not reduce overall offspring numbers. Effective asthma management is essential to ensuring the health and well-being of both mother and fetus.