Page 51 - Fertility in Women with Rheumatoid Arthritis Vruchtbaarheid van vrouwen met reumatoïde artritis

Fertility diagnoses
Eight subfertile women (10%) had never visited a gynaecologist. Of the other 74
subfertile women, 65 women (88%) gave permission to collect data from their gynaecologist. For 64 women data was obtained, of whom 61 women received a
diagnosis for subfertility. The other 3 women became pregnant spontaneously before
the fertility work-up was completed. The 61 women with a diagnosis were compared
to the 21 subfertile women without available diagnosis, showing no signi cant
differences regarding age, reproductive history, or disease characteristics. More 3 women without available gynaecological les had ever used methotrexate (81%
versus 54%, p=0.030).
In the 61 women for whom a diagnosis for subfertility was available, subfertility was most often caused by unexplained subfertility (48% of known diagnoses), anovulation (28%) and semen abnormalities (16%) (table 2). In 2 women (3%) anovulation was due to primary ovarian insuf ciency (POI). In 5% of the couples there was both a female and a male cause for subfertility. For 8 of the 61 couples the gynaecologist did not report the result of a sperm analysis. Diagnoses in these women were: unexplained (n=2), vaginismus (n=1), anovulation (n=4) and endometriosis (n=1). For the 10 women for whom no gynaecology le was available, the self-reported diagnoses were: unexplained subfertility (n=4), tubal factor (n=2), anovulation (n=3, n=1 due to POI), and endometriosis (n=1) (table 2).
Of the women diagnosed by a gynaecologist (n=61), 56 (92%) had a subfertile episode in the PARA study, of whom 27 had unexplained subfertility and 14 had anovulation. When comparing women with unexplained subfertility to other subfertile RA patients, there was a signi cant difference in periconceptional NSAIDs use (48% vs 17%, p=0.013), which was also signi cant when self-reported diagnoses were included (NSAIDs use 45% vs 22%, p=0.046). None of the other associations, amongst which were disease activity and periconceptional prednisone use, were signi cant. Women with anovulation showed no statistically signi cant differences compared to ovulatory subfertile women.
Fertility treatments
The most frequently performed fertility treatments are summarized in table 3. Treatments were performed in 59 subfertile women (72%), which is 80% of the women who visited a gynaecologist for subfertility. In 41 women (50% of all subfertile women), fertility treatments resulted in at least one pregnancy, and in 28
Fertility in RA – fertility assessments
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