Pos0878 Infertility and the Chance of Successful Assisted Reproduction Treatments in Childbearing Women With Rheumatic Diseases

Background: As the age of childbirth increases, there is a growing interest in infertility and assisted reproductive treatments (ART). Due to the high incidence of rheumatic diseases during the childbearing age, they can affect infertility and related medical procedures. However, there are no reported data on infertility and ART in Korean women of childbearing age with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Objectives: We examined the rate of infertility and the success rate of pregnancy and delivery after ART among Korean women of childbearing age with rheumatic diseases and the general population. Methods: We extracted patients with SLE and RA and their control groups, 5-fold matched by age, among 11,110,359 women of childbearing age (20-49 years) from the National Health Insurance Service (NHIS) data (2011-2021). Since insurance reimbursement for infertility procedures has been applied since September 2017, people diagnosed with infertility from 2018 to 2021 were identified. Infertility was defined as a case when ART procedures such as artificial fertilization (Z31) or in vitro fertilization (Z312) were performed with an infertility code (N97). We compared the pregnancy and childbirth success rates in each after receiving ART between SLE, RA and controls. In addition, factors for successful pregnancy and childbirth in the disease groups were analyzed. Results: Among 9,977 SLE patients and 49,073 controls, 93 (0.93%) and 416 (0.85%), respectively, were diagnosed with infertility with no significant difference in infertility rate. Among 23,802 RA patients and 116,986 controls, the infertility rate in the RA group was higher at 172 (0.72%) than in the general population of 660 (0.56%) (p=0.004). There was no significant difference in pregnancy and childbirth success rates after ART between SLE patients and the control group (32.24%, 11.84% vs. 35.35%, 11.84, p=0.36, 0.12). The pregnancy and delivery success rates were also comparable between RA patients and the control, with no significant difference observed (31.72% and 16.22% versus 30.63% and 13.32%, respectively; p=0.67 and 0.13). The likelihood of successful pregnancy was higher when accompanied by diabetes (Odd ratio (OR) 2.09, 95% CI 1.04-4.19) and antiphospholipid syndrome (OR 2.43, 95% CI 1.21-4.91) in patients with SLE. In patients with RA, the odds for a successful pregnancy (OR 0.89, 95% CI 0.84-0.95) and delivery (OR 0.89, 95% CI 0.82-0.97) were lower with aging. Conclusion: Although the infertility rate was found to be higher in RA patients than in the general population, the pregnancy and birth rates after ART in SLE and RA patients did not show much difference compared to the general population. Therefore, women of childbearing age with RD could actively try ART for pregnancy and childbirth if desired. REFERENCES: NIL.. Acknowledgements: NIL.. Disclosure of Interests: None declared.