Lupus, infertility and pregnancy

Lupus is a chronic, autoimmune disease, which can damage any part of the body. While teenagers and men are sometimes diagnosed with lupus, women of child bearing age comprise the largest statistical group affected. Like all other autoimmune diseases, lupus "tricks" the body into thinking that it needs to defend itself against it's own healthy tissue and organs. This malfunction of the immune system creates an invasion of auto-antibodies, which attacks the immune system itself.

Common symptoms can include inflammation, joint and muscle pain, sensitivity to light or sun, debilitating fatigue, headaches, mouth and nose ulcers, weight and hair loss, and low grade fever. Some people will experience a rash that appears in a butterfly shape across the cheeks and the bridge of the nose.

Lupus is a chronic disease marked by flares - meaning that symptoms can flare up and worsen, and then go into remission, in an unpredictable pattern over the course of many years.

Most patients diagnosed with lupus will experience normal fertility, however, a common drug often utilized to treat the disease, marketed under the name Cytoxan, can reduce fertility potential in both men and women. Cytoxan can lower the sperm count and also reduce testicle size in men that have taken the drug for five years or longer. It is recommended that men freeze their sperm prior to beginning treatment with Cytoxan. In women, Cytoxan reduces fertility potential by speeding up the rate at which a woman's egg supply is depleted, thus pushing her into premature ovarian failure, or early is recommended that women with lupus only take Cytoxan when vital organs are involved, and/or corticosteroids aren't effective

Around 50% of all women who have lupus will be able to experience a healthy, normal pregnancy. However, pregnancy can often signal a flare up of symptoms and for women with this disease, every pregnancy should be categorized as high risk. This means that a high risk obstetrician who is well versed in lupus and its symptoms should be chosen to oversee your pregnancy. As with most high risk pregnancies, pro active behaviors, including frequent medical check ups and getting adequate rest will be extremely important.

Additional complications of pregnancy may include:

  • Miscarriage during the first trimester
  • Formation of blood clots during the second trimester that can interfere with the function of the placenta or cause miscarriage, caused by a lupus antibody known as antiphospholipid antibody.
  • Pre-term birth and low birth weight babies
  • High blood pressure, or preeclampsia

If you have lupus and are considering pregnancy, all of this may seem daunting. However, it is important to remember that women with lupus can, and do experience normal pregnancies and deliver healthy babies. The keys are timing and communication. If you are ready to get pregnant talk to your doctor, if possible. Your doctor will recommend against attempting conception during flare up times when your lupus is active. Discuss your current medication protocol as well as the medications that will be recommended for you during your pregnancy. Take care of yourself, and have hope for the future. With careful timing, most women with lupus will be able to become moms both safely, and successfully.

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