A consensus paper concerning the interaction of anti-rheumatic drugs and 
reproduction was published in 2006, representing data collected during the year 
2004 and 2005. Because of an increasing use of biological agents in women of 
fertile age, the information was updated for the years 2006 and 2007. Experts 
disagree whether TNF-inhibitors should be stopped as soon as pregnancy is 
recognized or may be continued throughout pregnancy. Pregnancy experience with 
abatacept and rituximab is still too limited to prove their safety for the 
developing fetus. They must be withdrawn before a planned pregnancy. LEF has not 
been proven to be a human teratogen. Registries of transplant recipients have 
shown that cyclosporin (CsA) and tacrolimus do not increase the rate of 
congenital anomalies, whereas mycophenolate mofetil (MMF) clearly carries a risk 
for congenital anomalies. Prophylactic withdrawal of drugs before pregnancy is 
mandatory for abatacept, rituximab, LEF and MMF. Data remain insufficient for 
gonadal toxicity of immunosuppressive drugs in men and for excretion of these 
drugs in human breast milk.