Non-steroidal anti-inflammatory drugs as a possible cause for reversible infertility

Objective. To highlight the possible association between infertility and treatment with longterm non-steroidal anti-inflammatory drug (NSAIDs). NSAIDs act mainly through the inhibition of cyclooxygenase, the enzyme that catalyses the synthesis of prostaglandins, which are essential mediators of ovulation, implantation and placentation of the conceptus. Methods. Case reports of four women suffering from severe arthritis, on long-term NSAIDs and undergoing extensive investigation and treatment for infertility. Results. During the last 2 yr, four out of five women with severe arthritis and difficulty conceiving were counselled to stop NSAIDs, and they successfully conceived shortly after the withdrawal of NSAIDs. Conclusion. NSAIDs, used largely for the treatment of rheumatological conditions, may be responsible for some cases of infertility.