Does APS Impact Women's Fertility?

This review focuses on the relationship between anti-phospholipid antibodies (aPL) and female infertility by addressing three key questions: (i) how can aPL induce women's infertility?; (ii) are aPL more prevalent among infertile than fertile women?; (iii) do aPL-positive women display reduced fertility?

According to experimental data, aPL impair female fertility interfering with endometrial decidualization thus with implantation. Some aPL tests are more frequently detected among infertile women compared to controls; the association between aPL and assisted reproduction techniques outcome is not supported by most studies. Two reports suggest a decreased ovarian reserve among aPL-positive patients, while fertility is preserved in women with systemic lupus erythematosus, commonly associated with aPL positivity. Pregnancy rates drop after diagnosis and lupus women have fewer children than wished, due to many disease-related factors. While awaiting definitive conclusions on the relationship between aPL and infertility, rheumatologists should properly counsel female patients to safeguard fertility.