Fautrel B, Benhamou M
Service de rhumatologie, groupe hospitalier de la Pitié-Salpêtrière, université Paris-VI-Pierre-et-Marie-Curie, 83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
Gynecol Obstet Fertil. 2007 Sep;35(9):848-52. doi: 10.1016/j.gyobfe.2007.07.013. Epub 2007 Aug 17.
The desire of reproduction is a true challenge for the physicians in charge of patients with chronic inflammatory disorders such as rheumatoid arthritis or other connective tissue diseases. It requires: 1) the strict evaluation of the potential risks of flare of the rheumatic disease because of the pregnancy; 2) the assessment of risks on pregnancy outcome and fetus development; 3) the management of the different anti-rheumatic agents in order to maintain optimal control of disease activity and avoid any teratogenic problem. Besides this, it clearly appears that inflammatory rheumatic diseases may have an impact on patients' fertility, which may be explained by different mechanisms, physical, psychological, hormonal or immunological. Moreover, some treatments may directly affect fertility, which may justify specific managements in order to preserve gonadic functions.
对于负责治疗类风湿关节炎等慢性炎症性疾病或其他结缔组织疾病患者的医生来说,生育意愿是一个真正的挑战。这需要:1)严格评估妊娠导致风湿性疾病病情复发的潜在风险;2)评估对妊娠结局和胎儿发育的风险;3)管理不同的抗风湿药物,以维持疾病活动的最佳控制并避免任何致畸问题。除此之外,很明显炎症性风湿性疾病可能会对患者的生育能力产生影响,这可能由不同的机制来解释,包括身体、心理、激素或免疫方面的机制。此外,一些治疗可能会直接影响生育能力,这可能需要采取特定的管理措施以保护性腺功能。