Multiple sclerosis, fertility, pregnancy, and assisted reproductive technology: Current knowledge

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system that predominantly affects young women of childbearing age. While pregnancy was once discouraged for women with MS, recent studies have overturned many of the old assumptions about its risks. Current data indicate that MS has no adverse effect on fertility or pregnancy outcomes, and that pregnancy often leads to a decrease in disease activity in the third trimester. However, the reproductive life of these women will require careful and specialized management, particularly concerning the use of disease-modifying therapies (DMTs). We conducted a narrative review to summarize the latest knowledge on MS in relation to fertility, pregnancy, assisted reproductive technology (ART), and postpartum management. We focused on various topics, including fertility, the influence of pregnancy on disease progression and reciprocally, the management of MS women undergoing ART, as well as the specific aspects of postpartum care for these women. Understanding these aspects is crucial for neurologists, gynecologists, and reproductive specialists to provide appropriate and multidisciplinary care to women with MS who want to plan a pregnancy.