Assisted Reproductive Technologies For Women With Rheumatic Aid

Publication date: Available online 23 October 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Michael D. LockshinAbstractART procedures are safe for women with rheumatic autoimmune diseases (rAID) when illness is inactive. Medications incompatible with pregnancy should change to alternative, pregnancy-compatible medications months before planned ART procedures to allow time to verify the substitute medication’s efficacy and tolerability. Medications compatible with pregnancy should continue, as should anticoagulation (warfarin changing to low molecular weight heparin) before pregnancy begins. Protocols that provide details for specific medications are available. All rAID patients should be screened for diagnosis-relevant organ system damage, and those intending to carry their own pregnancies must be tested for aPL and anti-Ro/La autoantibodies. Patients with organ damage and/or positive tests for aPL and anti-Ro/La should be counseled about fetal and maternal risks, including implications to the child and family of maternal disability or death. Sperm donors with rAID may need to discontinue medications. REI and physicians treating rAID patients (usually rheumatologists) must work together to plan and accomplish ART.
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research