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Observational Study
. 2025 Apr;132(5):614-624.
doi: 10.1111/1471-0528.18050. Epub 2024 Dec 19.

Safety of Fertility Treatments in Women With Systemic Lupus Erythematosus: Data From a Prospective Population-Based Study

Amandine Dernoncourt  1 , Gaëlle Guettrot-Imbert  2 , Loïc Sentilhes  3 , Marie Charlotte Besse  4 , Anna Molto  5 , Viviane Queyrel-Moranne  6 , Maelle Le Besnerais  7 , Estibaliz Lazaro  8 , Nathalie Tieulié  6 , Christophe Richez  9 , Eric Hachulla  10 , Françoise Sarrot-Reynauld  11 , Gaëlle Leroux  12 , Pauline Orquevaux  13 , Jonathan London  14 , Laurent Sailler  15 , Odile Souchaud-Debouverie  16 , Perrine Smets  17 , Bertrand Godeau  18 , Emmanuelle Pannier  19 , Anne Murarasu  4 , Alice Berezne  20 , Tiphaine Goulenok  21 , Nathalie Morel  2 , Luc Mouthon  2 , Pierre Duhaut  1 , Véronique Le Guern  2 , Nathalie Costedoat-Chalumeau  2 ; Gr2 Study Group
Collaborators, Affiliations
Observational Study

Safety of Fertility Treatments in Women With Systemic Lupus Erythematosus: Data From a Prospective Population-Based Study

Amandine Dernoncourt et al. BJOG. 2025 Apr.

Abstract

Objective: To assess safety of fertility treatments in women with systemic lupus erythematosus (SLE).

Design: Data from the multicentre French observational GR2 (Groupe de Recherche sur la Grossesse et les Maladies Rares) study (2014-ongoing).

Setting: Seventy-six centres in France.

Population: All pregnancies in women with SLE enrolled in the GR2 study, conceived before 1 August 2022, with available end-of-pregnancy data and known conception type, were included; that is, 577 spontaneous and 53 assisted pregnancies.

Methods: A comparative analysis of spontaneous and assisted pregnancies was conducted. Logistic regression was used to determine if fertility treatments were independently associated with live birth prognosis, adjusting for confounders (e.g., maternal age). Kaplan-Meier analysis compared cumulative incidences of disease flares and adverse pregnancy outcomes (APOs), with confounding factors adjusted using a Cox regression model.

Main outcome measures: Live birth, disease flares, and APOs.

Results: The mean age was older (35.8 vs. 32.3 years, p < 1 × 10-4), and twins were more frequent in assisted pregnancies (5/50, 10.0% vs. 20/554, 3.6%; p = 0.047). Lupus disease was clinically inactive at baseline in 51 (96.2%) assisted pregnancies (vs. n = 511, 89.6%; p = 0.15), with 35 of 45 (77.8%) having no chronic damage (vs. 448/513, 87.3%; p = 0.07). The live birth rate was similar between assisted and spontaneous pregnancies (n = 46, 86.8% vs. n = 505, 87.5%; p = 0.83), with no statistical difference in the incidence of lupus flares and APOs. These results remained consistent after adjusting for confounding factors.

Conclusions: Fertility treatments in women with mostly well-controlled SLE did not appear to increase risks of maternal and neonatal complications, supporting current recommendations. Trial Registration ClinicalTrials.gov identifier: NCT02450396.

Keywords: assisted; high‐risk; in vitro fertilisation; pregnancy; pregnancy outcome; reproductive techniques; systemic lupus erythematosus.

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References

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