Pregnancy and Multiple Sclerosis - dummies

By Rosalind Kalb, Barbara Giesser, Kathleen Costello

The good news for couples is that women and men with multiple sclerosis (MS) can be effective, involved parents of healthy, happy children. Although the message prior to about 1950 was that women with MS shouldn’t even consider having kids, the research since then has confirmed repeatedly that MS and motherhood can go together just fine.

Men with MS haven’t received as much attention in this area, but no research suggests that MS interferes with a man’s ability to father a healthy child or to be a good parent.

Fertility isn’t affected by MS

Happily, MS doesn’t affect the production of eggs or sperm (or their ability to form healthy embryos). But, unless you’re ready to hear the pitter-patter of little feet, the fact that your fertility factories are functioning means that you and your partner need to make the same decisions about birth control as everyone else.

Keep in mind that some of the medications used to treat MS or its symptoms — including corticosteroids, anticonvulsants, and antibiotics — can reduce the effectiveness of oral contraceptives. So, couples are advised to use additional protection if the woman is taking any of these medications.

Even though sperm production isn’t affected by MS, problems with erectile function or ejaculation can interfere with conception. So, guys who are experiencing difficulty getting or maintaining an erection, or ejaculating, may want to consult a urologist about treatment for the problem.

Pregnancy hormones reduce MS disease activity

Many studies have shown that the risk of MS relapses (exacerbations) actually decreases during pregnancy. This may seem paradoxical, but there is a good reason for it. Consider one of the important functions of the hormones of pregnancy: They suppress a woman’s immune system so that her body doesn’t reject the developing fetus as a foreigner.

This, in turn, helps out your MS because as the hormone levels rise over the nine months of pregnancy, your likelihood of having a relapse decreases — particularly during your third trimester when the hormone levels are highest. Lots of women with MS say they feel so good when they’re pregnant that they wish they could stay pregnant forever.

As the pregnancy hormones return to normal levels during the three to six months following delivery (or the termination of the pregnancy by spontaneous or elective abortion), a woman’s risk of relapse rises significantly before it levels off to her pre-pregnancy rate. So, as a group, women have about a 10 percent risk of having a relapse while pregnant and a 29 percent risk of a relapse soon after the pregnancy ends.

However, the best way to predict your own risk of having a relapse following delivery is to look at your rate of relapses prior to becoming pregnant and during your pregnancy. The more active your MS was during that period, the more likely you are to experience a relapse in the months after your baby is born.

Pregnancies don’t increase a woman’s long-term MS disability level

Women with MS who have had one or more pregnancies don’t become any more disabled over the long run than women with MS who have no pregnancies. In fact, some research even suggests that women with MS who have been pregnant fare slightly better than women who have not, although the reasons for this aren’t clear.

This means that even though your risk of having a relapse increases immediately following pregnancy, this risk has not been found to increase your risk of becoming more disabled over time.