Live birth in women with multiple sclerosis receiving assisted reproduction

ABSTRACT Research question Multiple sclerosis (MS) 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 MS has not previously been studied. Our aim was to examine the chance of a live-born child after an embryo transfer in women with MS and to examine whether corticosteroids prior to embryo transfer had a beneficial effect. Design This cohort study is based on nationwide Danish health registries, including all women with embryo transfers from 1 January 1995 through 31 December 2017. The exposed cohort comprised 2,267 embryo transfers in women with MS and 200,684 in women without MS (unexposed). We used multilevel logistic regression analysis to compute the crude and the adjusted risk estimates. Results A total of 21.97% of the embryo transfers in women with MS resulted in a live born child compared to 24.17% in women without MS, and the adjusted odds ratio (aOR) was 0.91 (95% CI 0.81 - 1.02). The aOR of live birth in women with MS using corticosteroids prior to embryo transfer was 0.90 (95% CI 0.49 – 1.68), compared to women with MS receiving no corticosteroids. Conclusion The chance of a live birth was not decreased, in women with MS undergoing ART, compared to women without MS. The use of corticosteroids had no impact on the result. These novel results on ART treatment are useful when counseling women with MS undergoing assisted reproduction.