Can I plan a pregnancy while managing rheumatoid arthritis?

Hello,

Welcome to icliniq.com.

Your worries are valid.

Such issues are quite frequent and significant for women with rheumatoid arthritis (RA) who plan to conceive. It is true that RA itself can affect the hormone levels and inflammation within the body. In some cases, this can lead to menstrual irregularities or painful periods.

On the other hand, drugs used for the treatment of rheumatoid arthritis can also be the culprit. Certain medicines used for treating rheumatoid arthritis, such as:

• Methotrexate.
• Leflunomide.
• Certain biologics.

These medicines must be stopped well before attempting to conceive because they can harm a developing baby. Others are generally considered compatible with pregnancy, such as:

• Hydroxychloroquine.
• Sulfasalazine.

Low-dose Prednisone can sometimes be used if needed, so the key step is planning pregnancy with both your rheumatologist and an obstetrician experienced in high-risk or autoimmune pregnancies.

The reassuring point is that many women with rheumatoid arthritis can have healthy pregnancies and healthy babies. In fact, about half of two-thirds of women notice that their arthritis symptoms improve during pregnancy. However, flare-ups can occur after delivery, so the postpartum period also requires proper planning and monitoring.

Having controlled diseases prior to conception is an extremely crucial factor in ensuring a successful pregnancy. Normally, the doctors advise patients to have low disease activity for at least three to six months before conceiving.

Concerning the ability to conceive, rheumatoid arthritis normally does not affect the ability to conceive. The inflammation, pain, tiredness, and medications are the factors that could make conception hard for rheumatoid arthritis patients. IVF treatment is considered safe for rheumatoid arthritis patients.

However, hormonal stimulation could, at times, cause the flare-up of the disease. If fertility treatment becomes necessary, close coordination between the fertility specialist and the rheumatology team helps keep the disease stable during treatment.

Studies have found that women who suffer from rheumatoid arthritis might go through menopause at an earlier age. This is not always true, however. Various things, including the extent to which the disease affects a woman, smoking, body weight, and the prolonged use of medication, can affect the process. Thus, it is something to be watched for.

For contraception purposes, the safest method will depend on how much one is at risk for developing blood clots, whether their disease is active, and their medication. Hormonal contraceptives that use progesterone only, like an intrauterine device or implant, are recommended since they do not significantly cause the formation of blood clots and rarely make the inflammation worse. Some women cannot use combined oral contraceptive pills because of increased chances of blood clots or autoimmune antibodies.

Among the other important next steps will include a thorough review of all medications, discontinue or change any drugs that are harmful to the pregnancy in advance, maintain control over the disease, and start on folic acid supplements. It is necessary to plan ahead for the process of conception, pregnancy, and postpartum stages in collaboration with the medical team.

I hope I have answered your query appropriately. You can always revert to me for any further clarifications at iCliniq.

Thankyou.