The patient with systemic lupus erythematosus

Abstract

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of uncertain cause that can affect many organs of the body. Immunologic abnormalities, especially the production of a number of antinuclear antibodies, characterize the disease. The clinical course of SLE is highly variable. Long periods of remission may alternate with chronic or acute relapses. Women in the reproductive age group are particularly affected, and may suffer from multiple symptoms arising from inflammatory involvement that can affect almost every organ.1,2 The reported prevalence of SLE in the population is 40-50 cases per 100 000.1 Due to improved detection of mild disease, the incidence has increased in recent years.2Moreover, the impact of modern therapies on future fertility has been clarified. The effect of SLE treatment on subsequent fertility and improvements in the prognosis of SLE have led to an increase in the number of women with SLE presenting for infertility therapy. In this chapter, the potential risks of exacerbating the condition under fertility treatment, and the possible impact of SLE on in vitro fertilization (IVF) outcomes and subsequent pregnancy, are reviewed. Management options aimed at optimizing outcomes in this potentially difficult group of patients are proposed.