Infertility in women with systemic autoimmune diseases

Jamilya Khizroeva, Cecilia Nalli, Victoria Bitsadze, Andrea Lojacono, Sonia Zatti, Laura Andreoli, Angela Tincani*, Yehuda Shoenfeld, Alexander Makatsariya

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Infertility consists by definition in” failure to achieve a clinical pregnancy after 12 months or more of regular unprotected intercourse” while the term subfertility means a delay to achieve pregnancy. Several factors can contribute to infertility or subfertility in patients with systemic autoimmune diseases. The association of systemic autoimmune conditions with endometriosis, celiac disease and thyroid autoimmunity that are well known causes of infertility and/or subfertility need to be taken in consideration when difficulties in the onset of pregnancy is reported. The majority of the used antirheumatic drugs do not interfere with fertility. However, the use of cyclophosphamide, limited to severe disease, can provoke premature ovarian failure; to preserve fertility a preventive treatment is available. Nonsteroidal anti-inflammatory drugs can cause temporary infertility and corticosteroids are associated to a prolonged time to pregnancy in some rheumatic diseases. Data on the association of antiphospholipid antibodies (aPL) with infertility are still debated but in general an increased rate of aPL is described patients undergoing medically assisted reproductive techniques. In systemic lupus erythematosus aPL and other autoantibodies (i.e. anti-oocytes) can contribute to the infertility of some patients. Subfertility, rather than infertility, is observed in patients with rheumatoid arthritis; the particular physical conditions of these women can also account for this. Physicians should not forget the patients’ age, that is mandatory in order to preserve their chance to have children.

Original languageEnglish
Article number101369
JournalBest Practice and Research in Clinical Endocrinology and Metabolism
Volume33
Issue number6
DOIs
StatePublished - Dec 2019

Keywords

  • autoimmune diseases
  • infertility
  • pregnancy

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