In Vitro Fertilization in 37 Women with Systemic Lupus Erythematosus or Antiphospholipid Syndrome: A Series of 97 Procedures

Pauline Orquevaux^{1

2}, Agathe Masseau^{1

2}, Véronique Le Guern^{1

2}, Vanessa Gayet^{1

2}, Danièle Vauthier^{1

2}, Gaelle Guettrot-Imbert^{1

2}, Du Le Thi Huong^{1

2}, Bertrand Wechsler^{1

2}, Nathalie Morel^{1

2}, Patrice Cacoub^{1

2}, Jean-Loup Pennaforte^{1

2}, Jean-Charles Piette^{1

2}, Nathalie Costedoat-Chalumeau^{3

4}

Affiliations

¹ From the Centre de compétence de maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Robert Debré, Centre Hospitalier Universitaire (CHU), Reims Cedex; Service de médecine interne, CHU, Nantes; Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; Service de gynécologie-obstétrique, Hôpital Cochin, AP-HP; Service de gynécologie-obstétrique, Groupe Hospitalier Pitié Salpêtrière, AP-HP; Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); INSERM, UMR_S 959, F-75013; CNRS, FRE3632, F-75005; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France.
² P. Orquevaux, MD, Centre de compétence de maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Robert Debré, CHU; A. Masseau, MD, Service de médecine interne, CHU; V. Le Guern, MD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; V. Gayet, MD, Service de gynécologie-obstétrique, Hôpital Cochin, AP-HP; D. Vauthier, MD, Service de gynécologie-obstétrique, Groupe Hospitalier Pitié Salpêtrière, AP-HP; G. Guettrot-Imbert, MD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; D.L. Huong, MD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; B. Wechsler, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; N. Morel, MD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; P. Cacoub, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; J.L. Pennaforte, MD, PhD, Centre de compétence de maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Robert Debré, CHU; J.C. Piette, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; N. Costedoat-Chalumeau, MD, PhD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP.
³ From the Centre de compétence de maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Robert Debré, Centre Hospitalier Universitaire (CHU), Reims Cedex; Service de médecine interne, CHU, Nantes; Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; Service de gynécologie-obstétrique, Hôpital Cochin, AP-HP; Service de gynécologie-obstétrique, Groupe Hospitalier Pitié Salpêtrière, AP-HP; Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); INSERM, UMR_S 959, F-75013; CNRS, FRE3632, F-75005; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France. nathalie.costedoat@gmail.com.
⁴ P. Orquevaux, MD, Centre de compétence de maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Robert Debré, CHU; A. Masseau, MD, Service de médecine interne, CHU; V. Le Guern, MD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; V. Gayet, MD, Service de gynécologie-obstétrique, Hôpital Cochin, AP-HP; D. Vauthier, MD, Service de gynécologie-obstétrique, Groupe Hospitalier Pitié Salpêtrière, AP-HP; G. Guettrot-Imbert, MD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; D.L. Huong, MD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; B. Wechsler, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; N. Morel, MD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; P. Cacoub, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; J.L. Pennaforte, MD, PhD, Centre de compétence de maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Robert Debré, CHU; J.C. Piette, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; N. Costedoat-Chalumeau, MD, PhD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP. nathalie.costedoat@gmail.com.

PMID: 28089975
DOI: 10.3899/jrheum.160462

In Vitro Fertilization in 37 Women with Systemic Lupus Erythematosus or Antiphospholipid Syndrome: A Series of 97 Procedures

Pauline Orquevaux et al. J Rheumatol. 2017 May.

. 2017 May;44(5):613-618.

doi: 10.3899/jrheum.160462. Epub 2017 Jan 15.

Authors

Affiliations

¹ From the Centre de compétence de maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Robert Debré, Centre Hospitalier Universitaire (CHU), Reims Cedex; Service de médecine interne, CHU, Nantes; Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; Service de gynécologie-obstétrique, Hôpital Cochin, AP-HP; Service de gynécologie-obstétrique, Groupe Hospitalier Pitié Salpêtrière, AP-HP; Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); INSERM, UMR_S 959, F-75013; CNRS, FRE3632, F-75005; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France.
² P. Orquevaux, MD, Centre de compétence de maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Robert Debré, CHU; A. Masseau, MD, Service de médecine interne, CHU; V. Le Guern, MD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; V. Gayet, MD, Service de gynécologie-obstétrique, Hôpital Cochin, AP-HP; D. Vauthier, MD, Service de gynécologie-obstétrique, Groupe Hospitalier Pitié Salpêtrière, AP-HP; G. Guettrot-Imbert, MD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; D.L. Huong, MD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; B. Wechsler, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; N. Morel, MD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; P. Cacoub, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; J.L. Pennaforte, MD, PhD, Centre de compétence de maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Robert Debré, CHU; J.C. Piette, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; N. Costedoat-Chalumeau, MD, PhD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP.
³ From the Centre de compétence de maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Robert Debré, Centre Hospitalier Universitaire (CHU), Reims Cedex; Service de médecine interne, CHU, Nantes; Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; Service de gynécologie-obstétrique, Hôpital Cochin, AP-HP; Service de gynécologie-obstétrique, Groupe Hospitalier Pitié Salpêtrière, AP-HP; Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); INSERM, UMR_S 959, F-75013; CNRS, FRE3632, F-75005; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Paris, France. nathalie.costedoat@gmail.com.
⁴ P. Orquevaux, MD, Centre de compétence de maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Robert Debré, CHU; A. Masseau, MD, Service de médecine interne, CHU; V. Le Guern, MD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; V. Gayet, MD, Service de gynécologie-obstétrique, Hôpital Cochin, AP-HP; D. Vauthier, MD, Service de gynécologie-obstétrique, Groupe Hospitalier Pitié Salpêtrière, AP-HP; G. Guettrot-Imbert, MD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; D.L. Huong, MD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; B. Wechsler, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; N. Morel, MD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP; P. Cacoub, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; J.L. Pennaforte, MD, PhD, Centre de compétence de maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Robert Debré, CHU; J.C. Piette, MD, PhD, Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), and INSERM, UMR_S 959, F-75013, and CNRS, FRE3632, F-75005, and AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology; N. Costedoat-Chalumeau, MD, PhD, Université René Descartes Paris V, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, AP-HP. nathalie.costedoat@gmail.com.

PMID: 28089975
DOI: 10.3899/jrheum.160462

Abstract

Objective: To compile and assess data about complication and success rates for in vitro fertilization (IVF) of women with systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS). To date, such data are sparse.

Methods: This retrospective study described women with SLE and/or APS who have had at least 1 IVF cycle.

Results: Thirty-seven women with SLE (n = 23, including 8 with antiphospholipid antibodies), SLE with APS (n = 4), or primary APS (n = 10) underwent 97 IVF procedures. For 43% of cases, the infertility was female in origin, for 19% male, 14% mixed, and 24% unexplained. No women had premature ovarian insufficiency because of cyclophosphamide. Median age at IVF was 34 years (range 26-46). The median number of IVF cycles was 2.6 (1-8). Patients were treated with hydroxychloroquine (72%), steroids (70%), azathioprine (3%), aspirin (92%), and/or low molecular weight heparin (62%). There were 27 (28%) pregnancies, 23 live births among 26 neonates (3 twin pregnancies), 2 miscarriages, and 2 terminations for trisomy 13 and 21. Six spontaneous pregnancies occurred during the followup. Finally, 26 women (70%) delivered at least 1 healthy child. Complications occurred in or after 8 IVF cycles (8%): SLE flares in 4 (polyarthritis in 3 and lupus enteritis in 1) and thromboembolic events in 4 others. One SLE flare was the first sign of previously undiagnosed SLE. Poor treatment adherence was obvious in 2 other flares and 2 thromboses. No ovarian hyperstimulation syndrome was reported.

Conclusion: These preliminary results confirm that IVF can be safely and successfully performed in women with SLE and/or APS.

Keywords: ANTIPHOSPHOLIPID SYNDROME; ASSISTED REPRODUCTIVE TECHNOLOGY; IN VITRO FERTILIZATION; INFERTILITY; PREGNANCY; SYSTEMIC LUPUS ERYTHEMATOSUS.

PubMed Disclaimer

Comment in

Safety and Efficacy of in Vitro Fertilization in Women with Systemic Lupus Erythematosus and Antiphospholipid Syndrome.
Genest G, Laskin CA. Genest G, et al. J Rheumatol. 2017 May;44(5):547-549. doi: 10.3899/jrheum.170064. J Rheumatol. 2017. PMID: 28461516 No abstract available.

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- HighWire
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

In Vitro Fertilization in 37 Women with Systemic Lupus Erythematosus or Antiphospholipid Syndrome: A Series of 97 Procedures

Affiliations

In Vitro Fertilization in 37 Women with Systemic Lupus Erythematosus or Antiphospholipid Syndrome: A Series of 97 Procedures

Authors

Affiliations

Abstract

Comment in

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous