To synthesize evidence from meta-analyses on the impact of autoimmune diseases on female reproductive outcomes—including ovarian reserve, fertility, assisted reproductive technology (ART) outcomes, gynecological disorders, and menstrual abnormalities—to inform clinical decision-making in dermatology and reproductive medicine.

This umbrella review followed Joanna Briggs Institute methodology and PRIOR guidelines, registered on PROSPERO (CRD420250654372). Meta-analytical reviews reporting effect sizes for autoimmune conditions and reproductive outcomes in women were included. PubMed, Embase, Cochrane Database, and Web of Science were searched until January 2025. Methodological quality was assessed using AMSTAR 2, and overlap managed via corrected covered area. Data were collated and narratively synthesized without new quantitative pooling.

From 2,176 records, 17 non-overlapping reviews were included. In ART settings, thyroid autoimmunity was associated with reduced live birth (OR 0.71, 95% CI 0.53–0.94), implantation (OR 0.72, 95% CI 0.59–0.88), and increased miscarriage (OR 1.52, 95% CI 1.14–2.01). Systemic lupus erythematosus and rheumatoid arthritis increased endometriosis risk (ORs 1.40–5.23). Celiac disease (OR 4.04) and Sjögren’s syndrome (OR 1.49) were also linked to endometriosis. Polycystic ovary syndrome correlated with thyroid autoimmunity (OR 2.28). Across autoimmune diseases, ovarian reserve markers (AMH, AFC) and gonadotropins were impaired, while prolactin was elevated in SLE and systemic sclerosis. Considerable heterogeneity was observed.

Autoimmune diseases substantially impair female reproductive health, underscoring the need for integrated dermatological–reproductive care and further mechanistic research.