Rheumatoid Arthritis in Vitro Fertilization
Many patients with RA (rheumatoid arthritis) are
women of childbearing age. Since three quarters of all RA patients
are female, reproductive issues are very much an important question
to answer when living with this common autoimmune disease. Men with
RA also have some fertility issues to be addressed.
Both women and men with RA may have impaired fertility as the result
of the disease itself as well as a reaction to certain medications.
Sexual activity may also be inhibited when the disease is active or
when joint or other organ damage is present. For these and other
reasons, persons with RA may be more likely to use assisted
reproductive technologies such as in vitro fertilization, also
called IVF.
IVF for human beings was first successful in England in 1978 with
the birth of a baby girl, Louise Brown. Dr. Edwards and Dr. Steptoe
developed a method the press dubbed “test tube babies” although the
process was actually done in a Petrie dish. Techniques have since
become more refined and now embryo created by fertilization outside
the body may be implanted as an almost routine procedure. When
antibodies are present, sperm can be washed and it is even possible
to isolate a single sperm and inject it directly into an egg.
Women with obstructed Fallopian tubes are among those for whom IVF
has made pregnancy possible, but it is also used for many other
reasons when conception has proved impossible the natural way. Sperm
may be frozen and saved by men who need to undergo chemotherapy or
radiation or who have vasectomies as a boon to male fertility as
well. Even the embryos can be frozen and stored for later
implantation.
Women with RA have overactive immune systems and have many problems
with all organs in the body, the reproductive system not being
spared. Since pregnancy means tolerating a “foreign body” with every
fetus, it is normal for the system to be suppressed during pregnancy
and women with RA may often have remissions during pregnancy. Since
many RA drugs are problematic in pregnancy, this is a good thing and
may allow for a medication “holiday” during pregnancy.
For some women, even those in remission when pregnancy is best
attempted, have difficulty conceiving naturally. For them, IVF
offers hope and a way to have a family despite the illness. IVF for
an RA patient requires close communication and cooperation between
the fertility specialist, the rheumatologist, and the patient to
best manage the drugs and the underlying disease. For women with RA,
IVF represents hope for a normal reproductive life as well as other
measures to lead a productive life despite chronic illness.
Resources
Infertility issues for those who may have RA:
www.articlesbase.com/health-articles/
First person experiences of mothers who have RA:
www.momswithra.com/
Autoimmune illnesses as a cause of infertility and IVF failure:
http://humrep.oxfordjournals.org/
General history of IVF:
www.ivf.com/ivffaq.html
General information about assisted reproductive techniques:
www.emedicinehealth.com/in_vitro_fertilization/article_em.htm