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Familial Mediterranean fever: perspective on female fertility and disease course in pregnancy from a multicenter nationwide network

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Abstract

The aim of this study was to analyze the pregnancy process, especially the Familial Mediterranean fever (FMF) disease course and attack types during pregnancy, and to examine the relationship between disease-related factors and female infertility in FMF patients. The study, which was planned in a multicenter national network, included 643 female patients. 435 female patients who had regular sexual intercourse were questioned in terms of infertility. Pregnancy and delivery history, FMF disease severity and course during pregnancy were evaluated. The relationship between demographic and clinical findings, disease severity, genetic analysis results and infertility was investigated. 401 patients had at least 1 pregnancy and 34 patients were diagnosed with infertility. 154 patients had an attack during pregnancy. 61.6% of them reported that attacks during pregnancy were similar to those when they were not pregnant. The most common attack symptoms were fever, fatigue and abdominal pain-peritonitis (96%, 87%, and 83%, respectively) in the pregnancy period. The disease-onset age, disease activity score, gene mutation analyses, and regular colchicine use (> 90%) were similar between the fertile and infertile groups, while the frequency of previous appendectomy and alcohol consumption rates were higher in individuals with infertility. Our results indicated no significant change in the frequency and severity of attacks during pregnancy. The low rate of infertility (7.8%) in our patients was noted. It has been suggested that the risk of FMF-related infertility may not be as high as thought in patients who are followed up regularly and received colchicine.

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Patients did not provide consent for raw data sharing during the data collection.

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Funding

The study was not funded.

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey

    Fatma Gül Yurdakul

  2. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ministry of Health Ankara City Hospital, Yıldırım Beyazıt University, Ankara, Turkey

    Hatice Bodur

  3. Rheumatology Clinic, Department of Physical Medicine and Rehabilitation, Antalya Training and Research Hospital, Antalya, Turkey

    Hasan Fatih Çay & Ülkü Uçar

  4. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Yaşar Keskin & Ozan Volkan Yurdakul

  5. Department of Rheumatology, Aydın State Hospital, Aydin, Turkey

    Betül Sargın

  6. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey

    Gülcan Gürer

  7. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Erciyes University Faculty of Medicine, Kayseri, Turkey

    Mustafa Çalış & Hüseyin Kaplan

  8. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey

    Hülya Deveci

  9. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sakarya University, Sakarya, Turkey

    Yıldıray Aydın

  10. Department of Physical Medicine and Rehabilitation Rheumatology Clinic, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey

    Sami Hizmetli

  11. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakir, Turkey

    Remzi Çevik

  12. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Uşak University, Uşak, Turkey

    Ali Yavuz Karahan

  13. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ankara University, Ankara, Turkey

    Şebnem Ataman

  14. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey

    Mehmet Tuncay Duruöz

  15. Department of Physical Medicine and Rehabilitation Rheumatology Clinic, Faculty of Medicine, Karamanoğlu Mehmetbey University, Karaman, Turkey

    Hilal Ecesoy

  16. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Gazi University, Ankara, Turkey

    Zafer Günendi

  17. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey

    Murat Toprak

  18. Rheumatology Clinic, Kartal Dr. Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey

    Nesrin Şen

  19. Division of Rheumatology, Fatsa State Hospital, Fatsa/Ordu, Turkey

    Duygu Altıntaş

  20. Department of Physical Medicine and Rehabilitation, 19 Mayıs University Faculty of Medicine, Samsun, Turkey

    Ahmet Kıvanç Cengiz & Sertaç Ketenci

  21. Department of Physical Medicine and Rehabilitation Rheumatology Clinic, Cumhuriyet University Faculty of Medicine, Sivas, Turkey

    Gökhan Çağlayan

  22. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Akdeniz University Faculty of Medicine, Antalya, Turkey

    Ali Nail Demir & İlhan Sezer

  23. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Atatürk University, Erzurum, Turkey

    Meltem Alkan Melikoğlu

  24. Department of Physical Medicine and Rehabilitation Höxter, Asklepios Weserbergland Klinik, Höxter, Germany

    Mehmet Nayimoğlu

  25. Department of Physical Medicine and Rehabilitation, Division of Rheumatology and Immunology, Sakarya University Faculty of Medicine, Sakarya, Turkey

    Kemal Nas

  26. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey

    Banu Sarıfakıoğlu

Authors
  1. Fatma Gül Yurdakul
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  2. Hatice Bodur
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  3. Hasan Fatih Çay
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  4. Ülkü Uçar
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  5. Yaşar Keskin
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  6. Betül Sargın
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  7. Gülcan Gürer
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  8. Ozan Volkan Yurdakul
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  9. Mustafa Çalış
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  10. Hülya Deveci
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  11. Yıldıray Aydın
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  12. Sami Hizmetli
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  13. Remzi Çevik
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  14. Ali Yavuz Karahan
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  15. Şebnem Ataman
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  16. Mehmet Tuncay Duruöz
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  17. Hilal Ecesoy
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  18. Zafer Günendi
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  19. Murat Toprak
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  20. Nesrin Şen
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  21. Duygu Altıntaş
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  22. Ahmet Kıvanç Cengiz
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  23. Gökhan Çağlayan
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  24. Ali Nail Demir
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  25. Hüseyin Kaplan
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  26. Sertaç Ketenci
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  27. Meltem Alkan Melikoğlu
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  28. Mehmet Nayimoğlu
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  29. Kemal Nas
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  30. Banu Sarıfakıoğlu
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  31. İlhan Sezer
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Contributions

FGY, HB, HFÇ, ÜU, YK, BS, GG, OVY, MÇ, HD, YA, SH, RÇ, AYK, ŞA, MTD, HE, ZG, MT, NŞ, DA, AKC, GÇ, AND, HK, SK, MAM, MN, KN, BS, and İS made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; FGY, HB, HFÇ, ÜU, YK, BS, GG, OVY, MÇ, HD, YA, SH, RÇ, AYK, ŞA, MTD, HE, ZG, MT, NŞ, DA, AKC, GÇ, AND, HK, SK, MAM, MN, KN, BS, and İS drafted the work or revised it critically for important intellectual content; FGY, HB, HFÇ, ÜU, YK, BS, GG, OVY, MÇ, HD, YA, SH, RÇ, AYK, ŞA, MTD, HE, ZG, MT, NŞ, DA, AKC, GÇ, AND, HK, SK, MAM, MN, KN, BS, and İS approved the version to be published; FGY, HB, HFÇ, ÜU, YK, BS, GG, OVY, MÇ, HD, YA, SH, RÇ, AYK, ŞA, MTD, HE, ZG, MT, NŞ, DA, AKC, GÇ, AND, HK, SK, MAM, MN, KN, BS, and İS agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Fatma Gül Yurdakul.

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Conflict of interest

The authors FGY, HB, HFÇ, ÜU, YK, BS, GG, OVY, MÇ, HD, YA, SH, RÇ, AYK, ŞA, MTD, HE, ZG, MT, NŞ, DA, AKC, GÇ, AND, HK, SK, MAM, MN, KN, BS, and İS have no conflict of interests to declare.

Ethics approval

All the procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments (ethic committee approval date/no:22.11.2017/E-17-1626).

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Written informed consent was obtained from all the participants.

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Yurdakul, F.G., Bodur, H., Çay, H.F. et al. Familial Mediterranean fever: perspective on female fertility and disease course in pregnancy from a multicenter nationwide network. Rheumatol Int (2023). https://doi.org/10.1007/s00296-023-05436-w

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