RA and Lupus Reduce Fertility

Infertility high among women with chronic disease

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(RxWiki News) Living with an autoimmune disease poses many problems for women. For women who are diagnosed during their reproductive years, it may affect your childbearing choices and your ability to have a baby.

A new study looked at infertility, pregnancy loss and family size choice in women with rheumatoid arthritis (RA) and systemic lupus (SLE).

Doctors from several health institutes around the U.S. found that women with RA and lupus experience fewer pregnancies due to infertility and miscarriage, leading these women to have fewer children than they had originally planned.

"Women with RA or lupus should discuss childbearing goals with their doctor."

Dr. Megan Clowse, a physician at Duke University Medical Center’s Division of Medicine-Rheumatology and Immunology in Durham, N.C., and the study’s authors say that infertility and miscarriage play a role, but women might also choose to have a smaller family due to reproductive health concerns.

The women in the study were concerned about their ability to care for their children and side effects from medications taken during pregnancy, and also worried that their baby may inherit the disease.

Clowse and colleagues examined 1,017 women, including 578 women with RA and 114 women with systemic lupus (SLE). The women – all participants in the National Data Bank for Rheumatic Diseases - answered a questionnaire about reproductive health.

The researchers then categorized the women into three groups: women who wanted kids when signs of the disease appeared but ended up having fewer children (group A); women who had the same number of kids they had planned for (group B); and women who were no longer interested in having kids when they were diagnosed with their chronic disease.

The authors report that more than 60% of the women were categorized in group C, suggesting that women changed their family-building plans at or before their diagnosis. The team also found that 55% of women with RA and 64% with lupus had fewer children than they had originally planned.

The researchers report that women with RA who had fewer kids than planned had an infertility rate 1.5 times higher than those who had the same number of kids as planned. The two groups had similar rates of miscarriage.

The team found that miscarriage is one reason why some women with lupus weren’t able to have more kids. They report that women with lupus who had fewer kids than planned got pregnant as often as women with lupus who had their planned number of kids, but the women with fewer kids were three times more likely to suffer miscarriage.

The infertility rate among women with RA who had fewer children than planned was 42%. RA women who were diagnosed during childbearing years, compared to women who were diagnosed after childbearing was complete.

Educating women about safe medical options during pregnancy and effective control of these autoimmune diseases can help women achieve their family-planning goals, say the study's authors.

More research on the underlying causes of infertility and pregnancy loss in women with RA and lupus is needed in order to help fulfill their desire for children, concludes Dr. Clowse.

RA is a chronic inflammatory disorder that typically affects the small joints of the hands and feet. It is more common in women, and is usually diagnosed between the ages of 40 and 60.

Lupus, also a chronic inflammatory disease that’s more common in women, occurs when the body’s immune system attacks your tissues and organs. It’s most often diagnosed between the ages of 15 and 40.

This study was published in Arthritis Care & Research, a journal of the American College of Rheumatology.

Last Updated:
February 20, 2012