Pregnancy post autologous stem cell transplant with BEAM conditioning for multiple sclerosis

Area of Science:

• Neurology
• Reproductive Medicine
• Hematology

Background:

• Autologous haematopoietic stem cell transplant (AHSCT) is increasingly used for multiple sclerosis (MS).
• Women of childbearing age are a significant proportion of MS patients undergoing AHSCT.
• Understanding fertility and pregnancy outcomes post-AHSCT is crucial.

Purpose of the Study:

• To determine the incidence of pregnancy and associated complications in multiple sclerosis patients following AHSCT.
• To assess fertility outcomes in both male and female patients after AHSCT for MS.

Main Methods:

• Retrospective analysis of patients undergoing AHSCT with BEAM conditioning for MS since 2010.
• Evaluation of pregnancy rates, outcomes, and complications in a cohort of 55 patients (30 females, 21 males).

Main Results:

• Four pregnancies occurred in female patients post-AHSCT; two were carried to term with no maternal or neonatal complications.
• Two pregnancies were electively terminated due to unexpected conception.
• One male patient fathered three children post-AHSCT with no reported newborn complications.

Conclusions:

• This study is the first to report on fertility outcomes in both sexes after AHSCT for MS.
• Patients should be counseled on potential infertility and the importance of contraceptive use before undergoing AHSCT.
• AHSCT may preserve fertility in both males and females with MS.