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MS research update - MS more active after assisted reproduction technology - 10 October 2012

Assisted reproduction technology is a general term which is used to describe a range of methods used to achieve pregnancy by artificial or partly artificial means. This includes in vitro fertilisation (IVF) and artificial insemination (AI).

Many people are diagnosed with MS in their twenties and thirties, a time in their lives when they are often planning to have children. Consequently, there may be questions about whether MS could make a difference to pregnancy and childbirth.

There is no evidence that MS affects fertility (the chances of becoming pregnant). However, as in the general population, there will be a proportion of people with MS who experience difficulties becoming pregnant and decide to try IVF or other forms of assisted reproductive technology (ART).

This research project looked at whether a woman's MS was affected by the cycles of hormone treatments that are required for ART. 16 women with MS, who completed a total of 26 cycles (between them) of gonadotropin-releasing hormone (GnRH) agonists followed by recombinant follicle-stimulating hormone (FSH), were included in the study.

They were followed for 12 months before beginning hormone treatment and for nine months after the end of the final hormone cycle. Their MS was monitored every three months by neurological examination, MRI scans and immunological testing. The immunological testing looked at a range of markers of immune system activity including some more specific for MS.

The researchers found that there was a seven fold increase in MS symptoms and a nine fold increase in disease activity as seen by MRI. In addition, there were changes in immune system markers, prompted by the changes in hormone levels from the fertility treatment, which could explain the increase in MS activity.

The study concluded that there was a significant increase in MS disease activity in people receiving this form of assisted reproduction technology and suggested that neurologists should be aware of this. The researchers commented that reproductive hormones appear to play an important role in regulating immune responses in autoimmune diseases such as MS.

Correale J, Farez MF, Ysrraelit MC.
Increase in multiple sclerosis activity after assisted reproduction technology.
Ann Neurol. 2012 Oct 3. doi:10.1002/ana.23745. [Epub ahead of print]

More about pregnancy and MS

You can read more about pregnancy and MS in the A-Z of MS.

Research by topic areas...

Disease modifying treatments

Lundkvist M, Engdahl E, Holmén C, et al.
Characterization of anti-natalizumab antibodies in multiple sclerosis patients.
Mult Scler. 2012 Oct 8. [Epub ahead of print]

Ontaneda D, Hara-Cleaver C, Rudick RA, et al.
Early tolerability and safety of fingolimod in clinical practice.
J Neurol Sci. 2012 Oct 3. pii: S0022-510X(12)00501-1. doi: 10.1016/j.jns.2012.09.009. [Epub ahead of print]

Centonze D, Rossi S, Rinaldi F, et al.
Severe relapses under fingolimod treatment prescribed after natalizumab.
Neurology. 2012 Oct 3. [Epub ahead of print]

Other treatments

Restivo DA, Casabona A, Centonze D, et al.
Pharyngeal electrical stimulation for dysphagia associated with multiple sclerosis: A pilot study.
Brain Stimul. 2012 Sep 23. pii: S1935-861X(12)00155-6. doi: 10.1016/j.brs.2012.09.001. [Epub ahead of print]


Cristiano E, Rojas J, Romano M, et al.
The epidemiology of multiple sclerosis in Latin America and the Caribbean: a systematic review.
Mult Scler. 2012 Oct 8. [Epub ahead of print]

Assessment tools

Motl RW, Sandroff BM, Sosnoff JJ.
Commercially available accelerometry as an ecologically valid measure of ambulation in individuals with multiple sclerosis.
Expert Rev Neurother. 2012 Sep;12(9):1079-88.

Lehman KA, Burns MN, Gagen EC, et al.
Development of the brief inventory of perceived stress.
J Clin Psychol. 2012 Jun;68(6):631-44.

Causes of MS

Djelilovic-Vranic J, Alajbegovic A.
Role of early viral infections in development of multiple sclerosis.
Med Arh. 2012;66(3 Suppl 1):37-40.

Psychological aspects

Heesen C, Köpke S, Kasper J, et al.
Behavioral interventions in multiple sclerosis: a biopsychosocial perspective.
Expert Rev Neurother. 2012 Sep;12(9):1089-100.

Fiest KM, Patten SB.
The multiple sclerosis depression rating scale.
Expert Rev Neurother. 2012 Sep;12(9):1053-5.

Physical activity

Smith CM, Hale LA, Mulligan HF.
Participant perceptions of a novel physiotherapy approach ("Blue Prescription") for increasing levels of physical activity in people with multiple sclerosis: a qualitative study following intervention.
Disabil Rehabil. 2012 Oct 3. [Epub ahead of print]

Smith DC, Lanesskog D, Cleeland L, et al.
Motivational interviewing may improve exercise experience for people with multiple sclerosis: A small randomized trial.
Health Soc Work. 2012 May;37(2):99-109.


Saidha S, Sotirchos ES, Ibrahim MA, et al.
Microcystic macular oedema, thickness of the inner nuclear layer of the retina, and disease characteristics in multiple sclerosis: a retrospective study.
Lancet Neurol. 2012 Oct 4. pii: S1474-4422(12)70213-2. doi: 10.1016/S1474-4422(12)70213-2. [Epub ahead of print]


[no authors listed]
Abstracts of the 28th Congress of the European Committee for Treatment and Research in Multiple Sclerosis. October 10-13, 2012. Lyon, France.
Mult Scler.2012 Oct;18(4 Suppl):9-542.


Hofmann A, Stellmann J, Kasper J, et al.
Long-term treatment risks in multiple sclerosis: risk knowledge and risk perception in a large cohort of mitoxantrone-treated patients.
Mult Scler. 2012 Oct 4. [Epub ahead of print]

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