Women with systemic lupus erythematosus (SLE) face fertility and pregnancy challenges. Commonly used chemotherapeutic agents for SLE, such as cyclophosphamide (CYC), can cause gonado-toxicity, premature ovarian failure, and abnormal levels of reproductive hormones in premenopausal women with SLE. By analyzing data from existing literature, this study provides evidence that gonadotropin-releasing hormone (GnRH) agonists have protective effects on ovarian function in lupus patients receiving CYC treatment.

What is exciting about this article?

For women with SLE, the likelihood of experiencing a flare-up is higher during pregnancy, which can lead to adverse pregnancy outcomes. CYC, used to treat SLE, can cause premature ovarian failure and decreased levels of reproductive hormones. Embryo and oocyte cryopreservation is a costly and time-consuming procedure and often results in a high rate of fetal and maternal complications in women with lupus. According to this meta-analysis, GnRH agonists are effective in protecting the ovaries and increasing the odds of pregnancy in SLE patients who receive CYC treatment, in a noninvasive and relatively safe manner. In addition to determining the effectiveness and side effects of GnRH agonists in a large population of patients with SLE and other autoimmune conditions, this study indicates that more clinical trials with GnRH agonists might be needed.

How does this fit into the larger NIAMS portfolio?

This report suggests that GnRH agonists are effective in protecting the ovaries and increasing the possibility of pregnancy among premenopausal SLE females who are treated with CYC.

Grant support


Research Areas:

Autoimmunity Clinical Research Immunology


Use of gonadotropin-releasing hormone agonists for ovarian preservation in patients receiving cyclophosphamide for systemic lupus erythematosus: A meta-analysis.

Ejaz K, Abid D, Juneau P, Chu J, Hasni S
2022 Dec;
doi: 10.1177/09612033221128740
PMID: 36148853

Research reported in this publication was supported by the Intramural Research Program of the NIHʼs National Institute of Arthritis and Musculoskeletal and Skin Diseases.