Breaking barriers: A triumph in pregnancy for a patient with Sjögren syndrome: A case report

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RATIONALE: Sjögren syndrome (SS) is a systemic autoimmune disease with a variety of clinical presentations. Successful pregnancies and deliveries among these patients remain challenging. This manuscript describes a case report of diagnosis, detailed clinical management, and successful pregnancy and delivery of a patient of SS, which treated by immunosuppressive agents, especially cyclosporine A (CsA) and assisted reproductive technology. PATIENT CONCERNS: A 31-year-old female had been experiencing persistent infertility with a 5-year-long history. However, the results indicated that patent fallopian tubes, an ovulatory cycle, and normal semen analysis. DIAGNOSES: After obtaining clinical manifestations, medical history, and the serum biochemical and salivary gland histopathology examination results, main causes such as tubal factor, impaired endometrial function, endocrine dysfunctions and male factors were excluded, and the final diagnosis was SS-induced autoimmune infertility. INTERVENTIONS: The patient was treated with immunosuppressive agents and assisted reproductive technology. After 5 failed attempts of assisted reproductive technology treatment and treatment with 3 immunosuppressive agents, the application of a relatively potent immunosuppressive agent CsA was finally used and a high-quality frozen-thawed blastocyst embryo was transferred. OUTCOMES: A clinical pregnancy was confirmed. The newborn was delivered by elective cesarean section and showed normal development over the 1-year follow-up. LESSONS: The accurate diagnosis of autoimmune infertility requires a combination of clinical presentation, medical history, and biochemical findings, and, if available, histopathology examinations. The role of immunosuppressive agents, especially CsA is crucial for the clinical management of autoimmune infertility.

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