POS0716 FACTORS ASSOCIATED WITH FERTILITY OUTCOMES IN WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A SYSTEMATIC REVIEW

Background: Fertility is thought to be not reduced in women affected by systemic lupus erythematosus (SLE), however disease-related factors, psychosocial effects of chronic disease as well medication exposure might impair gonadal function. Objectives: The aim this systematic review was explore clinical, hormonal, serological, instrumental and management factors associated with fertility outcomes childbearing age SLE. Methods: This conducted following the Preferred Reporting Items for reviews Meta-analysis (PRISMA) statement. All articles available English, published from 1972 15th August 2020 Pubmed, EMBASE, Scopus Cochrane Library. Study selection data collection were performed two independent reviewers. extracted using a standardized template. Risk bias included studies assessed NIH risk-of-bias tool [1]. Results: Of 788 abstracts, we 45 which 1 literature reviews, 16 cross-sectional studies, 15 cohort 12 observational case-series study, total 4656 patients. mean 33.5 ± 5.4 years, while duration 97.4 65.2 months. Figure illustrates quality studies. Definitions fertility/premature ovarian failure (POF) adopted varied terms number months amenorrhea considered. Most did use hormonally based definition fertility. Clinical development POF older at time initiation therapy onset SLE disease. Cyclophosphamide (CYC) its cumulative dose influenced function women, leading amenorrhoea failure, reported 19 Mycophenolate, azathioprine, calcineurin inhibitors steroids seem lower risk compared CYC. 3 demonstrated that more frequent patients treated CYC receiving gonadotropin-releasing hormone analogues (GnRH) comparison those co-treated GnRH. 11 evaluated impact damage activity on reserve conflicting evidence. Finally, 18 investigated hormonal serological able influence outcomes; among others nor Anti-Müllerian Hormone, neither anti-corpus luteum antibodies POF. Conclusion: role contradictory. Regarding age, strongest evidence about treatment dose. Hormonal outcome but used surrogate fertility, especially after disease-specific drugs. References: [1]Study Quality Assessment Tools NIH. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools . [2]Andreoli L. et al. EULAR recommendations women’s health family planning, assisted reproduction, pregnancy menopause and/or antiphospholipid syndrome. Ann Rheum Dis. 2017; 76: 476–485. Disclosure Interests: None declared