Infertility Treatments and MS Don't Mix

Assisted reproduction technology in multiple sclerosis patients may worsen disease activity

(RxWiki News) Having difficulty conceiving is a reality for 10 to 20 percent of western couples. While some turn towards infertility treatments, those with conditions like multiple sclerosis (MS) may need to exercise caution in these important reproductive decisions.

A recent, limited study evaluates the link between infertility treatment and increased MS disease activity.

These researchers found undergoing assisted reproduction technology (ART) treatments, therapies that enhance the chance of conceiving artificially such as hormone manipulation, did worsen MS symptoms.

"Infertility treatments may affect MS - speak with a doctor."

Jorge Correale, MD, of the Institute for Neurological Research, Foundation Against Neurological Disease in Childhood and colleagues studied 16 patients with MS undergoing 26 ART cycles, 15 healthy volunteers and 15 MS patients in remission.

The study began one year before ART treatment and concluded nine months after a patient’s final ART cycle. Any disease-modifying therapies were stopped prior to the study.

The participants receiving ART were given a gonadotropin-releasing hormone daily, recombinant follicle-stimulating hormone daily for seven to ten days, and vaginal progesterone for support in the latter phase of the menstrual cycle.

Study participants were given neurological exams, brain magnetic resonance imaging (MRI) and immunology testing every three months. Blood samples were taken before and after ART at 3 month intervals.

Any MS exacerbations were treated with methylprednisolone followed by tapered oral prednisone for two weeks.

The results of clinical, MRI and immunology testing were compared to results at 3 month intervals for the year before ART began.

A seven-fold increase in MS exacerbation and a nine-fold increase of enhanced disease activity shown in MRI was associated with ART treatment.

Seventy-five percent of MS patients had increased disease activity after infertility treatment. MS relapses occurred in the three months following ART treatment in 58 percent of the participants receiving infertility treatment.

Twenty-seven percent of symptoms were pre-existing while 73 percent were new.

This study shows a significant risk of increase in disease activity in MS patients undergoing ART. These risks should be discussed between any MS patient considering infertility treatment and their doctor.

The study was published in Annals of Neurology, a journal of the American Neurological Association and Child Neurology Society.

The study was supported by an internal grant from the Institute of Neurological Research Dr Raul Carrea.

Authors of the study report associations with Merck Serono, Novartis, Biogen Idec and Teva-Ivax.

Review Date: 
November 8, 2012