Managing MS During and After Pregnancy

Disease activity during pregnancy

For some women with MS, pregnancy brings about fewer MS symptoms. This may be due to the body’s immune system being more tolerant of the growing human being inside. Clinical and MRI disease activity related to MS are suppressed, particularly during the third trimester. This connection has led to research using hormones such as estriol to treat MS. So far the studies have been small, showing modest benefit.

Disease-modifying therapy during pregnancy

Women with MS are encouraged to stop disease-modifying therapy (DMT) once they become pregnant, if they had not already stopped DMT use when trying to get pregnant. Women with MS who become pregnant while on a DMT should consider participating in a formal pregnancy registry such as the one sponsored by MothertoBaby.org or those hosted by pharmaceutical companies. Several small studies have reported outcomes related to the use of DMTs during pregnancy, particularly during the first trimester, but information is still limited. Data suggest that glatiramer acetate or interferon beta are safe to use. However, each person with MS needs to make personal decisions regarding DMT use and pregnancy in collaboration with her doctor.

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Modern MS Management During and After Pregnancy

Family Planning and Multiple Sclerosis

Multiple sclerosis is often diagnosed in young adults during their prime reproductive years. So pregnancy and parenthood are common concerns for many people living with multiple sclerosis. Contrary to what physicians thought decades ago, pregnancy does not make multiple sclerosis worse. With so many treatment options, family planning is an important part of disease management for men and women with MS.

Multiple sclerosis has no significant impact on the ability to conceive, on the development of the fetus, or the mother’s ability to carry to term. MS doesn’t seem to increase the risk of spontaneous abortions, stillbirth, cesarean delivery, premature birth, or birth defects. However, a recent study suggests that MS patients may have decreased ovarian reserve, a term used to describe the ovary’s capacity to produce egg cells that can be fertilized.

Paternal MS

A recent study of men with MS who fathered children found that paternal MS had no impact on birth weight or premature birth. Researchers also determined that factors such as disease duration and disability did not impact birth outcomes. Data regarding semen quality is limited, but one study reports lower total sperm counts, reduced sperm motility, and increased percentage of abnormally formed sperm in men with MS.

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Family Planning in the Modern Day of MS