17th February 2025

A 25-year-old man has been referred to the fertility clinic with his partner as they have been struggling to become pregnant despite regular sex for the last 1.5 years.

A 25-year-old man has been referred to the fertility clinic with his partner as they have been struggling to become pregnant despite regular sex for the last 1.5 years. He is a non-smoker and moved to the UK from Romania 5 years ago. He has no known past medical history but describes a background of chronic recurrent chest infections since childhood and a persistent productive cough with yellow or green sputum for the last few years. On examination, he has finger clubbing, appears to have a low BMI and has bilateral coarse chest crackles. External examination of genitalia appears normal. 

What is the most likely diagnosis?