Tight disease control is making safe pregnancies a reality for most patients with rheumatic and musculoskeletal diseases (RMDs), according to data from EULAR 2026. Continuing biologic therapies through pregnancy significantly reduces flares and obstetric complications. But mental health support and male fertility remain critically overlooked areas in reproductive rheumatology care.
For decades, a diagnosis of a rheumatic or musculoskeletal disease (RMD) often came with a discouraging message about starting a family. That's changing fast. Data presented at EULAR 2026 show that a strict treat-to-target approach now allows the vast majority of RMD patients to safely plan and carry pregnancies. A 10-year Japanese cohort study of 118 women with rheumatoid arthritis found that 85% maintained remission or low disease activity throughout pregnancy — and those who continued biologic DMARDs after conception fared significantly better than those who stopped.
Real-world US data echoed this shift: continuous TNF inhibitor use during pregnancy jumped from 55% in 2011 to 73% by 2021. The guiding principle is straightforward — a healthy mother means a healthier baby. Experts also spotlighted a long-neglected issue: male fertility. Uncontrolled systemic inflammation, not medication, is often the real threat to male reproductive health in RMD patients.
Key Takeaways:
Why it matters: As 1 in 10 people now live with an autoimmune condition — and more women of childbearing age are among them — reproductive counseling in rheumatology is becoming essential, not optional. Closing the gaps in psychological support and male fertility care could meaningfully improve outcomes for patients and their families.
