[In vitro fertilization and systemic lupus erythematosus or antiphospholipid syndrome: An update]

Rev Med Interne. 2015 Mar;36(3):154-8. doi: 10.1016/j.revmed.2014.08.004. Epub 2014 Sep 10.
[Article in French]

Abstract

Fertility is not impaired in systemic lupus erythematosus or antiphospholipid syndrome, but, similarly to the general population, these patients may undergo in vitro fertilization. This type of treatment increases the risk of lupus flare, thrombosis, and ovarian hyperstimulation syndrome. This review will focus on in vitro fertilization in systemic lupus erythematosus or antiphospholipid syndrome. Literature data are relatively scant with only 3 reported studies. The first one included 17 patients and 63 cycles of induction ovulation/in vitro fertilization leading to 25 % of lupus flare, no thrombosis, and 3 % of ovarian hyperstimulation syndrome. The second study included 10 patients and 40 cycles of in vitro fertilization showing 31 % of lupus flare, no thrombosis and no ovarian hyperstimulation syndrome. The last one included 34 patients and 83 procedures of in vitro fertilization leading to 8 % of flares, 5 % of thrombosis and no ovarian hyperstimulation syndrome. Interestingly, in this last study, half of the complications were explained by poor adherence to treatment. These data are reassuring but it is important to remember that in vitro fertilization should be scheduled and carefully supervised in the same way as the high-risk pregnancies occurring in these patients.

Keywords: Antiphospholipid syndrome; Assisted reproductive technology; Fécondation in vitro; In vitro fertilization; Infertility; Infertilité; Lupus érythémateux systémique; Procréation médicalement assistée; Syndrome des antiphospholipides; Systemic lupus erythematosus.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Antiphospholipid Syndrome / complications*
  • Antiphospholipid Syndrome / therapy
  • Female
  • Fertilization in Vitro / adverse effects*
  • Fertilization in Vitro / methods
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / therapy
  • Pregnancy