In Vitro Fertilization (IVF), Fertility, and Lupus

Fertility problems are common. Some women turn to in vitro fertilization to help get pregnant. While effective, it can add additional challenges for Lupus Warriors.

In vitro fertilization, or IVF, is a type of fertility treatment that uses hormone treatments. It works like this:

1. Hormone treatments cause ovulation from the ovaries
   • Ovulation is the release of mature eggs
2. A clinician removes the eggs from the woman’s body
3. The healthiest sperm extracted from a sperm sample
4. Eggs joined with sperm under laboratory conditions to make a zygote
   • Zygotes are the earliest stage of a human embryo
5. Zygotes inserted into the woman’s uterus
6. The woman receives hormone therapy that help start the the pregnancy

You can find out more about the process on Planned Parenthood’s website, here.

However, the success rates of IVF and other fertility are low. Multiple rounds of treatment are not uncommon. You should be aware of the risks that multiple rounds of IVF-related hormones can pose for people with lupus. 

What are the risks of in vitro fertilization for people with lupus?

IVF and lupus have a complicated relationship.

Hormonal changes in the body are notorious for causing problems for people with autoimmune diseases like systemic lupus (SLE.) This is why some people with lupus are careful about what contraceptives they use. Spikes in hormone levels from, say, a birth control pill may induce symptom flares. Thrombosis (life-threatening blood clots) has also been reported. You can read more about clot risks for people with lupus here.

IVF has been researched for the risk for causing disease flares because of its use of hormone therapy.

37 women with lupus (SLE) or antiphospholipid syndrome participated in a 2017 study published in the Journal of Rheumatology. 97 IVF procedures occurred during the study. The procedures resulted in 27 pregnancies. From those pregnancies, there were:

• 23 live births from 26 neonates (3 twin pregnancies)
• 2 miscarriages
• 2 terminations for trisomy 13 and 21

6 spontaneous pregnancies occurred during follow-up. In total, 26 of the 37 women delivered at least 1 healthy child.

Exploring the risks of IVF

The researchers noted that “complications occurred in or after 8 IVF cycles.” During the pregnancies, 4 people experienced lupus flares and 4 others experienced major thrombotic events. Also reported were 6 mild SLE and 1 deep-vein thrombosis. 

37% of the infants were pre-term (early) births, 15% had HELLP, and 7% had preeclampsia, a serious condition that can hurt both mother and child.

Rheumatology Advisor highlighted two challenges of this study:

• A relatively small sample size
• 15 procedures used Oocyte donation cycles. This type of procedure involved a milder stimulation protocol

A separate 2000 study found that neonatal lupus, a form of lupus that appears in newborns, was also sometimes reported.

IVF, pregnancy, & lupus

There is always a risk of complications with pregnancy, and lupus can add to those risks. Check out this article on pregnancy and lupus to learn more about those risks.

IVF success rates are good, but people with lupus have a slightly higher risk of complications according to the research. However, people with lupus can reduce this risk by sticking to their treatment plan.

In a study published in 2013, the researchers ruled that several symptom flares were not linked to IVF therapy at all. Failure to adhere to medication treatment plans and prescribed diets caused the symptom flares and thrombosis, according to the clinicians and researchers.

If you choose to undergo IVF, be sure to add all clinicians to your lupus and health treatment team. It will be important to continue consistently monitoring your health. You should also discuss any personal risks with your lupus treatment team.