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Erschienen in: Clinical Rheumatology 12/2014

01.12.2014 | Original Article

Fertility, ovarian failure, and pregnancy outcome in SLE patients treated with intravenous cyclophosphamide in Saudi Arabia

verfasst von: Abdurhman Saud Alarfaj, Najma Khalil

Erschienen in: Clinical Rheumatology | Ausgabe 12/2014

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Abstract

Intravenous cyclophosphamide (IV CYC) has been and still used for treatment of severe manifestations of systemic lupus erythematosus (SLE), a disease occurring predominantly in women. IV CYC has been shown to predispose patients to ovarian failure and adverse pregnancy outcomes. We studied the impact of prior IV CYC treatment on ovarian function and pregnancy in our SLE patients, in terms of amenorrhea, fertility, and pregnancy outcome over a 26-year period. The study included 535 women (319 married), out of which 188 received IV CYC and 347 did not. Sixty-one patients experienced amenorrhea; the rate of amenorrhea in IV CYC user group (28.2 %; n = 53) was significantly higher than that in non-IV CYC group (3.7 %; n = 8) (P < 0.05). The type of amenorrhea was assessed in 99 women receiving IV CYC. Thirty-four (34.3 %) of them developed amenorrhea which was transient in 21 (21.2 %) and sustained in 13 (13.1 %) women. The older age at the time of receiving IV CYC and its higher cumulative dose were found to be risk factors for amenorrhea. Among married women, 48 of 99 (48.5 %) in IV CYC group conceived 90 pregnancies and 128 of 220 (58.2 %) in non-IV CYC group conceived 293 pregnancies. The rates of abortions, fetal loss, and live births between the two groups were similar; however, women with prior IV CYC had significantly more preterm births. Prior IV CYC was no barrier to conception; pregnancy outcome was favorable but associated with amenorrhea and preterm deliveries.
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Metadaten
Titel
Fertility, ovarian failure, and pregnancy outcome in SLE patients treated with intravenous cyclophosphamide in Saudi Arabia
verfasst von
Abdurhman Saud Alarfaj
Najma Khalil
Publikationsdatum
01.12.2014
Verlag
Springer London
Erschienen in
Clinical Rheumatology / Ausgabe 12/2014
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-014-2686-z

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