HHT and Reproductive Health

Introduction to HHT and Fertility

• The American College of Medical Genetics recommends that individuals with HHT have normal fertility rates, as the genetic mutation affects vascular endothelial cells rather than reproductive tissues 1, 2

Pre-Conception Counseling and Management

• The American College of Obstetricians and Gynecologists suggests providing genetic counseling to all HHT patients of childbearing age about the 50% inheritance risk 1
• The European Respiratory Society recommends discontinuing tranexamic acid several days before attempting conception due to its half-life of 2-8 hours 3
• The American Academy of Allergy, Asthma, and Immunology advises stopping androgenic anabolic steroids 2 months before conception due to the risk of fetal sexual differentiation abnormalities 3

Post-Partum Care and Management

• The Society for Maternal-Fetal Medicine recommends close follow-up for at least 72 hours after delivery by staff familiar with HHT 3

Diagnostic Considerations

• The American Association for the Study of Liver Diseases recommends avoiding liver biopsy in any HHT patient due to the catastrophic hemorrhage risk from hepatic vascular malformations 4, 5, 6, 1