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Fertility Preservation for Patients with Autoimmune Diseases

Patients with cancer and those in need in of stem cell treatments often risk losing their fertility in exchange for a clean bill of health. Fertility preservation options give these patients the ability to have children. Additional patients, such as those with autoimmune diseases, can also benefit from fertility preservation.

Many people develop autoimmune diseases, such as rheumatoid arthritis, systemic lupus erethematosus, and sclerodoma, before or during their childbearing years. These diseases may inherently affect fertility or require treatments that inhibit reproductive ability. A variety of treatments, such as nonsteroidal antinflammatory drugs (NSAIDs) and chemotherapeutic agents can cause decreased sperm counts or affect the functioning of the ovaries.

As many of 80% of women with systemic lupus erethematosus, or lupus, who are treated with the alkylating chemotherapeutic agent called cyclophosphamide, experience at least a year without any periods, called amenorrhea. Another treatment for lupus, MMF, short for mycophenolate mofetil, may help women with less severe forms of the disease and who would like to preserve their fertility. Even women who do not initially lose ovarian function, indicated by amenorrhea, may still be at risk for early menopause and should be aware of this risk.

So what factors make people more or less likely to lose fertility from autoimmune diseases? Age, dose of treatment, and the inherited genetics of a patient all play a role. Prior to treatment, men may want to proceed with sperm banking. Women can undergo hormone stimulation to release multiple eggs that can either be immediately cryopreserved, or fertilized and then cryopreserved. Unfortunately, hormones may aggravate autoimmune diseases so women should also consider ovarian tissue cryopreservation. People who are interested in learning more about their fertility and autoimmune diseases should contact their doctor or call the FERTLINE.

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