Is Fertility Affected in Women of Childbearing Age with Multiple Sclerosis or Neuromyelitis Optica Spectrum Disorder?

Ovarian reserve in patients with multiple sclerosis: A systematic review and meta‐analysis

“…Sadeghpour et al 17 Çil et al 13 Graves et al 16 Sepúlveda et al 25 Thöne et al the contrasting results between AMH and AFC in women affected by MS, with the first found to be non-significantly different and the second significantly lower in women with MS than in controls.…”

“…Although there was no difference in the number of elective abortions, spontaneous abortions, or ectopic pregnancies after onset, the total fertility rate (TFR) was lower in women with MS than in controls 12 . Recently, it has been observed that women of reproductive age with relapsing remitting MS (RRMS) are characterized by lower levels of ovarian reserve markers, 13–15 but other studies showed contrasting results 16,17 …”

“…12 Recently, it has been observed that women of reproductive age with relapsing remitting MS (RRMS) are characterized by lower levels of ovarian reserve markers, [13][14][15] but other studies showed contrasting results. 16,17 The aim of this systematic review was to summarize the recent evidence about ovarian reserve markers in women affected by MS compared with healthy controls.…”

Pregnancy Management in Multiple Sclerosis and Other Demyelinating Diseases

“…thyroid disorders, whereas others suggest normal fertility. 48,52,53 In general, a lower rate of fertility treatments was seen in patients with MS despite a higher rate of infertility diagnosis. 54 In general, if pregnancy is not achieved after 3 to 6 months of optimal conception attempts, referral to a fertility clinic should be considered (in contrast to the 12-month recommendation in a patient without MS or NMOSD) to optimize time off therapy and minimize stressors.…”

“…In addition to possible differences in preferences and decision making surrounding childbearing, evidence on whether fertility is impaired in patients with MS or NMOSD is still sparse, and sometimes conflicting 23,48-51 . Some studies report decreased fertility because of lower levels of antimüllerian hormone, increased endometriosis, and frequent comorbid thyroid disorders, whereas others suggest normal fertility 48,52,53 . In general, a lower rate of fertility treatments was seen in patients with MS despite a higher rate of infertility diagnosis 54 …”