Oh boy, I know all about this.....
I've had Rheumatoid Arthritis since age 7, only in my knees. It flares up every 5 years or so. My husband and I have been TTC for over a year now, with absolutely no success. Everything is 100% perfect with both of us, so it was a mystery. Then in July, I got on Clomid, and my knees got extremely swollen. This became a vicious cycle for me every month - I would get on fertility medication, my knees would swell, I would end up having to have the fluid drained out, and then start all over again. However, during this entire process, none of my doctors believed that the fertility medication was causing my RA to flare up. But I KNEW it was... and in the back of my mind, I wondered if it was also working in reverse - my RA causing my infertility.
Then in January, I finally begged my RE (reproductive endocrinologist) to run their auto-immune blood workup on me. She really hesitated because that is something they usually don't do unless you've had a failed IVF. But the blood work came back showing that I have 4 auto-immune issues that ARE related to RA and are definitely affecting my fertility. I was positive for Anti-Nuclear-Antibodies (ANA), Sjogrens Antibodies, MTHFR, and Plasmenigen Activator Inhibitor. I'm still in a little bit of shock by the news, but so glad to finally have a diagnosis. The ANA is pretty much what is preventing pregnancy - my uterus flares in the same way my knees do, when there is an increase in estrogen in my body. The Sjogrens could possibly affect a baby's heart if not treated, and the MTHFR and PAI are both blood clotting disorders.
So this sounds bad... but it is apparently ALL treatable. I am doing IVF (in the middle of my first cycle right now). I take 10mg of prednisone daily for the ANA, and a baby aspirin and folic acid supplements for the MTHFR and PAI. If/when I do get pregnant, I will immediately start on a blood thinner, Lovenox. According to my doctors, this should be all I need to have a successful pregnancy! So we will see.
So for all of you with RA trying to conceive, you MUST beg your doctor to test you for these auto immune issues, and don't let anybody tell you that your RA is not affecting your fertility - it very much could be!!