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

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

[Article in French]

Author information

1
Service de médecine interne, centre de compétence maladies auto-immunes et systémiques rares, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51092 Reims cedex, France.
2
Service de médecine interne, centre de compétence maladies auto-immunes et systémiques rares, Hôtel Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
3
Service de médecine interne, centre de référence maladies auto-immunes et systémiques rares, pôle médecine, université René-Descartes, hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France.
4
Service de gynécologie-obstétrique, hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France.
5
Service de gynécologie-obstétrique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
6
Service de médecine interne, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
7
Service de médecine interne, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France.
8
Service de médecine interne, centre de référence maladies auto-immunes et systémiques rares, pôle médecine, université René-Descartes, hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France. Electronic address: nathalie.costedoat@gmail.com.

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

PMID:
25217451
DOI:
10.1016/j.revmed.2014.08.004
[Indexed for MEDLINE]

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