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Fertility and Lupus
R Swamy Venuturupalli, MD, FACR posted:
Fertility is usually normal in Lupus patients, however, several circumstances may affect fertility such as drugs, dialysis and disease activity.

If the disease is very active, patients can have irregular periods or none at all, as this is the body's reaction to stress. Once the disease is under sufficient control, menstrual regularity is restored. A third of patients have significant kidney disease, which often evolves into end-stage renal disease, which requires dialysis over a 10 year observation period. Dialysis is related to poor or no menstrual cycles. A successful kidney transplant would therefore restore regular periods. Furthermore, some chemotherapy drugs interfere with ovulation. Premature menopause is caused by Cyclophosphamide in upto half of the women in their 20's who take it for at least a year, and upto 80% of women who take it in their late 30's. Methotrexate, Azathioprine, Cyclosporine and nitrogen mustard are not related to loss of periods in women with Lupus. A few women need to be made hormonally "prepubertal" with leuprolide (Lupron) and need to take cyclophosphamide, which is akin to having their eggs removed and stored for use at a later date.

In terms of male fertility, men who take chemotherapy have decreased sperm counts. Sterility is uncommon. It's advisable for men to store (bank) their sperm before commencing treatment.
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