Causes and management of infertility in systemic lupus erythematosus

SLE is a multi-system, autoimmune condition that can influence both male and female fertility. Inability to conceive may be attributed to several factors that may act singly or in combination: (i) older age in patients with SLE compared with healthy controls; (ii) disease-related infertility; and (iii) infertility through gonadotoxic treatments. In addition, psychosocial factors related to the disease may lower fecundity and may be associated with apparent infertility. Many therapeutic avenues are open to counteract reproductive damage in the management of SLE and to assist conception once infertility is diagnosed. These treatments can include the administration of gonadotrophin-receptor hormone analogues while receiving CYC treatment, the use of assisted reproductive technologies, such as in vitro fertilization and psychosocial intervention to promote a healthier relationship with their partner. Knowledge of how these reproductive problems occur and its prevention/treatment in SLE patients should avert irreversible infertility as well as give hope to SLE patients with infertility.