In vitro fertilization may be effectively done in women with SLE, APS
It is possible to safely and successfully perform in vitro fertilization (IVF) in women with systemic lupus erythematosus (SLE) or antiphospholipid syndrome (APS), suggests a recent study.
A retrospective study was conducted to describe women with SLE or APS who have had at least one IVF cycle. Researchers compiled and assessed data about complication and success rates for IVF.
A total of 37 women (median age 34 years; range, 26 to 46) with SLE (n=23, including eight with antiphospholipid antibodies), SLE with APS (n=4) or primary APS (n=10) underwent 97 IVF procedures (median number of IVF cycles, 2.6; range, 1 to 8). The infertility was female in origin in 43 percent of cases, male in 19 percent, mixed in 14 percent and unexplained in 24 percent.
There was no woman who had premature ovarian insufficiency due to cyclophosphamide. Patients were treated with hydroxychloroquine (72 percent), steroids (70 percent), azathioprine (3 percent), aspirin (92 percent) or low molecular weight heparin (62 percent).
There were 27 (28 percent) pregnancies, 23 live births among 26 neonates (three twin pregnancies), two miscarriages, and two terminations for trisomy 13 and 21. During follow-up, six spontaneous pregnancies occurred. A total of 26 women (70 percent) delivered at least one healthy child.
Complications happened in or after eight IVF cycles (8 percent): SLE flares in four (polyarthritis in three and lupus enteritis in one) and thromboembolic events in four others. One of the SLE flares was the initial sign of previously undetected SLE. In two other flares and two thrombosis, it was obvious that patients had poor treatment adherence.
There was no ovarian hyperstimulation reported, according to researchers.