Pregnancy, Fertility, and Contraception Risk in the Context of Chronic
Chronic health conditions complicate everyday choices patients make regarding their health and reproductive options. The risks and possible complications of existing conditions should be clearly communicated to patients so they can make informed decisions regarding their care. This compilation of 4 articles presents the fertility, infertility, and contraceptive challenges faced by individuals living with 4 common chronic conditions: systemic lupus erythematosus, rheumatoid arthritis, scoliosis, and organ transplant history. The article centers on reproductive concerns and risks facing both men and women affected by these disorders. It is critical that clinicians be aware of the unique issues these patients face so that appropriate education and counseling can be provided. These articles provide a basic understanding of the issues and concerns for these 4 chronic conditions.

These 4 articles were prepared by graduates of the family nurse practitioner program at the Uniformed Services University of the Health Sciences. The articles discuss the fertility, infertility, and contraceptive issues facing patients living with 4 selected chronic medical conditions. The impact of the specific disease on reproductive and prenatal health will be discussed. The first article focuses on systemic lupus erythematosus (SLE). The author, MAJ David Farley, discusses the impact of SLE on fertility, describes associated pregnancy risks, and addresses contraceptive options for both men and women. The next 2 articles focus on rheumatoid arthritis (RA) and scoliosis, describing the impact of these diseases on the reproductive challenges facing both men and women living with these disorders. MAJ Robert Staggs and MAJ Diana Heinz describe the contraceptive challenges, prenatal risks and complications, and the importance of preconceptual counseling for optimizing pregnancy outcomes for people living with these disorders. The final article by CPT Wendy Gray discusses organ transplant recipients and the unique preconceptual, prenatal, and contraceptive challenges these individuals face. The articles provide a unique perspective because they capture issues germane to men and women, as well as touching on important issues across the conception/contraception continuum. The information is presented in a concise format, ideal for busy clinicians who want targeted, accurate information to offer to their patients as they navigate through the childbearing years.