According to the World Health Organization (WHO), infertility is the failure to achieve pregnancy after 12 months of regular unprotected sexual intercourse or more (World Health Organization, 2024). To achieve pregnancy, assisted reproductive technology (ART), which includes all fertility treatments or procedures in which eggs or embryos are handled in the embryologic laboratory to facilitate pregnancy, can be employed (Centers for Disease Control and Prevention, 2024). In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are the most commonly used ART techniques.

Women with rheumatic diseases who undergo ART represent a population that remains insufficiently studied. Rheumatic diseases encompass a wide range of disorders. Those attributed to immune-mediated mechanisms are of particular interest; they often present as multi-organ conditions affecting various systems. Autoimmune rheumatic diseases, more recently referred to as immune-mediated rheumatic diseases (IMRDs), are conditions with underlying autoimmune, autoinflammatory, or mixed mechanisms (Cruz-Jentoft et al., 2021; Moutsopoulos, 2021; Ntali et al., 2014).

The majority of IMRDs disproportionately affect females. Young women of reproductive age experience the highest incidence of diseases, such as systemic lupus erythematosus (SLE) (American College of Rheumatology, 2024, Marder et al., 2015). The diseases themselves, the treatments [e.g., disease-modifying antirheumatic drugs (DMARDs)], or both, may affect fertility parameters (Carp et al., 2012; Brouwer et al., 2015; Cuadrado-Torroglosa et al., 2024; Khizroeva et al., 2019; Sotskiy et al., 2021; Tan et al., 2021). As a result, an increasing number of women with IMRDs turn to infertility treatments. Due to the pathophysiology of their diseases and the effects of their treatments, their characteristics probably differ from those of other populations undergoing ART. These factors highlight the need to better understand ART success rates and potential complications in this population, to enable the provision of informed counseling and care.

Although a substantial body of literature focuses on the outcomes of ART, data on patients with rheumatic diseases remain limited. To our knowledge, no systematic review and meta-analysis has specifically addressed this topic. Herein, we aimed to evaluate the outcomes of ART in women diagnosed with IMRDs by synthesizing all relevant clinical studies published to date and to compare these outcomes between women with and without IMRDs.