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Fertility and infertility implications in rheumatoid arthritis; state of the art

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Abstract

Background

A bulk of investigations imply that women with rheumatoid arthritis (RA) deliver fewer children in comparison to healthy women.

Purpose

This review article attempts to clarify the involvement of infertility-related issues in both RA men and women. Moreover, the effect of RA disease on the fertility quality and quantity will be discussed.

Results

Declined fertility rate in RA women seems to stem from modified inflammatory settings, advanced maternal age, limited sexual activity, and adverse effects of drugs on ovarian function. Women with RA may have smaller families and seem to be slower to conceive relative to their peer women. The chance of gestation in RA women may drop due to suppressed sexual function through pain and fatigue. In addition, treatment of RA women with non-steroidal anti-inflammatory drugs (NSAIDs) may prevent ovulation and therefore hinder the conception.

Conclusions

A complex interaction between RA disease and fertility related issues is present. Despite an increase rate of infertility in RA females or males, the mechanisms involved in this outcome is still unknown. Plausible causes of the decreased fertility rate in RA patients might be due to inflammatory cytokines, suppressed sexual activity, drug treatments, mother age, personal choice, or a combination of these elements.

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Authors and Affiliations

  1. Research Center for Health Sciences and Technologies, Semnan University of Medical Sciences, Semnan, Iran

    Abolfazl Fattah

  2. Veterinary Medicine, Faculty of Veterinary Medicine, Karaj Branch, Islamic Azad University, Karaj, Iran

    Amirhooman Asadi

  3. Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Reza Hooshangi Shayesteh

  4. Department of Microbiology, Islamic Azad University East Tehran Branch, Tehran, Iran

    Forough Hatefi Hesari

  5. Department of Medical Laboratory Sciences, Iranshahr University of Medical Sciences, Iranshahr, Iran

    Sirous Jamalzehi

  6. Veterinary Medicine, Faculty of Veterinary Medicine, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran

    Mojtaba Abbasi

  7. Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran

    Mojtaba Abbasi

  8. Department of Hematology, Faculty of Allied Medicine, Bushehr University of Medical Sciences, Bushehr, Iran

    Mohammad Javad Mousavi

  9. Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Javad Mousavi & Saeed Aslani

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AF Participated in manuscript preparation and read the manuscript critically. SN Participated in manuscript preparation and read the manuscript critically. MRHS Participated in manuscript preparation and read the manuscript critically. FHH Participated in manuscript preparation and read the manuscript critically. SJ Participated in manuscript preparation and read the manuscript critically. MA Participated in manuscript preparation and read the manuscript critically. MJM Developed the main idea, participated in manuscript preparation and read the manuscript critically. SA Developed the main idea, participated in manuscript preparation, and read the manuscript critically.

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Abolfazl Fattah, Soheila Nouraei, Mohammad Reza Hooshangi Shayesteh, Forough Hatefi Hesari, Sirous Jamalzehi, Mojtaba Abbasi, Mohammad Javad Mousavi, and Saeed Aslani declare that they have no conflict of interest.

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Fattah, A., Asadi, A., Shayesteh, M.R.H. et al. Fertility and infertility implications in rheumatoid arthritis; state of the art. Inflamm. Res. 69, 721–729 (2020). https://doi.org/10.1007/s00011-020-01362-w

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