Impact of therapy for autoimmune rheumatic diseases on reproductive function

DOI

https://dx.doi.org/10.18565/aig.2021.7.53-60

Vlasova G.A., Perminova S.G., Kosheleva N.M., Veyukova M.A.
1) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) V.A. Nasonova Research Institute of Rheumatology, Ministry of Science and Higher Education of the Russian Federation, Moscow, Russia

Objective. To carry out a systematic analysis of the data available in the world literature on the effects of various groups of drugs used in therapy for immune-mediated inflammatory rheumatic diseases (IMIRDs) on the female and male reproductive system, as well as methods to preserve reproductive function in this patient contingent.
Materials and methods. The review includes Russian and foreign publications available in Pubmed on this topic over 2010–2020.
Results. The authors analyze the data available in the literature on the effects of drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids (GCs), cyclophosphamide (CP), methotrexate (MTX), mycophenolate mofetil (MMF), azathioprine (AZA), sulfasalazine (SUL), hydroxychloroquine (HC), leflunomide, and biological agents (BAs) on the female and male reproductive system. The possible teratogenic effects of some of these drugs used during pregnancy were studied. Procedures to preserve reproductive function were also analyzed in patients with IMIRDs.
Conclusion. CP is the only drug, the negative effect of which on female and male reproductive function was significantly proven. The negative effect of MTX and a tumor necrosis factor-α inhibitor on the male reproductive system and also the teratogenic effects of MMF and leflunomide during pregnancy are discussed. The effect of other drug groups remains controversial and requires further investigation. The design and clinical introduction of individual approaches to preserving reproductive function in this patient group also require further study.

immune-mediated inflammatory rheumatic diseases

infertility

systemic lupus erythematosus

rheumatoid arthritis

gonadotoxic therapy

diminished ovarian reserve

premature ovarian failure

oocyte/embryo cryopreservation

ART programs

Full text (in Russian)

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Received 21.05.2021

Accepted 15.06.2021

Galina A. Vlasova, graduate student of Reproductology Department, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia. Tel.: +7(906)079-44-49.
E-mail: galinavlasova089@gmail.com. 117997, Russia, Moscow, Ac. Oparina str., 4.
Svetlana G. Perminova, Dr. Med. Sci., Leading Researcher of Reproductology Department, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia.
Tel.: +7(977)053-44-44. E-mail: perisvet@list.ru. 117997, Russia, Moscow, Ac. Oparina str., 4.
Nadezhda M. Kosheleva, PhD, Senior Researcher of the Laboratory of Vascular Rheumatology, V.A. Nasonova Research Rheumatology Institute. Tel.: +7(495)109-29-10. E-mail: nadkosheleva@yandex.ru. 115522, Russia, Moscow, Kashirskoye Shosse, 34A.
Maria A. Veyukova, PhD (Bio), Senior embriologist of Reproductology Department, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia. Tel.: +7(977)053-44-44. E-mail: veymary@gmail.com. 117997, Russia, Moscow, Ac. Oparina str., 4.

For citation: Vlasova G.A., Perminova S.G., Kosheleva N.M., Veyukova M.A. Impact of therapy for autoimmune rheumatic diseases on reproductive function.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 7: 53-60 (in Russian)
https://dx.doi.org/10.18565/aig.2021.7.53-60

Impact of therapy for autoimmune rheumatic diseases on reproductive function

Vlasova G.A., Perminova S.G., Kosheleva N.M., Veyukova M.A.

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