Infertility affects millions of women worldwide, and recent research suggests that it may have long-term implications for autoimmune health. The study, "Association Between Infertility and Incident Onset of Systemic Autoimmune Rheumatic Disease After Childbirth: A Population-Based Cohort Study", published in the Annals of the Rheumatic Diseases, investigated whether women with a history of infertility are at an increased risk of developing SARDs (systemic autoimmune rheumatic disease), including Sjögren’s disease, rheumatoid arthritis and systemic lupus erythematosus, after giving birth.
Study Design
- Cohort: The study analyzed a large population-based cohort of women who had given birth between 2012-2021 in Ontario, Canada.
- Data Sources: Researchers utilized electronic health records, fertility treatment registries, and hospital databases to track infertility history and the development of autoimmune diseases postpartum.
- Comparison Groups: This study investigated whether infertility, with or without receipt of fertility treatment, is associated with SARD among women (18-50 years) who gave birth.
- Follow-Up Duration: Participants were monitored for an average of 6.5 years (4-9 years) post-childbirth to determine the onset of autoimmune diseases.
- Statistical Methods: Adjustments were made for potential confounding factors such as age, socioeconomic status, comorbidities, and pregnancy-related complications.
Key Findings
- Increased risk after childbirth: Women with a history of infertility were found to have a significantly higher incidence of developing SARDs postpartum compared to those without infertility. The risk was most pronounced within the first five years following childbirth.
- Persistence of risk: Even after adjusting for potential confounding factors, such as age, socioeconomic status, and pre-existing conditions, the risk remained elevated. This suggests that infertility itself, or associated treatments, may play a direct role in immune system alterations.
- Possible underlying mechanisms: Researchers suggest that immune system dysregulation, hormonal changes, and assisted reproductive technologies may contribute to the link between infertility and autoimmune disease onset. The physiological stress of infertility treatments, as well as pregnancy-related changes, may act as triggers for immune system disturbances.
These findings underscore the need for increased monitoring and early intervention for women with a history of infertility, particularly in the postpartum period. Healthcare providers should be aware of the potential autoimmune risks and consider routine screening for early signs of SARDs in this population. Greater awareness could lead to earlier diagnoses and improved management of autoimmune conditions, ultimately enhancing long-term health outcomes.
Further research is needed to explore whether specific infertility treatments or conditions contribute more significantly to autoimmune disease risk. Understanding the precise biological mechanisms at play could help develop targeted strategies for prevention and management in at-risk women.
Natalie V Scime, Maria P Velez, May Y Choi, Joel G Ray, Alexa Boblitz, Hilary K Brown, Association between infertility and incident onset of systemic autoimmune rheumatic disease after childbirth: a population-based cohort study, Human Reproduction, Volume 40, Issue 1, January 2025, Pages 157–166, https://doi.org/10.1093/humrep/deae253
