The evaluation of fertility, pregnancy and birth data in female Behçet’s patients
PDF
Cite
Share
Request
Original Article
P: 120-128
November 2023

The evaluation of fertility, pregnancy and birth data in female Behçet’s patients

J Turk Soc Rheumatol 2023;15(3):120-128
1. Akdeniz Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Antalya, Türkiye
2. Akdeniz Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Romatoloji Bilim Dalı, Antalya, Türkiye
No information available.
No information available
Received Date: 10.02.2023
Accepted Date: 16.06.2023
Publish Date: 27.11.2023
PDF
Cite
Share
Request

ABSTRACT

Objective:

Behçet’s disease (BD) is an inflammatory disease that also affects women of reproductive age, with mucocutaneous findings and systemic organ involvement. Like other inflammatory diseases, BH is likely to have effects on fertility. The aim of this study is to investigate the effects of BH on fertility, pregnancy and birth processes in women diagnosed with BD.

Methods:

Marriage, fertility and pregnancy histories of 274 female Behçet’s patients were evaluated retrospectively. Data of 563 pregnancies before (n=450) and after (n=113) diagnosis were analyzed.

Results:

The mean age of the patients included in the study was 39.8 years. Infertility rate was determined as 2.3% (n=5). The pregnancy rate with assisted reproductive techniques was 1.4% (n=3). The number of patients who had 3 and ≥4 pregnancies after the diagnosis of BD was statistically significantly less (p<0.001). The miscarriage rate, which was 24.8% before the diagnosis of BD, was 17.4% in the pregnancies after the diagnosis, the difference was not statistically significant. Intrauterine death (6.2% vs. 2.2%, p=0.027) and low birth weight infant rate (8.8% vs. 3.8%, p=0.024) were statistically significantly higher in pregnancies after BD diagnosis. Intrauterine death and fetal complications were associated with pre-pregnancy steroid use. The rate of cesarean section was found to be statistically significantly higher in pregnancies after diagnosis (p<0.001).

Conclusion:

In women with BD, it seems that the disease has no effect on fertility, but there is an increased risk for maternal and fetal complications.

Keywords:
Behçet’s disease, fertility, women

References

1
Akdeniz N, Elmas ÖF, Karadağ AS. Behçet syndrome: A great imitator. Clin Dermatol 2019;37:227-39.
2
Gül A. Genetics of Behçet’s disease: lessons learned from genomewide association studies. Curr Opin Rheumatol 2014;26:56-63.
3
Jadaon J, Shushan A, Ezra Y, Sela HY, Ozcan C, Rojansky N. Behçet’s disease and pregnancy. Acta Obstet Gynecol Scand 2005;84:939-44.
4
Gungor AN, Kalkan G, Oguz S, et al. Behcet disease and pregnancy. Clin Exp Obstet Gynecol 2014;41:617-9.
5
Marsal S, Falgá C, Simeon CP, Vilardell M, Bosch JA. Behçet’s disease and pregnancy relationship study. Br J Rheumatol 1997;36:234-8.
6
Orgul G, Aktoz F, Beksac MS. Behcet’s disease and pregnancy: what to expect? J Obstet Gynaecol 2018;38:185-8.
7
Erenel H, Davutoğlu EA, Özel A, Karslı F, Korkmaz SÖ, Madazlı R. Behçet Hastalığı ve Gebelik: 33 Olgunun Gebelik Sonuçları. Şişli Etfal Hastanesi Tıp Bülteni 2017;51:318-21.
8
Gilio M, Tramontano G, D’Angelo S, et al. FRI0252 Behcet’s Disease and Pregnancy: What is the Relationship? BMJ Publishing Group Ltd; 2015.
9
Uzun S, Alpsoy E, Durdu M, Akman A. The clinical course of Behçet’s disease in pregnancy: a retrospective analysis and review of the literature. J Dermatol 2003;30:499-502.
10
Criteria for diagnosis of Behçet’s disease. International Study Group for Behçet’s Disease. Lancet 1990;335:1078-80.
11
Hiz O, Ediz L, Gülcü E, Tekeoglu I. Effects of Behçet’s disease on sexual function and psychological status of male patients. J Sex Med 2011;8:1426-33.
12
Aksu K, Keser G, Günaydin G, et al. Erectile dysfunction in Behçet’s disease without neurological involvement: two case reports. Rheumatology (Oxford) 2000;39:1429-31.
13
Erdoğru T, Koçak T, Serdaroğlu P, Kadioğlu A, Tellaloğlu S. Evaluation and therapeutic approaches of voiding and erectile dysfunction in neurological Behçet’s syndrome. J Urol 1999;162:147-53.
14
Orem A, Vanizor B, Cimşit G, Kiran E, Değer O, Malkoç M. Decreased nitric oxide production in patients with Behçet’s disease. Dermatology 1999;198:33-6.
15
Koçak M, Başar MM, Vahapoğlu G, Mert HC, Güngör S. The effect of Behçet’s disease on sexual function and psychiatric status of premenopausal women. J Sex Med 2009;6:1341-8.
16
Taner E, Coşar B, Burhanoğlu S, Calikoğlu E, Onder M, Arikan Z. Depression and anxiety in patients with Behçet’s disease compared with that in patients with psoriasis. Int J Dermatol 2007;46:1118-24.
17
Uzunaslan D, Saygin C, Hatemi G, Tascilar K, Yazici H. No appreciable decrease in fertility in Behçet’s syndrome. Rheumatology (Oxford) 2014;53:828-33.
18
Şahin A, Karakuş S, Durmaz Y, Yildiz Ç, Aydin H, Cengİz AK. Ovarian reserve is preserved in Behçet’s disease. Int J Rheum Dis 2017;20:2070-6.
19
Mont’Alverne AR, Yamakami LY, Gonçalves CR, Baracat EC, Bonfá E, Silva CA. Diminished ovarian reserve in Behçet’s disease patients. Clin Rheumatol 2015;34:179-83.
20
Mizushima Y, Matsumura N, Mori M, et al. Colchicine in Behçet’s disease. Lancet 1977;2:1037.
21
Ferreira NR, Buoniconti A, Frota-Pessoa O. Colchicine therapy and aneuploid cells. Rev Bras Pesqui Med Biol 1973;6:141-8.
22
Shimoni Y, Shalev E. Pregnancy and complicated familial Mediterranean fever. Int J Gynaecol Obstet 1990;33:165-9.
23
Mijatovic V, Hompes PG, Wouters MG. Familial Mediterranean fever and its implications for fertility and pregnancy. Eur J Obstet Gynecol Reprod Biol 2003;108:171-6.
24
Sarica K, Süzer O, Gürler A, Baltaci S, Ozdiler E, Dinçel C. Urological evaluation of Behçet patients and the effect of colchicine on fertility. Eur Urol 1995;27:39-42.
25
Both T, van Laar JA, Bonte-Mineur F, van Hagen PM, van Daele PL. Colchicine heeft geen negatief effect op fertiliteit en zwangerschap [Colchicine has no negative effect on fertility and pregnancy]. Ned Tijdschr Geneeskd 2012;156:A4196.
26
Diav-Citrin O, Shechtman S, Schwartz V, et al. Pregnancy outcome after in utero exposure to colchicine. Am J Obstet Gynecol 2010;203:144.e1-6.
27
Noel N, Wechsler B, Nizard J, et al. Behçet’s disease and pregnancy. Arthritis Rheum 2013;65:2450-6.
28
Uhler ML, Hsu JW, Fisher SG, Zinaman MJ. The effect of nonsteroidal anti-inflammatory drugs on ovulation: a prospective, randomized clinical trial. Fertil Steril 2001;76:957-61.
29
Bata MS, Al-Ramahi M, Salhab AS, Gharaibeh MN, Schwartz J. Delay of ovulation by meloxicam in healthy cycling volunteers: A placebo-controlled, double-blind, crossover study. J Clin Pharmacol 2006;46:925-32.
30
Sussman A, Leonard JM. Psoriasis, methotrexate, and oligospermia. Arch Dermatol 1980;116:215-7.
31
Østensen M. New insights into sexual functioning and fertility in rheumatic diseases. Best Pract Res Clin Rheumatol 2004;18:219-32.
32
Lee S, Czuzoj-Shulman N, Abenhaim HA. Behcet’s disease and pregnancy: obstetrical and neonatal outcomes in a population-based cohort of 12 million births. J Perinat Med 2019;47:381-7.
33
Hwang I, Lee CK, Yoo B, Lee I. Necrotizing villitis and decidual vasculitis in the placentas of mothers with Behçet disease. Hum Pathol 2009;40:135-8.
34
Guzelian G, Norton ME. Behçet’s syndrome associated with intrauterine growth restriction: a case report and review of the literature. J Perinatol 1997;17:318-20.
35
Iskender C, Yasar O, Kaymak O, Yaman ST, Uygur D, Danisman N. Behçet’s disease and pregnancy: a retrospective analysis of course of disease and pregnancy outcome. J Obstet Gynaecol Res 2014;40:1598-602.
36
Farrag OA, Al-Suleiman SA, Bella H, Al-Omari H. Behçet disease in pregnancy. Wiley Online Library; 1987. p. 161-3.
37
Hurt WG, Cooke CL, Jordan WP, Bullock JP Jr, Rodriguez GE. Behçet’s syndrome associated with pregnancy. Obstet Gynecol 1979;53(3 Suppl):31S-33S.
38
Bismuth E, Hadengue A, Hammel P, Benhamou JP. Hepatic vein thrombosis in Behçet’s disease. Hepatology 1990;11:969-74.
39
Wechsler B, Généreau T, Biousse V, et al. Pregnancy complicated by cerebral venous thrombosis in Behçet’s disease. Am J Obstet Gynecol 1995;173:1627-9.