Reproductive Effect by Rheumatoid Arthritis and Related Autoantibodies

Li, Ping-Fen; Li, Shan; Zheng, Peng-Sheng

doi:10.1007/s40744-023-00634-1

Rheumatol Ther

2024

DOI: 10.1007/s40744-023-00634-1

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Reproductive Effect by Rheumatoid Arthritis and Related Autoantibodies

Ping-Fen Li,

Shan Li,

Peng-Sheng Zheng

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Cited by 8 publications

References 107 publications

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Exploring the impact of 2-hydroxyestradiol on heme oxygenase-1 to combat oxidative stress in rheumatoid arthritis

Agnihotri,

Malik,

Saquib

et al. 2024

International Journal of Biological Macromolecules

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Exploring the impact of 2-hydroxyestradiol on heme oxygenase-1 to combat oxidative stress in rheumatoid arthritis

Agnihotri,

Malik,

Saquib

et al. 2024

International Journal of Biological Macromolecules

View full text Add to dashboard Cite

Reproductive Health in RA, Lupus, and APS

Zucchi,

Tani,

Mosca

2024

J Clin Rheumatol

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Systemic lupus erythematosus, antiphospholipid syndrome, and rheumatoid arthritis are chronic autoimmune diseases affecting women of childbearing age. These diseases may impair fertility and fecundity, as well as complicate pregnancy and the puerperium in these patients including disease flare and obstetric complications on both the maternal and fetal side. For each patient, an appropriate preconceptional counseling with risk stratification is required, including assessment of disease activity, organ involvement, serological profile, and comorbidities. In cases of pregnancy, the aims of treatment are to prevent disease activity, to treat disease activity in cases of flare, and to prevent maternal and fetal complications such as preeclampsia or fetal loss. In all patients with these diseases, close clinical monitoring during pregnancy and puerperium is mandatory. This review aims to summarize the fertility issues in patients with systemic lupus erythematosus, antiphospholipid syndrome, and rheumatoid arthritis and to provide an update on pregnancy management and outcomes in these patients.

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Preserving Fertility in People With Rheumatic Diseases

Leavitt,

Adeleye,

Edens

2024

J Clin Rheumatol

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Rheumatology patients historically were told they “can't” or “shouldn't” become pregnant. Improved rheumatic diagnostics and treatments have led to decreased morbidity and mortality and increased quality of life resulting in an opportunity to focus on fertility and its preservation. In the same vein as rheumatic disease care, assisted reproductive technology (ART), which includes freezing of egg and sperm as well as in vitro fertilization, has made considerable strides in the recent past. ART is safe for those with rheumatic diseases and has comparable outcomes to the general public, but may take additional effort due to optimal timing, rheumatic medications, and other nuances. In a specialty that treats chronic inflammatory diagnoses using teratogens and gonadotoxins, it is important to address family building desires with patients so their goals can be met. Rheumatologists have little knowledge of ART and how it impacts or applies to their patients; however, patients want their rheumatologist to be the source of knowledge for this information (Arthritis Rheumatol. 2022;74:suppl 9). Many barriers to ART exist and will be explored, with the financial burden being paramount (Glob J Health Sci. 6;1:181–191). Future efforts to examine the future fertility of rheumatology patients in an era of biologics and “treat-to-target” are needed to better understand who would most benefit from this costly and not without risk medical treatment. Given the changing landscape of financial support for ART due to insurance mandates, rheumatologists should not modify counseling based on the anticipated ability of patients to afford care. Preservation should also be broached with patients without partners and those from the LGBTQAI+ community. In addition to expanding the education of rheumatologists regarding this topic and its incorporation into clinical care, advocacy for ART access and insurance coverage is a much-needed future direction.

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Reproductive Effect by Rheumatoid Arthritis and Related Autoantibodies

Cited by 8 publications

References 107 publications

Exploring the impact of 2-hydroxyestradiol on heme oxygenase-1 to combat oxidative stress in rheumatoid arthritis

Exploring the impact of 2-hydroxyestradiol on heme oxygenase-1 to combat oxidative stress in rheumatoid arthritis

Reproductive Health in RA, Lupus, and APS

Preserving Fertility in People With Rheumatic Diseases

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