Psoriatic Arthritis, Family Planning, and Fertility

My rheumatologist has been more involved in my family planning and fertility decisions than my OB-GYN. I think many people are surprised by this statement. Others do not realize that having psoriatic arthritis (PsA) can affect every part of your life.

I was only 10 to 19 years old when I was diagnosed. Being so young, I was terrified of how PsA would impact my future, including my fertility. I worried I would have to delay pregnancy, even when I was ready. I also worried if PsA would make it harder to get pregnant and carry a baby to term.

I wish I could go back in time to reassure myself about how things turned out. I would tell myself that PsA will affect my journey, but it is not a curse. In 2026, I got pregnant with my first child. My rheumatologist was always there for me, every step of the way.

Planning for pregnancy with psoriatic arthritis

I was always honest with my rheumatologist about wanting a family. Even when I was not ready, my doctor and I talked openly about my goals and timing.

Some drugs used to treat PsA are not recommended for pregnancy. When I took any of those drugs, my doctor made sure I used reliable birth control. At every appointment, she checked in case I was considering getting pregnant.

My doctor reassured me that nothing I took would affect my fertility long term. There were times after finishing my last dose when I was told not to get pregnant. But those times passed quickly.

I only used those drugs when starting a family was not in the picture yet. Once a pregnancy was in the near future, we changed our approach to treatment.

Navigating treatment choices when starting a family

When I first got married, we decided on a drug that was safe for pregnancy. Even though I was not planning a pregnancy yet, I wanted to be on the safe side. My doctor counseled me on next steps if I became pregnant. She also shared resources from MotherToBaby.

When my husband and I decided to start a family, my rheumatologist was the first to know. She gave me her blessing. Generally, PsA did not affect my fertility. Though I know of some people whose ovulation was delayed by flare-ups.

Managing pregnancy care and flare-ups

When I became pregnant, my rheumatologist was the first to know again. I had a few flare-ups in my first and second trimesters, but they did not affect my pregnancy. I kept my doctor in the loop through my patient portal.

Since I use biologics, I had to consult with a high-risk OB-GYN. They are keeping a closer eye on me, but overall they are pleased. Everyone's experience is different. People with active PsA and other risk factors may be watched more closely. While I have not needed too much extra care yet, I am grateful for the caution.

Overcoming myths about psoriatic arthritis and pregnancy

I think there is a lot of misinformation around these topics. I was the victim of assumptions, and I still deal with them from well-meaning people. People made me worry that PsA always makes a pregnancy risky. Or that I should stop all drugs before trying to conceive. But those assumptions were not true at all.

If fertility is on your mind, it is worth having a chat with your rheumatologist. I promise, they are used to these kinds of discussions! Family planning is not a topic to be shy about.