Tennis star Caroline Wozniacki’s grip on her husband’s hand was stronger than any time she had held a racket, and her heart raced faster than at any championship point. Caroline had just been diagnosed with rheumatoid arthritis (RA) and wanted to know if the debilitating condition would stop her dream of having a family.
It is a question that disturbs thousands of women with chronic conditions that require regular medication and can affect fertility and pregnancy health.
“It was a super tense moment,” says the 30-year-old. “It was the second question I asked after getting a diagnosis and we were holding hands very tight. It felt like an age before the consultant said we could.”
Caroline was diagnosed with RA, which causes the body’s immune system to attack the cell lining of its own joints, in the prime of a playing career that had seen her hold the top spot for 67 consecutive weeks.
Staying healthy with a chronic condition was important but the goal of becoming a mother burned the deepest. “I’ve always wanted to have children and to start a family so it was a scary question,” says the Danish star, who was just 28 when she was diagnosed.
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“I remember going to the appointment with my now husband David and we were both anxious. But I’ve always been a person that would rather know the truth.
“You don’t know much when you are first diagnosed and there’s a lot of false information on the internet, so being able to talk to my doctor was really important. It would have been devastating if I couldn’t have children but thankfully we got a positive answer. It was a huge relief.”
Her first task was to control her RA which, at its worst, prevented her from lifting her arms in the morning and made everyday movements painful.
Her conditioned fitness and diet were a strong foundation to build a regime that involved regular exercise, a diet that avoided foods with known inflammatory properties and RA medication.
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Caroline, who married former professional basketball player David Lee, 37, in 2019, amassed 30 WTA titles and won the Australian Open in January 2018 before RA forced her retirement.
The condition, which is incurable and affects more than 400,000 people in the UK, is three times more common in women than men, but research has not been able to define its causes or why it suddenly strikes.
It is treated in stages with patients initially being prescribed steroids to relieve pain and joint swelling, moving on to disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate before, depending on response, being prescribed advanced biological treatments self-administered weekly or fortnightly.
Research revealed that 42 per cent of female patients with RA take 12 months or more to get pregnant, compared to a rate of 10 per cent in the general population. Doctors may also adjust medication prior to and during pregnancy as methotrexate is linked with an increased risk of miscarriage as well as birth defects.
Non-steroidal anti-inflammatory drugs (NSAIDs), taken for relief of pain and stiffness, have also been associated with reduced fertility.
“My doctor worked out a plan with the main aim of getting my RA under control before we started a family,” adds Caroline. “Everyone is different, and everyone’s bodies react so differently to RA. What’s right for me may not be right for someone else. David and I both wanted kids and it was a natural step as we had retired from professional sport. We discussed everything with my consultant and my strong advice is to build a relationship with your doctor.”
Caroline, who launched the Advantage Hers campaign to help women deal with chronic conditions, found out she was expecting just before Christmas and her daughter is due in June. “We’re so excited and everyone is thrilled,” she says. “It was fantastic – though it took a while to sink in that I was actually pregnant.”
Caroline suffered some morning sickness in the first three months but says: “I’ve been feeling great lately and we can’t wait for the special day.
“Our number one concern is that the rest of the pregnancy goes well and the baby is healthy and then it is about raising a strong, independent woman who can do whatever she wants to do. “We’re excited and nervous about becoming parents.”
With a tennis star and former professional basketball player as parents, their daughter could have a fast track to an athletic future but Caroline is cautious: “We talked about that and, if she has our personality and approach, then I don’t think there’s anything stopping her, but tennis is such a gruelling and tough sport. I’d like her to play and enjoy it but to be a professional you have to put a lot of effort in.
“For the moment, we are focusing on keeping my RA under control and making the pregnancy as easy as possible. I try to eat a healthy diet with protein and vegetables but I’m not depriving myself.”
Caroline adds: “There’s never a guarantee in life for anything but having RA and being able to start a family and live out that dream sends a positive message for the women out there who may be concerned about their chronic condition.
“It was possible for me to get pregnant so hopefully that’s going to inspire other women out there and help them believe that it can happen for them if that’s what they choose.”
- Visit AdvantageHers.com for various resources, patient guides and tips, articles and video content for women with chronic inflammatory diseases.