Two successive pregnancies after ursodeoxycholic acid therapy in a previously infertile woman with anti mitochondrial antibody-negative primary biliary cirrhosis

Objective: To describe the benefit of ursodeoxycholic acid (UDCA) for the initiation and completion of a successful pregnancy in a previously infertile woman with primary biliary cirrhosis. Design: Case report. Setting: A university hospital with relevant departments. Patient(s): A 29-year-old woman with primary biliary cirrhosis and failure to conceive for 6 years. Intervention(s): Establishment of diagnosis with a liver biopsy, pretreatment of patient with UDCA before conception, and continuation of UDCA after first trimester until term. UDCA was used in the second pregnancy again after the first trimester. Main Outcome Measure(S): Achievement of a safe conception and full-term pregnancy. Result(S): Two consecutive successful pregnancies, a healthy 3,250-g male infant and a healthy 3,000-g female infant. The second conception occurred in a period without the use of UDCA, implicating a latent beneficial effect of either UDCA orthe previous pregnancy via some possible immune mechanism. Conclusion(s): Ursodeoxycholic acid could help achieve conception in infertile women with primary biliary cirrhosis. The use of UDCA after the first trimester is shown to be safe in two consecutive pregnancies. Although it cannot be conclusive, the unintentional use of UDCA in the first 20 days after conception did not result in any teratogenicity in the first child. (c) 2005 by American Society for Reproductive Medicine.