Popular Anti-Inflammatory, Arthritis Drugs May Make It Harder to Conceive

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Popular Pain Relievers May Affect Pregnancy

Popular Anti-Inflammatory, Arthritis Drugs May Make It Harder to Conceive

By DeNoon WebMD Medical News

Reviewed By Brunilda Nazario, MD

March 18, 2004 -- Women trying to become pregnant may want to avoid a

popular

class of pain relievers and arthritis drugs.

The warning comes in a brief editorial in the March issue of Fertility and

Sterility. J. Norman, MD, and Ruijin Wu, MD, of the University of

Adelaide, in South Australia, point out several studies showing that newer

anti-inflammatory pain killers -- called -2 inhibitors -- may interfere

with several

stages of a woman becoming pregnant. These pain relievers include Bextra,

Celebrex, and Vioxx.

But they note there's no scientific proof at this point that -2

inhibitors

actually make it harder for a woman to become pregnant.

Norman and Wu warn that there's good evidence that the pain relievers can

affect ovulation, fertilization, and even labor. They also note that older

anti-inflammatory pain relievers, such as ibuprofen, appear to have the same

effects. Both older and newer anti-inflammatory pain relievers are known

collectively

as NSAIDs (nonsteroidal anti-inflammatory drugs). Another common pain

reliever, Tylenol, is not an NSAID and these findings do not apply to this

drug.

" Women seeking to become pregnant should quit using -2 inhibitors or

NSAIDs for at least a week or two before attempting to become pregnant, "

Norman

tells WebMD. " There are concerns about -2 inhibitors in pregnancy,

largely due

to the effect on the fetus. "

-2 inhibitors were created to help decrease some of the side effects

associated with older anti-inflammatory pain relievers, such as stomach

irritation

and bleeding. Both types of pain relievers block the production of chemicals

called prostaglandins, which cause inflammation. However, prostaglandins

play a

major role in ovulation and follicle maturation.

Norman and Wu note that there's increasing evidence that -2 inhibitors

impair fertilization, implantation of the fertile egg in the uterus, and

continuation of pregnancy. However, they stress that more research is needed

to define

the exact effects these pain relievers have at various stages of conception

and pregnancy.

" -2 inhibitors or NSAIDs, all of those can potentially affect or diminish

ovulation, " agrees Celia Dominguez, MD, a reproductive endocrinologist at

Emory University in Atlanta. " That is the thinking behind it, but this is

not very

strong science. It is just the concept that ovulation is associated with

prostaglandin that makes people worry. "

The -2 inhibitors Bextra, Celebrex, and Vioxx offer substantial relief to

people who need these pain relievers. Norman suggests that women should talk

to their doctors about whether to continue taking these medications before

and

during pregnancy.

" Women taking -2 inhibitors may take longer to become pregnant. If there

is a delay in fertility they should stop these drugs, " Norman says. " If

women

are already pregnant, alternative drugs should be discussed with their

doctor. "

Dominguez agrees with this advice.

" When trying to get pregnant, avoid -2 inhibitors, " she says. " And during

pregnancy, we always advise women to avoid all medications as much as

possible. "

SOURCES: Norman, R.J. and Wu, R. Fertility and Sterility, March 2004; vol

81:

pp 493-494. J. Norman, MD, University of Adelaide, South Australia,

Australia. Celia Dominguez, MD, Emory University, Atlanta.

© 2004 WebMD Inc. All rights reserved.

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