From the Guidelines
Humira (adalimumab) is not used to treat infertility. Humira is a biologic medication that belongs to a class of drugs called TNF inhibitors, primarily prescribed to treat autoimmune conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, and certain skin conditions like psoriasis 1. The medication works by blocking tumor necrosis factor (TNF), a protein involved in inflammatory processes in the body. While some autoimmune conditions can potentially impact fertility, Humira itself is not a fertility treatment and is not prescribed specifically to address infertility issues.
Key Points to Consider
- According to the 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases, tumor necrosis factor inhibitors like adalimumab are considered compatible with pregnancy, but their use during pregnancy should be carefully considered and monitored 1.
- The guideline conditionally recommends continuing tumor necrosis factor inhibitor therapy with infliximab, etanercept, adalimumab, or golimumab prior to and during pregnancy, but suggests discontinuing these medications in the third trimester if the patient's disease is under good control 1.
- If you're experiencing fertility problems, it's essential to consult with a reproductive endocrinologist or fertility specialist who can recommend appropriate treatments such as fertility medications, intrauterine insemination (IUI), or in vitro fertilization (IVF), depending on your specific situation and the underlying cause of infertility.
Important Considerations
- The use of Humira during pregnancy is a complex issue that requires careful consideration of the potential risks and benefits, and should only be done under the guidance of a healthcare provider 1.
- Women with autoimmune conditions who are planning to become pregnant should discuss their treatment options with their healthcare provider to determine the best course of action for managing their condition while minimizing potential risks to the fetus 1.
From the Research
Humira and Infertility
- Humira, also known as adalimumab, is used to treat various autoimmune diseases, and its use in infertility treatment has been studied in several research papers 2, 3, 4.
- A study published in 2009 found that treatment with adalimumab and intravenous immunoglobulin improved pregnancy rates in women undergoing IVF, particularly in those with T helper 1/T helper 2 cytokine elevation 2.
- Another study published in 2011 found that preconception treatment with adalimumab did not increase the birth defect rate in women undergoing IVF 3.
- A 2011 study also found that the degree of TNF-α/IL-10 cytokine elevation correlated with IVF success rates in women undergoing treatment with adalimumab and IVIG, suggesting that modulating high cytokine levels may improve IVF success rates 4.
Mechanism of Action
- The exact mechanism of how Humira improves infertility is not fully understood, but it is thought to be related to its ability to inhibit tumor necrosis factor-alpha (TNF-α), a cytokine that can disrupt implantation and pregnancy 2, 4.
- By reducing TNF-α levels, adalimumab may improve the implantation rate and increase the chances of a successful pregnancy 2, 4.
Clinical Applications
- Humira may be used in combination with other treatments, such as intravenous immunoglobulin, to improve IVF outcomes in women with immunologic-based infertility 2, 4.
- The use of Humira in infertility treatment is still considered experimental and requires further research to fully understand its effects and potential benefits 2, 3, 4.