Multiply sclerosis and fertility

Abstract

The article is a review of modern scientific publications, which are devoted to the problems of fertility and disorders of reproductive functions in patients with multiple sclerosis, the direct impact of this disease and disease-modifying therapy on human reproductive health.Multiple sclerosis belongs to autoimmune neurodegenerative diseases, which today remains the leading cause of non-traumatic disability and leads to the formation of permanent physical defects, cognitive disorders and a decrease of the quality of life. Every year an increased number of people are diagnosed with multiple sclerosis, especially among the young persons of reproductive age, because the debut of the disease falls between the ages of 20 and 40 years.This pathology affects both women and men. Moreover, it should be noted that there are twice more women with multiple sclerosis than men, and the reason for this «phenomenon» remains unknown for certain. It is also unclear why the course and manifestations of the disease differ among individuals of different sexes. Multiple sclerosis has a significant impact on all areas of a person’s life, limiting his capabilities.For many years, it was believed that pregnancy is harmful for women with multiple sclerosis, so doctors did not recommend pregnancy due to the fear that patients would not be able to care for their children due to significant worsening of the disease and progression of disability. And that’s why today among patients, both male and female, fears often arise regarding: the effect of this disease and the drugs used in the treatment of multiple sclerosis on fertility; safety and risks during pregnancy and the postpartum period; possibilities and effectiveness of using assisted reproductive technologies as needed.A rather important step for a patient with multiple sclerosis is family planning, which should include counseling on the choice of contraceptive methods, drugs for disease-modifying and symptomatic therapy, a multidisciplinary approach to pregnancy management in such patients in order to optimize treatment and minimize all possible negative effects to ensure the best result