Multiple sclerosis: Pregnancy, fertility, and assisted reproductive technology–a review

IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY Multiple sclerosis and related disorders Pub Date : 2024-09-21 DOI:10.1016/j.msard.2024.105893
Celia Oreja-Guevara , Inés Gónzalez-Suárez , Mar Mendibe Bilbao , José Luis Gómez-Palomares , Corazón Hernández Rodríguez , Aintzane Rabanal , Yolanda Aladro Benito
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Abstract

Background

Pregnancy is not discouraged in multiple sclerosis (MS) patients. However, MS patients tend to delay motherhood since they must wait for a low clinical and radiological activity before considering pregnancy, which impacts their fertility and their need for assisted reproductive technology (ART). This review aimed to cover, from a multidisciplinary perspective, the most critical aspects revolving around pregnancy in MS patients.

Methods

A group of seven experts (four neurologists and three gynaecologists) met for three discussion sessions to review current knowledge on ART in patients with MS. PubMed searches for journal articles published in English or Spanish between 2000 and 2024 were undertaken. 354 articles were revised at the title level.

Results

We reviewed current evidence on fertility in women and men with MS, on the effects of pregnancy on MS, the disease's pharmacological treatment during pregnancy, MS during delivery and breastfeeding, ART (intrauterine insemination, in vitro fertilisation, intracytoplasmic sperm injection, and oocyte cryopreservation) in patients with MS.

Conclusion

Early family planning, supported by good coordination between neurology and gynaecology departments, is paramount to managing MS women with motherhood desire. Besides, although a well-planned, early pregnancy is always the most desirable outcome, ART is considered safe and valuable for MS patients. Finally, multidisciplinary units are deemed pivotal to guide MS patients with parenthood desire through pregnancy.
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多发性硬化症:怀孕、生育和辅助生殖技术--综述。
背景:多发性硬化症(MS)患者并不排斥怀孕。然而,多发性硬化症患者往往会推迟怀孕,因为他们必须等到临床和放射学活动度较低时才能考虑怀孕,这影响了他们的生育能力和对辅助生殖技术(ART)的需求。本综述旨在从多学科角度探讨与多发性硬化症患者妊娠有关的最关键问题:由七位专家(四位神经科医生和三位妇科医生)组成的小组进行了三次讨论,回顾了目前有关多发性硬化症患者辅助生殖技术的知识。他们在 PubMed 上搜索了 2000 年至 2024 年间以英文或西班牙文发表的期刊文章。对 354 篇文章的标题进行了修订:我们回顾了目前有关多发性硬化症女性和男性患者生育、妊娠对多发性硬化症的影响、妊娠期间的药物治疗、多发性硬化症的分娩和哺乳、多发性硬化症患者的抗逆转录病毒疗法(宫腔内人工授精、体外受精、卵胞浆内单精子注射和卵母细胞冷冻)的证据:结论:在神经内科和妇科之间良好协调的支持下,及早进行计划生育对于管理有生育愿望的多发性硬化症妇女至关重要。此外,尽管计划周全的早孕总是最理想的结果,但 ART 被认为对多发性硬化症患者是安全和有价值的。最后,多学科小组被认为是指导有生育愿望的多发性硬化症患者完成妊娠的关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.80
自引率
20.00%
发文量
814
审稿时长
66 days
期刊介绍: Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.
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