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Rheumatoid arthritis and pregnancy after assisted reproductive technology – case report

Problem: Compelling evidence suggests that an abnormally functioning maternal immune system often leads to poor reproductive performance. Failure of proper function of immunologic interaction during implantation has been implicated as a cause of recurrent miscarriage, late pregnancy fetal loss, IVF failure and infertility. Women with risk factors such as a positive personal or family history of autoimmune disorders such as rheumatoid arthritis, lupus erythematosis and hypothyroidism (Hashimoto’ s disease) need properly evaluation because immunologic problems may lead to implantation failure. The selective use of immunotherapy (heparin/aspirin, intravenous immunoglobulin G, corticosteroid therapy) has enabled to achieve successful pregnancies in-patients who had previously suffered repeated IVF failures. Disease therapy and drugs continue to be a concern in the first trimester and throughout pregnancy. Some drugs can cause birth defects, others can cause miscarriages. The greatest risk of these drugs comes later in pregnancy, when they may interfere with labor, affect amniotic fluid production or cause excessive bleeding during delivery. Method of study: We presented case report of 27 year old woman with iuvenile rheumatoid arthritis and infertility problems who gave healthy term birth after second IVF procedure in our institution. Conclusion: There are many risk for pregnancy in rheumatoid arthritis patient. Successful pregnancy is possible after assisted reproductive technology, also. Pregnancy surveillance needs multidisciplinary approach.

Rheumatoid arthritis; pregnancy; assisted reproductive technology; IVF

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