Fertility disorder associated with undifferentiated connective tissue disease

Overview

In this article, we present the issue of pregnancy complications in patients with rheumatic diseases with a summary of the available literature. In the case report, we focus on the case of a patient with undifferentiated connective tissue disease (UCTD), who suffered from repeated spontaneous abortions in the first trimester of pregnancy, even with the use of assisted reproduction methods, without evidence of antiphospholipid syndrome or other genetic, anatomical or hormonal causes. From the literature, we find that the association of this and other complications of pregnancy, such as low birth weight, premature birth, preeclampsia, or even cesarean delivery, with chronic rheumatic inflammatory diseases, including UCTD, has been repeatedly described by many authors. In clinical practice, there is still a lack of experience in how to approach such patients, and the possibilities of therapy for these complications are limited. In the management of our patient, we consulted a currently ongoing randomized trial ILIFE (Immunosuppressants for LIving FEtuses), which aims to ascertain the effect of immunosuppressive therapy on the outcome of pregnancy in patients with UCTD suffering from repeated miscarriage. After starting a similar treatment protocol, our patient spontaneously became pregnant within 2 months of therapy initiation, and less than a year later, the patient gave birth to a healthy child.

Keywords:

complications of pregnancy in patients with a rheumatic disease – undifferentiated connective tissue disease – therapy of complications