Family Planning and Rheumatoid Arthritis

Patients with rheumatoid arthritis (RA) need tailored guidance when it comes to family planning decisions, including contraception, pregnancy, and breastfeeding. To achieve the best reproductive health outcomes, a coordinated, multidisciplinary approach is essential. This article aims to support healthcare providers in addressing key reproductive health concerns for both male and female patients, such as timing conception, infertility, and the management of RA medications during pregnancy and lactation.

Some women with RA may experience subfertility, however assisted reproductive technology is a safe option. RA disease activity may change for some women during pregnancy, but this is influenced by disease activity going into pregnancy and medication use in pregnancy. Pregnancy complications are more common among women with RA compared to the general population, which may be explained, in part, by disease activity, extra-articular manifestations of RA, and/or use of certain medications. Neonates exposed to biologic medications in utero can receive all recommended vaccinations. Contraception, including emergency contraception, is safe for women with RA. Preliminary data suggests pregnancy termination is safe in women with RA and does not increase the risk for disease flare.

RA is a chronic inflammatory disease that can impact both women and men during their reproductive years. Rheumatologists have an essential role in patient’s reproductive health and family planning. This article highlights key considerations and offers strategies to assist providers in understanding and supporting their patients' reproductive goals.