Abstract
In rheumatoid arthritis and any other chronic inflammatory rheumatism or autoimmune disease treated with immunosuppressants or immunomodulators, it is essential to consider the couple's desire to become pregnant and to ensure, at best in a pre-conception consultation, a modification of the treatments before any pregnancy to avoid being in a situation of exposed pregnancy (or paternity). Certain basic treatments for polyarthritis or immunosuppressants are clearly at risk, such as cyclophosphamide, for both women and men; they are prohibited or must have measures taken to protect gametes. Methotrexate and leflunomide are prohibited during pregnancy. Salazopyrine, hydroxychloroquine and azathioprine for the most common ones can be continued in women without concern. In men, salazopyrine may cause oligo-asthenospermia or reversible azoospermia. Breastfeeding is another situation where maternal exposure to csDMARD should be verified through the Teratogen Reference Centre (CRAT, Paris, equivalent to OTIS) site.
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