Читать книгу Assisted Reproduction Techniques - Группа авторов - Страница 87

Challenge: Infertility treatments in women with SLE with or without APS.

Background:

 SLE mainly affects young women during their childbearing years.

 aPL antibodies are present in around 40% of SLE women.

 Neither SLE nor APS are a cause of primary infertility.

 aPL antibodies are a risk factor for adverse events, vascular or obstetric.

 Increased risk of maternal complications (lupus flares, thrombosis) in women with SLE and/or APS undergoing ovarian stimulation.

Management options:

 Mild ovarian stimulation.

 Coadjuvant therapy (anticoagulation, corticosteroids, immunosuppressants) according to the individual risk profile

 Nonoral route administration of natural progesterone for luteal phase support and during pregnancy.

Prevention:

 Postpone pregnancy at least 6 months after a lupus flare.

 Avoid OHSS and multiple pregnancy.

 Strict pregnancy monitoring for the early identification of pregnancy complications related to placental insufficiency.