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Review
. 2023 Apr;12(2):427-439.
doi: 10.1007/s40120-023-00439-y. Epub 2023 Feb 7.

Assisted Reproductive Techniques in Multiple Sclerosis: Recommendations from an Expert Panel

Celia Oreja-Guevara #  1   2 , Aintzane Rabanal  3 , Corazón Hernández Rodríguez  4 , Yolanda Aladro Benito  5 , Mar Mendibe Bilbao  6 , Inés Gónzalez-Suarez  7 , José Luis Gómez-Palomares #  8
Affiliations
Review

Assisted Reproductive Techniques in Multiple Sclerosis: Recommendations from an Expert Panel

Celia Oreja-Guevara et al. Neurol Ther. 2023 Apr.

Abstract

Introduction: Multiple sclerosis (MS) is mainly diagnosed in women of reproductive age. However, there is a paucity of guidelines jointly prepared by neurologists and gynaecologists on managing women with MS and the desire for motherhood. Therefore, in this review we propose recommendations for such cases, with an particular focus on those requiring assisted reproductive techniques (ART).

Methods: A group of seven MS experts (4 neurologists and 3 gynaecologists) came together for three discussion sessions to achieve consensus.

Results: The recommendations reported here focus on the importance of early preconception counselling, the management of disease-modifying therapies before and during ART procedures, important considerations for women with MS regarding ART (intrauterine insemination, in vitro fertilisation and oocyte cryopreservation) and the paramount relevance of multidisciplinary units to manage these patients.

Conclusions: Early preconception consultations are essential to individualising pregnancy management in women with MS, and an early, well-planned, spontaneous pregnancy should be the aim whenever possible. The management of women with MS and the desire for motherhood by multidisciplinary units is warranted to ensure appropriate guidance through the entire pregnancy.

Keywords: Assisted reproductive technology; GnRH antagonists; Multiple sclerosis; Oocyte cryopreservation; Preconception counselling.

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