Can abatacept affect fertility, pregnancy or breastfeeding?
If you're planning to try for a baby, if you become pregnant or if you're thinking of breastfeeding we suggest you discuss your medications with your rheumatologist.
We don't yet know how abatacept might affect an unborn baby but it does not cross the placenta until 16 weeks of pregnancy so it's unlikely to be harmful if taken in the first three months of pregnancy. To be on the safe side, however, women of childbearing age are advised to use contraception while on abatacept. If you're planning to become pregnant, you should continue to use contraception for three months after stopping abatacept. If you're also on methotrexate this should also be stopped at least three months before trying for a baby.
It's also unknown whether abatacept affects men who are trying to father a baby. There's no evidence to suggest that it's harmful but it's probably a good idea for men to take contraceptive precautions for at least three months after stopping treatment. For men who are also taking methotrexate, current guidelines state that this drug doesn't need to be stopped when trying to father a child.
Breastfeeding isn't recommended if you're on abatacept because the effects are unknown. You shouldn't re-start your abatacept until you've stopped breastfeeding.