wonderfully useful post, Leslie - thank you so much!i
your post made me realize how little awareness there is within the medical community about the long-term consequences of medication. When you juxtaposed how women with cancer are freezing their eggs versus women with RA usually not even having a discussion with the doctor about the impact of meds on their fertility, it really made me think. Why aren't doctors having this conversation with their new patients? Why is this not on their radar at all?
For users were interested in more information on this topic, we have a number of posts in our Pregnancy and Parenting with RA area.
The Organization of Teratology Information Specialists (OTIS) has an ongoing study on autoimmune diseases and pregnancy: http://www.otispregnancy.org/autoimmune-studies-s13049
The OTIS website also has many useful resources & fact sheets: http://www.otispregnancy.org/otis-fact-sheets-s13037
NSAIDs are associated with some risks during the third trimester of pregnancy, so it's important to keep that in mind.
Thank you for writing such a good article. There are so many questions left unanswered for patients with autoimmune diseases, and this leads to many, many uncertainties about the future. It will be great to see more research over time.
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Good rheumatologists do consider future pregnancy in young female patients. I was fortunate enough to have given birth to both of my boys before RA, but my doctor (who is also a neighbor) asked me if I was planning to have more kids and explained the drug risks in pregnancy before we started treatments.
On the other hand, I know someone who was told when she was diagnosed with RA that she should never get pregnant. Personally I take most never statements from doctors as a good reason to seek a second opinion (or a different doctor).