Annualized relapse rate (ARR) in women with multiple sclerosis (MS) increased significantly in the period after in vitro fertilization (IVF), compared with the period immediately before fertilization and a control period, researchers reported in the June 11 online Journal of Neurology, Neurosurgery, and Psychiatry. The increase may be associated with treatment with gonadotrophin-releasing hormone agonists and failure of IVF.
Laure Michel, MD, a neurologist at the Centre Hospitalier Universitaire de Nantes in France, and colleagues analyzed data from 32 patients with MS who had undergone IVF. Patients’ mean age at MS onset was 26.3, and the mean disease duration at the first IVF was 6.6 years. Patients were followed up for a mean of 10.5 years. The investigators reviewed patient data to gather information about patients’ MS and about the treatments used for IVF. The association between IVF and MS relapse was analyzed using univariate and multivariate statistical tests.
Of the 32 patients, 19 had an MS relapse during the three months following IVF. In this period, mean ARR increased to 1.60 ± 2.40, compared with the three-month period before fertilization (mean ARR: 0.80 ± 1.61) and the control period one year earlier (mean ARR: 0.68 ± 1.51). When IVF failed, ARR increased to 1.96 ± 2, compared with 0.98 ± 1.74 before IVF.
“To our knowledge and to date, this is the largest cohort analysis of the short-term relationship between IVF and the risk of relapse in MS patients,” said Dr. Michel. “MS patients should be aware of a possible increased risk of MS relapse after IVF, particularly if the procedure does not result in a pregnancy.”
Michel L, Foucher Y, Vukusic S, et al. Increased risk of multiple sclerosis relapse after in vitro fertilisation. J Neurol Neurosurg Psychiatry. 2012 Jun 11; [Epub ahead of print].