A new insight into the impact of systemic lupus erythematosus on oocyte and embryo development as well as female fertility

Abstract

BackgroundSystemic lupus erythematosus (SLE) is often associated with adverse reproductive outcomes. But it’s currently unclear regarding the role of SLE in oocyte and embryonic development. Also, it’s controversial whether SLE has an adverse effect on fertility. There is a lack of comprehensive understanding and assessment of fertility in patients with SLE.ObjectiveThis study was aim to investigate oocyte and embryonic development as well as ovarian reserve, and clinical outcomes in SLE patients during in vitro fertilization (IVF) treatment. By combining data on embryonic and gamete development in SLE patients, we hope to provide new insights into a comprehensive assessment of fertility in SLE patients.MethodsIn this study, we collected data from 34 SLE patients who were previously diagnosed and in remission for a total of 44 IVF cycles and matched 102 infertile women with a total of 148 IVF cycles by Propensity Score Matching (PSM) of 1:3 ratio. We then evaluated baseline characteristics, ovarian reserve, IVF laboratory outcomes, and clinical outcomes between the two groups.ResultsAfter PSM matching, baseline characteristics including age, infertility types, and duration, as well as infertility causes overall coincided between the two groups. Anti-müllerian hormone (AMH) was significantly lower in the SLE group vs comparison (1.9 vs. 3.3 ng/mL, P=0.001). The SLE group performed a significant reduction in available embryo rate (76.6% vs. 86.0%, P=0.001), good-quality blastocyst formation rate (35.1% vs. 47.0%, P=0.003), and blastocyst formation rate (51.0% vs. 67.7%, P=0.001) compared to the comparison. As for clinical outcomes, the implantation rate in the SLE group was notably lower (37.9% vs. 54.9%, P=0.022). The CLBR following every embryo-transfer procedure was distinctly lower (41.2% vs 64.7%, P=0.016) in the SLE group vs comparison. Also, the conservative and optimal CLBRs following every complete cycle procedure were significantly reduced in the SLE group vs the comparison (P=0.001, both).ConclusionPatients with SLE present worse outcomes in oocyte and embryonic development, thus yielding compromised female fertility and clinical pregnancy. Individualized fertility assessment and early fertility guidance are necessary for these special groups.

A new insight on evaluation of the fertility and pregnancy outcome in patients with primary Sjögren syndrome: a propensity score matched study in multi-IVF centers

“…Additionally, our previous work found that SLE patients also exhibit oocyte and embryonic developmental abnormalities [ 31 ], which may imply some commonalities between autoimmune diseases.Delving deeper into the potential mechanisms may enrich our understanding of their complex relationship.In relation to the clinical pregnancy, our study provides a more comprehensive assessment of clinical outcomes, and our results show that even when more embryos are transferred on average, the rates of implantation, LBR per complete cycle, and LBR per transfer are distinctly decreased in pSS patients than in comparison patients. Actually, similar to our findings, a case–control study by Priori et al reported that the average number of pregnancies in pSS patients were quite lower than normal patients [ 32 ].…”

Aberrant CD8+T cells drive reproductive dysfunction in female mice with elevated IFN-γ levels

“…We report here that though ARE +/- and ARE -/- female mice with mild to moderately elevated IFN-γ (respectively) ovulate, develop CL (though reduced), and whose fertilization is not impaired, there is increased CD8 + T cell infiltration in the ovary and uterus. However, unlike existing lupus mouse models, ARE -/- female mice do not get pregnant or show implantation sites, while ARE +/- female mice have reduced litter sizes, mimicking infertility phenotypes found in SLE and most autoimmune patients ( 55 , 58 , 59 ). Furthermore, we report that aberrant CD8 + T cells in the ARE +/- and ARE -/- mouse ovary and uterus acquire effector memory signatures capable of propagating self-tissue damage.…”

Ovarial Reserve in Systemic Lupus Erythematosus: Current Status of the Problem

“…Длительное использование нестероидных противовоспалительных препаратов у больных СКВ может приводить к бесплодию, а применение высоких доз кортикостероидов провоцирует различные нарушения менструального цикла из-за воздействия на гипоталамо-гипофизарнояичниковую ось [11]. 3,3 нг/мл, р=0,001) [29]. По данным Angley M. и соавт., низкие значения АМГ у женщин с СКВ наблюдаются в 1,5-1,6 раза чаще, нежели у женщин без СКВ [30].…”