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MS Relapse Rate Not Increased After Fertility Treatments

Mean annualized relapse rate not different before versus after controlled ovarian stimulation

By Elana Gotkine HealthDay Reporter

THURSDAY, March 16, 2023 (HealthDay News) — For women with multiple sclerosis (MS), there is no increased relapse rate after fertility treatment (FT), according to a study published online March 15 in Neurology, Neuroimmunology & Neuroinflammation.

Edith L. Graham, M.D., from Northwestern University in Chicago, and colleagues examined the annualized relapse rate (ARR) 12 months pre-FT and three months post-FT in a multicenter cohort composed of patients with clinically isolated syndrome or MS aged 18 to 45 years (nine and 56 patients, respectively). Controlled ovarian stimulation followed by fresh embryo transfer (COS-ET), COS alone, embryo transfer (ET) alone, and oral ovulation induction (OI) were included as FTs of interest.

Data were included for 124 FT cycles: 61 COS-ET, 19 COS alone, 30 ET alone, and 14 OI. The researchers found that within three months of treatment, only five relapses occurred among four unique patients across 80 cycles with COS. There was no difference observed in mean ARR after versus before COS; no significant difference was seen in the incidence rate ratio. Three-month relapse was not reported in any cycles with therapeutic disease-modifying therapies during COS. There was no variation noted in relapse rates based on COS protocol. The ARR decreased from 0.26 to 0.09 within the first trimester of pregnancy among COS-ET cycles that achieved pregnancy. No relapses were reported within three months of ET alone, while one relapse occurred after OI.

“We hope our findings provide reassurance to those with MS as well as fertility experts that these treatments are not associated with elevated risks of relapses,” Graham said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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