Emerging biomarkers for improving pregnancy planning in multiple sclerosis

Area of Science:

• Neurology
• Reproductive Endocrinology
• Biomarker Discovery

Background:

• Multiple sclerosis (MS) management often considers patient disability, relapse rate, and age for family planning.
• There is a recognized need for more accurate biomarkers to guide family planning decisions in women with MS.
• This study investigates the influence of age on key biomarkers relevant to fertility and disease activity in MS.

Purpose of the Study:

• To explore the influence of age on anti-Müllerian hormone (AMH), neurofilament light chain (sNfL), and glial fibrillary acidic protein (GFAP) in multiple sclerosis (MS) patients.
• To assess differences in these biomarkers between MS patients and healthy controls.
• To inform tailored family planning strategies for women with MS.

Main Methods:

• A case-control study involving 95 MS patients and 61 healthy control women (HCW).
• Measurement of sNfL and GFAP levels using a single-molecule array assay.
• Measurement of AMH levels using the automated Elecsys® Anti-Müllerian Hormone Assay.

Main Results:

• No significant differences in AMH, sNfL, or GFAP levels were observed between MS patients and HCW across age-matched categories.
• Age negatively correlated with AMH in both groups, with a slight tendency towards reduced ovarian reserve in MS patients.
• Among MS patients under 40, a notable percentage exhibited low AMH levels, indicating potential risks for ovarian reserve and premature ovarian failure.

Conclusions:

• AMH, sNfL, and GFAP levels did not significantly differ between MS patients and controls within age-matched groups.
• Despite no group differences, a tendency for reduced ovarian reserve was noted in MS patients.
• Assessing AMH, sNfL, and GFAP at MS onset can aid in personalized therapeutic and family planning strategies for women of childbearing age.