Reviews
Assessment of fertility and sexual dysfunction in women with systemic sclerosis: a narrative review of the literature
C. Mandosi1, C. Galli2, V. Matys3, C. Di Dio4, M. Briante5, V. Riccieri6, R. Priori7, M.G. Piccioni8
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy. viviana.matys@uniroma1.it
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
- Rheumatology, Azienda Ospedaliera Universitaria Policlinico Umberto I, Sapienza University of Rome, Italy.
- Rheumatology, Azienda Ospedaliera Universitaria Policlinico Umberto I, Sapienza University of Rome, and UniCamillus, Saint Camillus International University of Health Sciences, Roma, Italy.
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
CER17563
2024 Vol.42, N°8
PI 1690, PF 1698
Reviews
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PMID: 39152748 [PubMed]
Received: 16/02/2024
Accepted : 10/06/2024
In Press: 14/08/2024
Published: 14/08/2024
Abstract
OBJECTIVES:
The aim of this work is to review the existing literature regarding sexual and reproductive function of women affected by systemic sclerosis and to establish the impact of the disease on the gynaecological-obstetrical field.
METHODS:
A systematic search has been conducted by means of PubMed, Cochrane, Google Scholar, until January 2024 by the keywords ‘‘systemic sclerosis’’, ‘‘fertility’’, “sexual dysfunction” and “pregnancy”.
RESULTS:
Sexual dysfunction has been described in most of the studies. This could be related to dryness and dyspareunia, but also to the psychosocial impact of SSc on body and facial appearance, which impacts on social and sexual relationships. There is conflicting evidence regarding the influence of SSc and fertility. Before the 1980s pregnancies in these patients were rare. This could be linked to the satisfied reproductive desire before the onset of SSc, or to the fact that pregnancy was labelled as high-risk, leading to counsel against it in most patients. Recently, the evidence supporting infertility is conflicting. There is no certain theory on how the disease may interfere with reproductive function, but a possible linkage can be detected in a pro-inflammatory milieu which can impair the ovarian reserve.
CONCLUSIONS:
Women affected by SSc should be followed-up by a multidisciplinary team to prevent sexual dysfunction. Although there is no consensus on the impact of SSc on fertility, these patients should be provided with adequate pre-conceptional counselling and a strict follow-up in high-risk pregnancy units.
