title: Non-steroidal anti-inflammatory drugs as a possible cause for reversible infertility.
abstract: OBJECTIVE
  To highlight the possible association between infertility and treatment with long-term 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.
  
  
  CONCLUSIONS
  NSAIDs, used largely for the treatment of rheumatological conditions, may be responsible for some cases of infertility.
authors.affiliation: Lupus in Pregnancy Clinic, St Thomas' Hospital, London, UK.
authors.forename: L L
authors.initials: LL
authors.lastname: Mendonça
authors.forename: M A
authors.initials: MA
authors.lastname: Khamashta
authors.forename: C
authors.initials: C
authors.lastname: Nelson-Piercy
authors.forename: B J
authors.initials: BJ
authors.lastname: Hunt
authors.forename: G R
authors.initials: GR
authors.lastname: Hughes
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004008:Diclofenac / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac