The Effects of Medications Used in the Treatment of Rheumatological Diseases on Pregnancy and Fertilization: A Single-center Experience

Objective: Considering that the group of rheumatological patients generally consists of women in their reproductive period due to hormonal effects, we aimed to investigate the effects of the treatments given to prevent joint and organ damage caused by these diseases on pregnancy and fertilization. Methods: This study included 1,000 female patients who were followed up due to rheumatological diseases at the rheumatology department of the internal medicine department of our hospital between January 2014 and January 2021. The patients’ ages, rheumatological disease diagnoses, pregnancy status, abortion status, curettage status, medications used, medications used during pregnancy, pregnancy complications, infertility data were retrospectively analyzed. Results: The number of patients who became pregnant after diagnosis increased with the use of colchicine and anakinra, while it decreased with the use of methotrexate and leflunomide. It was observed that the number of abortions before diagnosis increased in the presence of antiphospholipid antibody syndrome (APS) and systemic lupus erythematosus. It was determined that the number of patients giving live births decreased in the presence of an APS diagnosis. It was determined that the number of patients who had live births with the use of colchicine and hydroxychloroquine during pregnancy increased. Conclusion: It should be considered that women of reproductive age with rheumatic diseases may desire pregnancy and may present to the clinic with either planned or unplanned pregnancies during their follow-ups, and accordingly, efforts should be made to avoid medications that could cause infertility as much as possible.