RHEUMATOID ARTHRITIS AND FERTILITY:LITERATURE REVIEW

Abstract

Introduction. Rheumatoid arthritis is a chronic inflammatory autoimmune disease that leads to disability, which occurs in
women of predominantly childbearing age three times more often than men. Unfortunately, the issue of childbirth can be
associated not only with the activity of the disease, but also with the availability of comprehensive medical care and
knowledge of pharmacological treatment methods. Therefore, many women are struggling to find adequate information about
planning pregnancy, childbirth and lactation.
Availability and advanced choice of pharmacotherapy can maintain the optimal level of the disease before pregnancy
and improve physical condition in order to successfully overcome the problems, but require a detailed understanding of their
risks and safety during pregnancy and breastfeeding.
Aim: search and review relevant sources on fertility in patients with rheumatoid arthritis.

Search strategy: In order to select and summarize the sources, a search of the literature for 20 years of the PubMed
(MEDLINE) database was conducted by keywords. Criteria for inclusion: reports of randomized and cohort studies
conducted on large populations, reviews, as well as publications with well-formulated and statistically proven findings in
English language. Criteria for exclusion: articles describing isolated cases, summaries of reports, private messages and
newspaper publications, abstracts, personal messages.
Searching results: Review describes the various situational problems that rheumatologists face in assisting women of
the reproductive age group interested in creating a family. Modern evidence-based solutions are being reviewed,
emphasizing the safe use of antirheumatic disease modifying agents and biological response modifiers to assist
rheumatologists in caring for pregnant and lactating women with RA.
Conclusion: Unfortunately, the issue of fertility in patients with RA is relatively insufficiently explored. At the same time,
women with RA have a higher risk of adverse pregnancy outcomes, and, therefore, it is necessary to carry out careful
prenatal and postnatal monitoring in order to reduce complications. Pregnancy should be preceded by careful planning,
taking into account pharmacotherapy and complete clinical remission of rheumatoid arthritis.
Further research is needed to examine data regarding the severity of the disease, the drugs used and the presence of
other concomitant diseases.