The road to conception for women with multiple sclerosis

Dessa Sadovnick; Maria Criscuoli; Irene Yee; Robert Carruthers; Alice Schabas; Penelope Smyth

doi:10.1177/20552173211032313

The road to conception for women with multiple sclerosis

Mult Scler J Exp Transl Clin. 2021 Jul 15;7(3):20552173211032313. doi: 10.1177/20552173211032313. eCollection 2021 Jul-Sep.

Authors

Dessa Sadovnick¹, Maria Criscuoli², Irene Yee¹, Robert Carruthers², Alice Schabas³, Penelope Smyth²

Affiliations

¹ Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada.
² Department of Medicine (Neurology), University of Alberta, Edmonton, Alberta, Canada.
³ Faculty of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada.

Abstract

Objective: The objective of this prospective "real world" study is to gain insight into the different "roads to conception" that women with MS take as part of the prospective Canadian Multiple Sclerosis Pregnancy Study (CANPREG-MS).

Methods: Participants are women with MS who are planning a pregnancy. Data cut-off for analyses was April 30, 2020.

Results: We believe this is the first prospective National study of women with MS planning pregnancies.The data are for the first 44 women enrolled of whom 26 achieved pregnancy by cut-off date. Seven women used assisted reproductive technologies (ARTs); 6 stopped disease modifying therapy (DMT) against their neurologists' recommendations; 6 had an interruption(s) in trying to conceive due to MS relapses, MRI-detected inflammation, or limited "windows of opportunity" between DMT courses.

Conclusion: The study illustrates the roads that women take to conception, even if they are on the same therapy and have similar clinical expression of MS. Advice given by treating neurologists on washout periods show discrepancies. This paper highlights the real problem that there is no definitive, international consensus on managing these women due to the lack of "real world" data and thus the goal of CANPREG-MS is to provide such real world data.

Keywords: Multiple sclerosis; conception; disease modifying therapies; family planning; pregnancy.