Assisted reproductive treatment (ART)
Women with MS who are having difficulty conceiving may benefit from fertility treatments [1]. Indeed, use of ART appears to be rising among women with MS [2-4]. A Finnish study found that 4.9% of women with MS used ART during the years 2003 to 2005, compared with 0.9% of women without MS [2]. A more recent evaluation from Spain reported that 14% of women with MS underwent ART [3]. Therefore the potential impact of ART is becoming an increasingly relevant consideration for women with MS [2-4].
While there is some concern that ART could increase risk of relapse, data is limited and conflicting [1,4]. Gonadotropin releasing hormone (GnRH) agonists and antagonists may lead to increased MS activity [1,4,5]. However other factors such as a potential rebound effect after withdrawal of MS therapy, stress associated with infertility, and hormone-induced immunological changes may also play a role in MS activation.
Shortening the time between MS therapy discontinuation and ART, or continuing use of MS therapy such as the injectables during ART may help overcome a potentially increased risk of MS activity following ART [4].
References
- Hellwig H, Correale J. Clinical Immunology 2013; 149(2): 219-24. Return to content
- Jalkanen A et al. Mult Scler 2010; 16(8): 950-5. Return to content
- Cuello JP et al. Neurología 2017; 32(2): 92-8. Return to content
- Bove R et al. Mult Scler 2020; 26(11): 1410-1419; 1352458519865118. Return to content
- Torkildsen O et al. Mult Scler Rel Disord 2018; 22: 38-40. Return to content
