[Assisted fertilization with at term pregnancies in two patients with severe rheumatoid arthritis while in treatment...

There are numerous reports of patients with rheumatoid arthritis (RA) who became pregnant while on treatment with etanercept. In spite of being formally contraindicated during pregnancy and lactation its discontinuation in cases of women with severe RA is no longer recommended since an increase in congenital malformations nor perinatal complications has not been reported. There are few data on the success or failure of pregnancies achieved by assisted fertilization in patients with RA treated with etanercept.

Two cases of severe RA under etanercept treatment and assisted fertilization are described.

After 4 failed attempts both patients became pregnant. They finally arrived at term without obstetric or perinatal complications. No congenital malformations nor infectious complications of the newborns occurred.

The risk-benefit profile of etanercept in severe RA patients has been changing with postmarketing surveillance. If there is clinical indication, the benefit of not stopping etanercept during assited fertilization and pregnancy should be .evaluated.