Infertility in women with systemic autoimmune diseases

Jamilya Khizroeva, J. Kh. Khizroeva, Nalli C, Cecilia Nalli, Victoria Bitsadze, В. О. Бицадзе, Bitsadze V, Lojacono A, Andrea Lojacono, Sonia Zatti, Zatti S, Laura Andréoli, Laura Andreoli, Angela Tincani, Tincani A, Anǵela Tincani, Yehuda Shoenfeld, Shoenfeld Y, А. D. Makatsariya, Alexander Makatsariya
Best practice & research. Clinical endocrinology & metabolism · 2019 · vol. 33(6) , pp. 101369 · doi:10.1016/j.beem.2019.101369 · PMID:31837981 · W2991537028
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This paper investigates infertility in women diagnosed with systemic autoimmune diseases.

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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.

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Condition tags

endometriosisinfertility

MeSH descriptors

Autoimmune Diseases Infertility, Female Primary Ovarian Insufficiency Antibodies, Antiphospholipid Antibodies, Antiphospholipid Autoantibodies Autoantibodies Autoantibodies Autoimmune Diseases Autoimmune Diseases Autoimmunity Autoimmunity Child Endometriosis Endometriosis Endometriosis Endometriosis Female Humans Infant, Newborn

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References (63)

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