Live birth in women with multiple sclerosis receiving assisted reproduction

• Published in: Reproductive biomedicine online 2020-05, Vol.40 (5), p.711-718
• Main Authors: Jølving, Line Riis, Larsen, Michael Due, Fedder, Jens, Nørgård, Bente Mertz
• Format: Article
• Language: English
• Subjects: Adult; Assisted reproductive technology; Chronic disease; Clinical epidemiology; Denmark; Embryo Transfer; Female; Humans; In vitro fertilization; Live Birth; Multiple Sclerosis; Pregnancy; Pregnancy Rate; Registries; Reproductive Techniques, Assisted
• ISSN: 1472-6483; 1472-6491
• DOI: 10.1016/j.rbmo.2020.01.013

Multiple sclerosis is predominant in women during the childbearing years and, in case of problems with conceiving naturally, assisted reproductive technology (ART) becomes relevant. The efficacy of ART treatment in women with multiple sclerosis has not previously been studied. Our aim was to examine the chance of a liveborn infant after an embryo transfer in women with multiple sclerosis and to examine whether corticosteroids before embryo transfer had a beneficial effect. This cohort study is based on nationwide Danish health registries, including all women who underwent embryo transfers between 1 January 1995 to 31 December 2017. The exposed cohort comprised 2267 embryo transfers in women with multiple sclerosis and the unexposed cohort comprised 200,684 in women without multiple sclerosis. Multilevel logistic regression analysis was used to compute the crude and the adjusted risk estimates. A total of 21.97% of the embryo transfers in women with multiple sclerosis resulted in a liveborn infant compared with 24.17% in women without multiple sclerosis, and the adjusted odds ratio was 0.91 (95% CI 0.81 to 1.02). The adjusted odds ratio of live birth in women with multiple sclerosis using corticosteroids before embryo transfer was 0.90 (95% CI 0.49 to 1.68), compared with women with multiple sclerosis receiving no corticosteroids. The chance of a live birth was not decreased in women with multiple sclerosis undergoing ART compared with women without multiple sclerosis. The use of corticosteroids had no effect on the result. These novel results on ART treatment are useful when counselling women with multiple sclerosis undergoing assisted reproduction.