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Infertility Treatments May Significantly Increase MS Activity

2/5/2016

A new study finds that women with multiple sclerosis who undergo assisted reproduction technology (ART) infertility treatment are at risk for increased disease activity. The findings suggest reproductive hormones contribute to regulation of immune responses in autoimmune diseases such as MS.

Women with MS typically do not have diminished fertility except in those treated with cyclophosphamide or high-dose corticosteroids. Medical evidence shows sex hormones and those involved in ovulation play an important role in the development of autoimmune disorders. To further understand the effect of infertility treatment on disease activity, researchers, led by Dr. Jorge Correale, with the Raúl Carrea Institute for Neurological Research in Buenos Aires, analyzed clinical, radiological, and immune response data in 16 MS patients who were subject to 26 ART cycles. The team recruited 15 healthy volunteers and 15 MS patients in remission not receiving ART to serve as controls.

Results show that 75 percent of MS patients experienced disease exacerbation following infertility treatment. Relapses were reported in 58 percent of the cycles during the three month period following ART treatment. Furthermore, ART was associated with a seven-fold increase in risk of MS exacerbation and a nine-fold increase of greater disease activity on MRIs. The authors found that 73 percent of exacerbations were new symptoms and 27 percent were attributed to a worsening of pre-existing symptoms.

“Our findings indicate a significant increase in MS disease activity following infertility treatment,” said Dr. Correale. “Neurologists should be aware of possible disease exacerbation so they may discuss the benefits and risks of ART with MS patients.”

The study was published in Annals of Neurology, a journal of the American Neurological Association and Child Neurology Society.



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