Fertility and course of pregnancy in chronic liver disease

Chronic liver diseases may affect fertility and pregnancy because of metabolic and hormonal changes. Cirrhosis decreases fertility and increases the risk of maternal and perinatal complications. Metabolic dysfunction-associated steatotic liver disease is often associated with polycystic ovary syndrome and insulin resistance, which reduces fertility and increases the risk of gestational complications. Women with chronic viral hepatitis B and hepatitis C and autoimmune liver diseases have normal fertility; however, there is an increased risk of gestational implications, as argued in this review.