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Individuals with cystic fibrosis often experience infertility primarily due to the anatomical and physiological effects of the condition. In males, cystic fibrosis is typically associated with congenital absence of the vas deferens, the duct responsible for transporting sperm from the testicles to the urethra. This anatomical abnormality results in obstructive azoospermia, where no sperm is present in the ejaculate, leading to infertility.

While females with cystic fibrosis may have some fertility, they can face challenges such as thick cervical mucus, which can impede sperm passage and affect fertility. However, many women with cystic fibrosis are capable of conceiving, although they might require medical assistance.

The distinction between the genders is significant because the degree of infertility is almost universally definitive in males, making them almost always infertile due to cystic fibrosis. In contrast, while females may also experience fertility challenges, they are not universally infertile.