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Ovarian Function and Reproductive Outcomes of the Female Patients with Systemic Lupus Erythematosus and the Strategies to Preserve their Fertility | OMICS International | Abstract
ISSN: 2155-9899

Journal of Clinical & Cellular Immunology
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Review Article

Ovarian Function and Reproductive Outcomes of the Female Patients with Systemic Lupus Erythematosus and the Strategies to Preserve their Fertility

Ozgur Oktem1,2*, Elvin Aydin3 and Bulent Urman1,2
1Koc University, School of Medicine, Department of Obstetrics and Gynecology, Istanbul, Turkey
2American Hospital Women’s Health Center, Assisted Reproduction Unit, Comprehensive Cancer Care and Fertility Preservation Programs, Istanbul, Turkey
3American Hospital, Comprehensive Cancer Care Program Department of Psychology, Istanbul, Turkey
Corresponding Author : Ozgur Oktem MD
Department of Obstetrics and Gynecology
Koc University School of Medicine, Office MedZ1071
Rumelifeneri yolu 34450, Istanbul, Turkey
Tel: 902123381071, 905339553830
E-mail: [email protected]
Received March 14, 2014; Accepted May 28, 2014; Published June 04, 2014
Citation: Oktem O, Aydin E, Urman B (2014) Ovarian Function and Reproductive Outcomes of the Female Patients with Systemic Lupus Erythematosus and the Strategies to Preserve their Fertility. J Clin Cell Immunol 5:220. doi: 10.4172/2155-9899.1000220
Copyright: © 2014 Oktem O, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Systemic lupus erythematosus (SLE) is a chronic auto-immune systemic disease that mainly affects women at reproductive age. Unfortunately, reproductive function of the young female patients suffering from this disease is commonly compromised by different etiologies. First, ovarian reserve is diminished even in the presence of mild disease suggesting a direct impact of the disease itself on ovarian function possibly due to ovarian involvement in the form of autoimmune oophoritis. Second, SLE patients with severe manifestations of the disease are treated with alkylating chemotherapy agent cyclophosphamide. Cyclophosphamide and other drugs of alkylating category have the highest gonadotoxicity. Therefore SLE patients exposed to cyclophosphamide have a much higher risk of developing infertility and premature ovarian failure than do the counterparts who are treated with other less toxic treatments. Third, the functions of the hypothalamic pituitary ovarian axis are pertubed by chronic inflammatory state. And finally adverse pregnancy outcomes are more commonly observed in SLE patients such as fetal loss, preterm birth, intrauterine fetal growth restriction, preeclampsia-eclampsia and fetal congenital heart blocks. We aimed in this review article to provide an update on the ovarian function and other reproductive outcomes in SLE patients, and the current strategies to preserve their fertility in the lights of the most recent guidelines of fertility preservation.

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