Characterization of the profiles of patients’ requiring rheumatological consultation before of assisted reproduction techniques in real-world clinical practice: data from a tertiary rheumatology centre

ABSTRACT

Objective. Infertility is a growing concern, particularly among women with autoimmune diseases, where immune system dysregulation may contribute to both infertility and the development of autoimmune conditions. Assisted reproductive technologies (ART) offer potential solutions for these women, but their impact on autoimmune disease progression remains to be investigated more largely. This study aimed to explore the immunological profiles and previous ART outcomes in women seeking rheumatological consultation prior to ART.

Materials and Methods. We analysed data from 80 women attending the Rheumatology Unit of the University of Naples Federico II for pre-ART counselling between January and June 2024.

Results. The cohort displayed a high prevalence of autoimmune conditions, including systemic lupus erythematosus (SLE, 23.8%), and significant immunological abnormalities, such as positive antinuclear antibodies (ANA) in 31.3% of patients. Despite a history of previous ART failures and pregnancy losses, most of these patients were on disease-modifying treatments, including biologic DMARDs.

Conclusions. Our findings underscore the importance of integrating rheumatological evaluation into pre-ART counselling to optimize reproductive outcomes. A multidisciplinary approach, including collaboration between rheumatologists and fertility specialists, is crucial for mitigating risks and ensuring both maternal and fetal health. Further prospective studies are needed to clarify the effects of autoimmune profiles and treatments on ART success rates and long-term pregnancy outcomes.

Key words
ART; rheumatology; lupus; SLE; pregnancy.