Assisted Reproductive Techniques in Multiple Sclerosis: Recommendations from an Expert Panel.

Area of Science:

• Reproductive medicine
• Neurology
• Women's health

Background:

• Multiple sclerosis (MS) predominantly affects women of reproductive age.
• Lack of joint guidelines for neurologists and gynecologists managing MS in women desiring pregnancy.
• Focus on assisted reproductive techniques (ART) for conception in MS patients.

Purpose of the Study:

• To propose recommendations for managing women with MS desiring pregnancy.
• To address specific considerations for those undergoing assisted reproductive techniques (ART).
• To highlight the need for collaborative care between neurologists and gynecologists.

Main Methods:

• Consensus reached by a panel of seven experts (4 neurologists, 3 gynecologists).
• Three discussion sessions were conducted to establish recommendations.
• Review focused on integrating neurological and gynecological management strategies.

Main Results:

• Emphasis on early preconception counseling for women with MS.
• Guidelines for managing disease-modifying therapies before and during ART.
• Considerations for various ART procedures including intrauterine insemination, in vitro fertilization, and oocyte cryopreservation.
• Importance of multidisciplinary units for patient management.

Conclusions:

• Individualized pregnancy management for women with MS is essential, starting with preconception consultations.
• Prioritizing well-planned, spontaneous pregnancies when feasible.
• Multidisciplinary team management is vital for guiding women with MS through their pregnancy journey.