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Review
. 2024 Dec:92:105893.
doi: 10.1016/j.msard.2024.105893. Epub 2024 Sep 21.

Multiple sclerosis: Pregnancy, fertility, and assisted reproductive technology-a review

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

Multiple sclerosis: Pregnancy, fertility, and assisted reproductive technology-a review

Celia Oreja-Guevara et al. Mult Scler Relat Disord. 2024 Dec.
Free article

Abstract

Background: Pregnancy is not discouraged in multiple sclerosis (MS) patients. However, MS patients tend to delay motherhood since they must wait for a low clinical and radiological activity before considering pregnancy, which impacts their fertility and their need for assisted reproductive technology (ART). This review aimed to cover, from a multidisciplinary perspective, the most critical aspects revolving around pregnancy in MS patients.

Methods: A group of seven experts (four neurologists and three gynaecologists) met for three discussion sessions to review current knowledge on ART in patients with MS. PubMed searches for journal articles published in English or Spanish between 2000 and 2024 were undertaken. 354 articles were revised at the title level.

Results: We reviewed current evidence on fertility in women and men with MS, on the effects of pregnancy on MS, the disease's pharmacological treatment during pregnancy, MS during delivery and breastfeeding, ART (intrauterine insemination, in vitro fertilisation, intracytoplasmic sperm injection, and oocyte cryopreservation) in patients with MS.

Conclusion: Early family planning, supported by good coordination between neurology and gynaecology departments, is paramount to managing MS women with motherhood desire. Besides, although a well-planned, early pregnancy is always the most desirable outcome, ART is considered safe and valuable for MS patients. Finally, multidisciplinary units are deemed pivotal to guide MS patients with parenthood desire through pregnancy.

Keywords: Assisted reproductive technology; Family planning; Multiple sclerosis; Pregnancy.

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Conflict of interest statement

Declaration of competing interest Celia Oreja-Guevara has received speaking and/or consultancy fees from Alexion, Biogen, BMS, Jannsen, Merck, Novartis, Roche, Sanofi, and Teva. Inés González-Suárez has received funding for research projects and conference fees, mentoring, and assistance for conference attendance from Merck, Biogen, Roche, Merck, Novartis, and Sanofi. Mar Mendibe-Bilbao has received funding for research projects and conference fees, mentoring, and assistance for conference attendance from Teva, Merck, Biogen, Roche, Merck, Novartis, Almirall, and Sanofi. José Luis Gómez-Palomares has received funding for conference fees, mentoring, and assistance for conference attendance from Gedeon-Richter, Fertypharm, Theramex, Angelini, Ferring, MSD, Igenomix and Stada. Yolanda Aladro Benito has received funding for research projects or in the form of conference fees, mentoring, and assistance for conference attendance from Bayer, Biogen, Roche, Merck, Novartis, Almirall, and Sanofi. The remaining authors declare no financial or other conflicts of interest.

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