Infertility in women with systemic autoimmune diseases

被引:54
|
作者
Khizroeva, Jamilya [1 ]
Nalli, Cecilia [2 ]
Bitsadze, Victoria [1 ]
Lojacono, Andrea [3 ]
Zatti, Sonia [3 ]
Andreoli, Laura [2 ]
Tincani, Angela [2 ,4 ]
Shoenfeld, Yehuda [4 ,5 ,6 ]
Makatsariya, Alexander [1 ]
机构
[1] Sechenov Univ, IM Sechenov Moscow State Med Univ 1, Dept Obstet & Gynecol, Moscow, Russia
[2] Univ Brescia, Dept Clin & Expt Sci, Rheumatol & Immunol Unit, ASST Spedali Civili Brescia, Brescia, Italy
[3] Univ Brescia, Dept Clin & Expt Sci, Obstetr & Gynecol Unit, ASST Spedali Civili Brescia, Brescia, Italy
[4] IM Sechenov First Moscow State Med Univ, Sechenov Univ, Minist Hlth Russian Federat, Moscow, Russia
[5] Sheba Med Ctr, Zabludowicz Ctr Autoimmune Dis, Dept Med B, Ramat Gan, Israel
[6] Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel
关键词
infertility; autoimmune diseases; pregnancy; ANTI-MULLERIAN HORMONE; LUPUS-ERYTHEMATOSUS; ANTIPHOSPHOLIPID ANTIBODIES; ASSISTED REPRODUCTION; THYROID-HORMONES; OVARIAN-FUNCTION; PREGNANCY; THERAPY; ENDOMETRIOSIS; PATHOGENESIS;
D O I
10.1016/j.beem.2019.101369
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. antioocytes) 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. (C) 2019 Published by Elsevier Ltd.
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页数:11
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