The road to conception for women with multiple sclerosis

Area of Science:

• Neurology
• Reproductive Medicine
• Epidemiology

Background:

• Managing multiple sclerosis (MS) in women planning pregnancy presents unique challenges.
• Lack of standardized guidelines for disease-modifying therapy (DMT) management during conception attempts.
• Need for real-world data to inform clinical practice.

Purpose of the Study:

• To investigate the various approaches women with MS take to achieve pregnancy.
• To identify factors influencing conception in women with MS.
• To gather real-world data for the Canadian Multiple Sclerosis Pregnancy Study (CANPREG-MS).

Main Methods:

• Prospective observational study of women with MS planning pregnancy.
• Data collected from the Canadian Multiple Sclerosis Pregnancy Study (CANPREG-MS).
• Analysis of conception pathways, including use of assisted reproductive technologies (ARTs) and DMT management.

Main Results:

• 26 out of 44 enrolled women with MS achieved pregnancy.
• Seven women utilized assisted reproductive technologies (ARTs).
• Six women discontinued disease-modifying therapy (DMT) against medical advice; six experienced conception delays due to MS relapses or DMT scheduling.

Conclusions:

• Women with MS follow varied routes to conception.
• Discrepancies exist in neurologist recommendations regarding DMT washout periods.
• The study underscores the critical need for international consensus and real-world data in managing MS in pregnant women.