American singer and actress Selena Gomez's battles with lupus and mental health issues like anxiety and depression are not unknown. Now, she has opened up that her health issues have affected her chances of getting pregnant. The 32-year-old has revealed that she will not be able to carry a child, as her health issues would put her "life and the baby’s in jeopardy". It is something the "Calm Down" hitmaker had to "grieve for a while.” Her revelation has shed light on the complex relationship between medical conditions and fertility.

Selena Gomez on pregnancy

Selema Gomez had plans of starting a family by the time she turned 35, but in a new interview with Vanity Fair, she says, “I haven’t ever said this, but I unfortunately can’t carry my own children. I have a lot of medical issues that would put my life and the baby’s in jeopardy. That was something I had to grieve for a while," she added.

Selena Gomez was diagnosed with lupus that may affect fertility. Image courtesy: Freepik

The "Only Murders in the Building" star didn’t share which health issue is affecting fertility, but she has previously spoken about being diagnosed with lupus, a chronic autoimmune disease that can attack different parts of the body, including kidney, joints, and skin. “I was diagnosed with lupus, and I have been through chemotherapy," she told Billboard in 2015.

Later, the singer also opened up about her mental health issues. During an interview with Harper's Bazaar in 2018, she shared, "I have had a lot of issues with depression and anxiety, and I have been very vocal about it, but it is not something I feel I will ever overcome."

In 2022, Gomez, who also has bipolar disorder, told Rolling Stone that she takes medications for the mental health condition that could possibly affect her chances of having a safe pregnancy. She said, “That’s a very big, big, present thing in my life."

Still, she has not lost all hope. Gomez hopes to become a mother some day with the help of adoption or surrogacy. “It is not necessarily the way I envisioned it. I thought it would happen the way it happens for everyone,” she told Vanity Fair.

However, she has come to terms to reality. “I’m in a much better place with that. I find it a blessing that there are wonderful people willing to do surrogacy or adoption, which are both huge possibilities for me.” She is "excited for what that journey will look like, but it will look a little different. At the end of the day, I don’t care. It will be mine. It will be my baby,” she added.

How health issues impact fertility

Whether it is lupus or a mental health problem, they can affect fertility.

1. Impact of lupus on fertility

Careful monitoring of pregnancy and treatment of lupus can decrease the risks for the mother and the baby, but adverse maternal and fetal outcomes may still occur, according to a 2016 study published in the Middle East Fertility Society Journal. "Lupus can cause inflammation of the reproductive organs, which may interfere with ovulation and the ability to conceive," says obstetrician and gynaecologist Dr Pooja C Thukral. Many women with lupus have an associated condition called antiphospholipid syndrome, which increases the risk of blood clots. "It can cause complications during pregnancy, such as recurrent miscarriages, and stillbirth, making it more difficult for women to carry a pregnancy to term," says the expert,

Also, if lupus leads to significant damage to the kidneys or other organs, the body may not be in optimal condition for pregnancy, which can further reduce fertility. "Kidney function is crucial for maintaining a healthy pregnancy, and chronic kidney disease can disrupt hormone levels, particularly those related to reproduction," says the expert.

2. Impact of mental health issues on fertility

Mental health problems like anxiety and depression can also affect a woman's chances of getting pregnant. Women with fertility problems reported high levels of anxiety and depression during a study published in the Dialogues in Clinical Neuroscience journal in 2018. Another study published in Psychiatry Research in 2019 found that people with bipolar disorder have fewer children or low fertility rates.

Mental health conditions may impact fertility. Image courtesy: Freepik

"Cortisol, which is the stress hormone, can come in the way of the production of gonadotropin-releasing hormone, which is important for triggering ovulation. This can lead to irregular menstrual cycles or anovulation (lack of ovulation), reducing the chances of conception," explains Dr Thukral. Due to mental health conditions women may follow a poor diet or not exercise that can further decrease fertility.

Medications can also reduce chances of getting pregnant. Antidepressants may reduce the chances of a woman with a history of depression to conceive in a natural way, as per research published in the American Journal of Obstetrics and Gynecology in 2017. Antidepressants like selective serotonin reuptake inhibitors may affect fertility by altering hormone levels or causing sexual dysfunction. "Women taking SSRIs should discuss their options with their doctor if they are trying to conceive," says Dr Thukral.

Gomez’s health conditions can contribute to fertility challenges. For women with similar health conditions, it is best to work closely with doctors to carefully manage their conditions and explore fertility options.

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