Fertility and Disabilities

Only certain types of disabilities interfere with fertility in women. Fertility is defined as the ability to conceive, in other words, the ability to get pregnant. Few studies have been done on the effects of disabilities on fertility in women. It appears that most women with disabilities who are sexually active do not have problems getting pregnant that are related to their disabilities.

Fertility rates have been examined in few types of disabilities, but, when they have been examined, these rates are similar to rates for women without disabilities. For example, fertility rates are the same for women with spinal cord injury and spina bifida as they are for women in general. In studies in which fewer women became pregnant after injury, their self-reports that they had decided to not have children accounted for the difference.

Other factors that would ultimately reduce fertility rates are:

• Lack of a regular sex partner
• Single marital status
• Problems such as positioning, lack of lubrication and urinary tract infection that can interfere with having sexual intercourse.

It is barriers reported by women with disabilities, rather than the physical ability to conceive, that likely result in fewer women with disabilities having children in the long run.

Disabilities that directly interfere with fertility are autoimmune and connective tissue disorders such as rheumatoid arthritis, lupus and scleroderma. Women with autoimmune disorders make auto-antibodies that may destroy sperm, ovaries, hormones or cut off oxygen and nutrients to the fetus.

Hormonal control of ovulation may be impaired with rheumatoid arthritis. Kidney disease occurring with lupus or scleroderma can also cause problems with fertility. Taking non-steroidal anti-inflammatory drugs to treat these disorders, such as Motrin, or cytotoxic drugs, such as Imuran, may also impair fertility; however, the pregnancy rate of women with autoimmune disorders can be increased safely by taking daily steroids or aspirin.