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Introduction Systemic Lupus Erythematosus is a multisystem autoimmune disease largely affecting women in the reproductive age group. We present an interesting case of Lupus with 2 missed abortions and 4 IVF failures. Management of the autoimmune condition and control of disease activity, combined with astute infertility management led to a successful outcome. Case description A 42 year old female, with secondary amenorrhoea for 7 years, had a history of 2 missed abortions (IVF conceived) and 4 IVF failures. She had pain and swelling in the joints of the hands, malar rash, and hairfall. This history aroused a strong suspicion of an undiagnosed immunological cause of recurrent implantation failure. A rheumatology consult was sought and she was diagnosed with lupus based on clinical features and serological evidence. APLA panel and Anti SSA and SSB were negative. She also had a completely diminished ovarian reserve with low AMH. She had a very thin endometrium. Her disease activity was controlled with prednisolone, hydroxychloroquine and azathioprine. Parallelly, diagnostic hysteroscopy was done. She was given pentoxyfylline and tocopherol for 2 months, which was continued in the final endometrial preparation. We gave her 3 endometrial PRPs along with estradiol and aspirin. 2 good quality blastocysts (OD+SS) were transferred. She conceived successfully. Immunosupressants were continued throughout pregnancy along with aspirin and enoxaparin (for 3 months). She delivered a healthy baby girl at term. Discussion Lupus is a multisystem disorder that can adversely impact female fertility. It can cause diminished ovarian reserves, can be associated with APLA syndrome, may lead to menstrual irregularities, can cause miscarriages and fetal cardiac blocks. Other unknown mechanisms may also affect fertility among Lupus patients. Our case demonstrates that lupus, when managed well, along with patient specific IVF treatment can lead to good outcomes.