Background: Numerous observational studies have found a higher risk of infertility in patients with rheumatoid arthritis(RA), but the causal relationship is subject to inherent confounding bias in traditional retrospective studies, and the causal relationship between the two has not been definitively established.
Methods: This paper analyzes the causal relationship between RA and infertility using two-sample MR. In this paper,we performed a bidirectional two-sample Mendelian randomization (MR) analysis to test for the causal association between RA and infertility using data from Independent single nucleotide polymorphisms(SNP) closely associated with RA were selected as instrumental variables from a genome-wide association meta-analysis including 14,361 patients with RA and 43,923 controls of European ancestry. The summary statistics of infertility were obtained from the Finnish Biobank, which included 6,481 cases and 68,969 controls in women and 680 cases and 73,479 controls in men. Inverse variance weighting was used as the main estimator, supplemented by MR-Egger, Weighted median. MR-PRESSO was used to remove biased SNPs, Cochran's Q test to and MR-Egger intercept analysis to detect heterogeneity and horizontal pleiotropy.
Results: Individuals with higher genetic liability to RA were more likely to develop female infertility ([OR,1.04; 95%CI,1.01-1.07; p<0.05]).But,RA is not causally related to male infertility.
Conclusions: We found that genetically predicted RA causes a higher risk of infertility in women, a risk that has existed since conception. However, in terms of genetic variation, there is no evidence that RA increases the risk of infertility in men. the damage to reproductive health from RA is greater in women than in men. Our findings help women of childbearing age with RA to intervene early before they are ready to conceive, with the expectation of improving conception rates and reducing the risk of infertility in women with RA.