Subfertility in women with familial Mediterranean fever

The aim of this study was to examine the causes and different modalities used for management of subfertile patients with familial Mediterranean fever (FMF).

The study comprised of 74 infertile women with FMF. All patients were diagnosed as having FMF. All patients underwent a full infertility work-up. They were scheduled to expectant treatment, ovulation induction and timed intercourse, intrauterine insemination or intracytoplasmic sperm injection.

Anovulation was reported in 18 patients (24.32%). Anovulation was due to polycystic ovary syndrome in 12 (16.22%) cases and due to other causes in six patients (8.11%). Excessive clear peritoneal fluid was present in 56 (57.67%) and male-factor infertility was present in 14 couples (18.91%). Ovulation induction and timed intercourse was adopted for a maximum of six cycles and intrauterine insemination for three cycles. In vitro fertilization/intracytoplasmic sperm injection was needed in six cases using standard long agonist protocol. Twenty-six women became pregnant.

The causes of infertility in patients with FMF are not different from those expected in the general population. Treatment of the problem should be causal, adopting the conventional lines of treatment up to in vitro fertilization/intracytoplasmic sperm injection when appropriate. Colchicine is the treatment of choice and it is important to use it in its proper doses to control the disease.