Decreased chance of a live born child in women with rheumatoid arthritis after assisted reproduction treatment

a nationwide cohort study

Bente Mertz Nørgård*, Michael Due Larsen, Sonia Friedman, Torben Knudsen, Jens Fedder

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

68 Downloads (Pure)

Abstract

OBJECTIVES: No studies have examined the efficacy of assisted reproductive technology (ART) treatment in women with rheumatoid arthritis. Therefore, we examined the chance of live birth after ART treatment in women with rheumatoid arthritis compared with women without rheumatoid arthritis.

METHODS: Our cohort study is based on nationwide Danish health registries, comprising all women with an embryo transfer during 1 January 1994 through 30 June 2017. The cohorts comprised 1149 embryo transfers in women with rheumatoid arthritis, and 198 941 embryo transfers in women without rheumatoid arthritis. Our outcome was live birth per embryo transfer, and we controlled for multiple covariates in the analyses. In subanalyses, we examined a chance of biochemical/clinical pregnancy after ART and a possible impact of corticosteroid use prior to embryo transfer.

RESULTS: The adjusted OR (aOR) for a live birth per embryo transfer in women with rheumatoid arthritis, relative to women without rheumatoid arthritis, was 0.78 (95% CI 0.65 to 0.92). The aORs for biochemical and clinical pregnancies were 0.81 (95% CI 0.68 to 0.95) and 0.82 (95% CI 0.59 to 1.15), respectively. Corticosteroid prescription prior to embryo transfer increased the OR for live birth (aOR=1.32 (95% CI 0.85 to 2.05)).

CONCLUSIONS: The chance of a live birth was significantly reduced in women with rheumatoid arthritis receiving ART treatment, relative to women without rheumatoid arthritis, and our result suggested that the problem was related to an impaired chance of embryo implantation. The role of corticosteroid use prior to embryo transfer must be a subject for further research.

Original languageEnglish
JournalAnnals of the Rheumatic Diseases
Volume78
Issue number3
Pages (from-to)328-334
ISSN0003-4967
DOIs
Publication statusPublished - Mar 2019

Fingerprint

Cohort Studies
Adrenal Cortex Hormones
Live Birth
Health
Prescriptions
Registries
Research

Keywords

  • assisted reproductive technology
  • clinical epidemiology
  • in vitro fertilisation
  • reproduction
  • rheumatoid arthritis

Cite this

@article{d416e85a8ce149b4a19b696d606c4bf0,
title = "Decreased chance of a live born child in women with rheumatoid arthritis after assisted reproduction treatment: a nationwide cohort study",
abstract = "OBJECTIVES: No studies have examined the efficacy of assisted reproductive technology (ART) treatment in women with rheumatoid arthritis. Therefore, we examined the chance of live birth after ART treatment in women with rheumatoid arthritis compared with women without rheumatoid arthritis.METHODS: Our cohort study is based on nationwide Danish health registries, comprising all women with an embryo transfer during 1 January 1994 through 30 June 2017. The cohorts comprised 1149 embryo transfers in women with rheumatoid arthritis, and 198 941 embryo transfers in women without rheumatoid arthritis. Our outcome was live birth per embryo transfer, and we controlled for multiple covariates in the analyses. In subanalyses, we examined a chance of biochemical/clinical pregnancy after ART and a possible impact of corticosteroid use prior to embryo transfer.RESULTS: The adjusted OR (aOR) for a live birth per embryo transfer in women with rheumatoid arthritis, relative to women without rheumatoid arthritis, was 0.78 (95{\%} CI 0.65 to 0.92). The aORs for biochemical and clinical pregnancies were 0.81 (95{\%} CI 0.68 to 0.95) and 0.82 (95{\%} CI 0.59 to 1.15), respectively. Corticosteroid prescription prior to embryo transfer increased the OR for live birth (aOR=1.32 (95{\%} CI 0.85 to 2.05)).CONCLUSIONS: The chance of a live birth was significantly reduced in women with rheumatoid arthritis receiving ART treatment, relative to women without rheumatoid arthritis, and our result suggested that the problem was related to an impaired chance of embryo implantation. The role of corticosteroid use prior to embryo transfer must be a subject for further research.",
keywords = "assisted reproductive technology, clinical epidemiology, in vitro fertilisation, reproduction, rheumatoid arthritis",
author = "N{\o}rg{\aa}rd, {Bente Mertz} and Larsen, {Michael Due} and Sonia Friedman and Torben Knudsen and Jens Fedder",
note = "{\circledC} Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2019",
month = "3",
doi = "10.1136/annrheumdis-2018-214619",
language = "English",
volume = "78",
pages = "328--334",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "B M J Group",
number = "3",

}

Decreased chance of a live born child in women with rheumatoid arthritis after assisted reproduction treatment : a nationwide cohort study. / Nørgård, Bente Mertz; Larsen, Michael Due; Friedman, Sonia; Knudsen, Torben; Fedder, Jens.

In: Annals of the Rheumatic Diseases, Vol. 78, No. 3, 03.2019, p. 328-334.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Decreased chance of a live born child in women with rheumatoid arthritis after assisted reproduction treatment

T2 - a nationwide cohort study

AU - Nørgård, Bente Mertz

AU - Larsen, Michael Due

AU - Friedman, Sonia

AU - Knudsen, Torben

AU - Fedder, Jens

N1 - © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019/3

Y1 - 2019/3

N2 - OBJECTIVES: No studies have examined the efficacy of assisted reproductive technology (ART) treatment in women with rheumatoid arthritis. Therefore, we examined the chance of live birth after ART treatment in women with rheumatoid arthritis compared with women without rheumatoid arthritis.METHODS: Our cohort study is based on nationwide Danish health registries, comprising all women with an embryo transfer during 1 January 1994 through 30 June 2017. The cohorts comprised 1149 embryo transfers in women with rheumatoid arthritis, and 198 941 embryo transfers in women without rheumatoid arthritis. Our outcome was live birth per embryo transfer, and we controlled for multiple covariates in the analyses. In subanalyses, we examined a chance of biochemical/clinical pregnancy after ART and a possible impact of corticosteroid use prior to embryo transfer.RESULTS: The adjusted OR (aOR) for a live birth per embryo transfer in women with rheumatoid arthritis, relative to women without rheumatoid arthritis, was 0.78 (95% CI 0.65 to 0.92). The aORs for biochemical and clinical pregnancies were 0.81 (95% CI 0.68 to 0.95) and 0.82 (95% CI 0.59 to 1.15), respectively. Corticosteroid prescription prior to embryo transfer increased the OR for live birth (aOR=1.32 (95% CI 0.85 to 2.05)).CONCLUSIONS: The chance of a live birth was significantly reduced in women with rheumatoid arthritis receiving ART treatment, relative to women without rheumatoid arthritis, and our result suggested that the problem was related to an impaired chance of embryo implantation. The role of corticosteroid use prior to embryo transfer must be a subject for further research.

AB - OBJECTIVES: No studies have examined the efficacy of assisted reproductive technology (ART) treatment in women with rheumatoid arthritis. Therefore, we examined the chance of live birth after ART treatment in women with rheumatoid arthritis compared with women without rheumatoid arthritis.METHODS: Our cohort study is based on nationwide Danish health registries, comprising all women with an embryo transfer during 1 January 1994 through 30 June 2017. The cohorts comprised 1149 embryo transfers in women with rheumatoid arthritis, and 198 941 embryo transfers in women without rheumatoid arthritis. Our outcome was live birth per embryo transfer, and we controlled for multiple covariates in the analyses. In subanalyses, we examined a chance of biochemical/clinical pregnancy after ART and a possible impact of corticosteroid use prior to embryo transfer.RESULTS: The adjusted OR (aOR) for a live birth per embryo transfer in women with rheumatoid arthritis, relative to women without rheumatoid arthritis, was 0.78 (95% CI 0.65 to 0.92). The aORs for biochemical and clinical pregnancies were 0.81 (95% CI 0.68 to 0.95) and 0.82 (95% CI 0.59 to 1.15), respectively. Corticosteroid prescription prior to embryo transfer increased the OR for live birth (aOR=1.32 (95% CI 0.85 to 2.05)).CONCLUSIONS: The chance of a live birth was significantly reduced in women with rheumatoid arthritis receiving ART treatment, relative to women without rheumatoid arthritis, and our result suggested that the problem was related to an impaired chance of embryo implantation. The role of corticosteroid use prior to embryo transfer must be a subject for further research.

KW - assisted reproductive technology

KW - clinical epidemiology

KW - in vitro fertilisation

KW - reproduction

KW - rheumatoid arthritis

U2 - 10.1136/annrheumdis-2018-214619

DO - 10.1136/annrheumdis-2018-214619

M3 - Journal article

VL - 78

SP - 328

EP - 334

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 3

ER -