Fertilization, reproductive system, and pregnancy in familial Mediterranean fever: Clinical state of art.

This article focuses on the impact of familial Mediterranean fever (FMF), a hereditary autoinflammatory disease, on fertility and pregnancy management, particularly in the context of colchicine and interleukin-1 (IL-1) inhibitor treatments. FMF can affect both male and female reproductive systems, with infertility linked primarily to disease-related inflammation, amyloidosis, and pelvic adhesions rather than colchicine use, which is considered safe during pregnancy and lactation. Pregnancy outcomes in FMF patients are generally comparable to the general population when colchicine is used regularly, although risks such as miscarriage, preterm delivery, and antenatal complications may be elevated in untreated or poorly controlled cases. IL-1 inhibitors, including anakinra and canakinumab, have emerged as effective and safe options for managing colchicine-resistant FMF during pregnancy and breastfeeding. The article emphasizes the importance of strict adherence to treatment to optimize reproductive health and pregnancy outcomes in FMF patients.