Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
Rheumatology, Azienda Ospedaliera Universitaria Policlinico Umberto I, Sapienza University of Rome, Italy.
Clin Exp Rheumatol. 2024 Aug;42(8):1690-1698. doi: 10.55563/clinexprheumatol/en1u7r. Epub 2024 Aug 14.
The aim of this work is to review the existing literature regarding sexual and reproductive function of women affected by systemic sclerosis and to establish the impact of the disease on the gynaecological-obstetrical field.
A systematic search has been conducted by means of PubMed, Cochrane, Google Scholar, until January 2024 by the keywords ''systemic sclerosis'', ''fertility'', "sexual dysfunction" and "pregnancy".
Sexual dysfunction has been described in most of the studies. This could be related to dryness and dyspareunia, but also to the psychosocial impact of SSc on body and facial appearance, which impacts on social and sexual relationships. There is conflicting evidence regarding the influence of SSc and fertility. Before the 1980s pregnancies in these patients were rare. This could be linked to the satisfied reproductive desire before the onset of SSc, or to the fact that pregnancy was labelled as high-risk, leading to counsel against it in most patients. Recently, the evidence supporting infertility is conflicting. There is no certain theory on how the disease may interfere with reproductive function, but a possible linkage can be detected in a pro-inflammatory milieu which can impair the ovarian reserve.
Women affected by SSc should be followed-up by a multidisciplinary team to prevent sexual dysfunction. Although there is no consensus on the impact of SSc on fertility, these patients should be provided with adequate pre-conceptional counselling and a strict follow-up in high-risk pregnancy units.
本研究旨在回顾系统性硬化症女性患者的性与生殖功能的现有文献，并探讨该疾病对妇科-产科领域的影响。
通过PubMed、Cochrane、Google Scholar 等数据库，以“systemic sclerosis”“fertility”“sexual dysfunction”和“pregnancy”等关键词进行了系统性检索，检索时间截至 2024 年 1 月。
大多数研究都描述了系统性硬化症患者存在性功能障碍。这可能与干燥和性交困难有关，但也与系统性硬化症对身体和面部外观的心理社会影响有关，这会影响社交和性关系。关于系统性硬化症和生育能力的影响，证据存在争议。在 20 世纪 80 年代之前，这些患者的妊娠很少见。这可能与系统性硬化症发病前患者的生殖愿望得到满足有关，或者与妊娠被标记为高危，导致大多数患者不建议妊娠有关。最近，支持不孕的证据存在争议。目前尚不清楚该疾病如何干扰生殖功能，但在可能损害卵巢储备的促炎环境中可以发现潜在的联系。
应通过多学科团队对系统性硬化症女性患者进行随访，以预防性功能障碍。尽管关于系统性硬化症对生育能力的影响尚无共识，但应向这些患者提供充分的孕前咨询，并在高危妊娠单位进行严格随访。
