Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-nr4z6 Total loading time: 0 Render date: 2024-06-12T10:44:13.392Z Has data issue: false hasContentIssue false

Chapter 10 - Reproductive Issues

Published online by Cambridge University Press:  10 February 2021

Carlos A. Perez ,
Andrew Smith  and
Flavia Nelson
By
Andrew Smith
Carlos A. Perez
Affiliation:
University of Texas, Houston
Andrew Smith
Affiliation:
OhioHealth Riverside Methodist Hospital in Columbus, Ohio, USA
Flavia Nelson
Affiliation:
University of Minnesota, Minneapolis
Get access

Summary

With multiple sclerosis (MS) affecting women two to three times more often than men, and an average age of onset of 20–50 years, a good portion of MS patients will be women of reproductive potential. Therefore, it is critical to develop an understanding of how the disease affects reproduction and menopause, and how it might impact their life goals. Over the course of this chapter, epidemiological risk factors based on gender, pregnancy, and the need for family planning will be reviewed.

Type
Chapter
Information
Multiple Sclerosis
A Practical Manual for Hospital and Outpatient Care
 , pp. 177 - 192
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Trojano, M, Lucchese, G, Graziano, G, et al. Geographical variations in sex ratio trends over time in multiple sclerosis. PLoS One. 2012;7(10):e48078.CrossRefGoogle ScholarPubMed
Ysrraelit, MC, Correale, J. Impact of sex hormones on immune function and multiple sclerosis development. Immunology. 2019;156(1):9–22.CrossRefGoogle ScholarPubMed
Fontenot, JD, Gavin, MA, Rudensky, AY. Pillars article: Foxp3 programs the development and function of CD4+CD25+ regulatory T cells. J Immunol. 2017;198(3):986–92.Google Scholar
Voskuhl, RR, Sawalha, AH, Itoh, Y. Sex chromosome contributions to sex differences in multiple sclerosis susceptibility and progression. Mult Scler. 2018;24(1):22–31.CrossRefGoogle ScholarPubMed
Haines, JL, Terwedow, HA, Burgess, K, et al. Linkage of the MHC to familial multiple sclerosis suggests genetic heterogeneity. The Multiple Sclerosis Genetics Group. Hum Mol Genet. 1998;7(8):1229–34.CrossRefGoogle ScholarPubMed
Mosca, L, Mantero, V, Penco, S, et al. HLA-DRB1*15 association with multiple sclerosis is confirmed in a multigenerational Italian family. Funct Neurol. 2017;32(2):83–8.Google Scholar
Biro, FM, Khoury, P, Morrison, JA. Influence of obesity on timing of puberty. Int J Androl. 2006;29(1):272–7; discussion 86–90.Google Scholar
Chitnis, T. Role of puberty in multiple sclerosis risk and course. Clin Immunol. 2013;149(2):192–200.CrossRefGoogle ScholarPubMed
Mohammadbeigi, A, Kazemitabaee, M, Etemadifar, M. Risk factors of early onset of MS in women in reproductive age period: survival analysis approach. Arch Womens Ment Health. 2016;19(4):681–6.CrossRefGoogle ScholarPubMed
Waubant, E. Effect of puberty on multiple sclerosis risk and course. Mult Scler. 2018;24(1):32–5.CrossRefGoogle ScholarPubMed
Koch-Henriksen, N, Sorensen, PS. The changing demographic pattern of multiple sclerosis epidemiology. Lancet Neurol. 2010;9(5):520–32.CrossRefGoogle ScholarPubMed
Degelman, ML, Herman, KM. Smoking and multiple sclerosis: a systematic review and meta-analysis using the Bradford Hill criteria for causation. Mult Scler Relat Disord. 2017;17:207–16.CrossRefGoogle Scholar
Rotstein, DL, Chen, H, Wilton, AS, et al. Temporal trends in multiple sclerosis prevalence and incidence in a large population. Neurology. 2018;90(16):e1435–41.CrossRefGoogle ScholarPubMed
Hellwig, K, Chen, LH, Stancyzk, FZ, Langer-Gould, AM. Oral contraceptives and multiple sclerosis/clinically isolated syndrome susceptibility.PLoS One. 2016;11(3):e0149094.CrossRefGoogle ScholarPubMed
Alonso, A, Jick, SS, Olek, MJ, et al. Recent use of oral contraceptives and the risk of multiple sclerosis.Arch Neurol. 2005;62(9):1362–5.Google Scholar
Cavalla, P, Rovei, V, Masera, S, et al. Fertility in patients with multiple sclerosis: current knowledge and future perspectives. Neurol Sci. 2006;27(4):231–9.CrossRefGoogle ScholarPubMed
Gava, G, Bartolomei, I, Costantino, A, et al. Long-term influence of combined oral contraceptive use on the clinical course of relapsing-remitting multiple sclerosis. Fertil Steril. 2014;102(1):116–22.CrossRefGoogle ScholarPubMed
Sena, A, Couderc, R, Vasconcelos, JC, et al. Oral contraceptive use and clinical outcomes in patients with multiple sclerosis. J Neurol Sci. 2012;317(1–2):47–51.CrossRefGoogle ScholarPubMed
Thone, J, Kollar, S, Nousome, D, et al. Serum anti-Mullerian hormone levels in reproductive-age women with relapsing-remitting multiple sclerosis. Mult Scler. 2015;21(1):41–7.CrossRefGoogle ScholarPubMed
Ferraro, D, Simone, AM, Adani, G, et al. Definitive childlessness in women with multiple sclerosis: a multicenter study. Neurol Sci. 2017;38(8):1453–9.Google Scholar
Alwan, S, Yee, IM, Dybalski, M, et al. Reproductive decision making after the diagnosis of multiple sclerosis (MS). Mult Scler. 2013;19(3):351–8.Google Scholar
Correale, J, Farez, MF, Ysrraelit, MC. Increase in multiple sclerosis activity after assisted reproduction technology. Ann Neurol. 2012;72(5):682–94.CrossRefGoogle ScholarPubMed
Hellwig, K, Correale, J. Artificial reproductive techniques in multiple sclerosis. Clin Immunol. 2013;149(2):219–24.Google Scholar
Michel, L, Foucher, Y, Vukusic, S, et al. Increased risk of multiple sclerosis relapse after in vitro fertilisation. J Neurol Neurosurg Psychiatry. 2012;83(8):796–802.Google Scholar
Bove, R, Alwan, S, Friedman, JM, et al. Management of multiple sclerosis during pregnancy and the reproductive years: a systematic review. Obstet Gynecol. 2014;124(6):1157–68.Google Scholar
Parnell, GP, Booth, DR. The multiple sclerosis (MS) genetic risk factors indicate both acquired and innate immune cell subsets contribute to MS pathogenesis and identify novel therapeutic opportunities. Front Immunol. 2017;8:425.CrossRefGoogle Scholar
Confavreux, C, Hutchinson, M, Hours, MM, et al. Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in Multiple Sclerosis Group. N Engl J Med. 1998;339(5):285–91.Google Scholar
D'Hooghe, MB, Nagels, G, Uitdehaag, BM. Long-term effects of childbirth in MS. J Neurol Neurosurg Psychiatry. 2010;81(1):38–41.CrossRefGoogle ScholarPubMed
Lu, E, Zhu, F, van der Kop, M, et al. Labor induction and augmentation in women with multiple sclerosis. Mult Scler. 2013;19(9):1182–9.Google Scholar
Vukusic, S, Durand-Dubief, F, Benoit, A, et al. Natalizumab for the prevention of post-partum relapses in women with multiple sclerosis. Mult Scler. 2015;21(7):953–5.Google Scholar
Coyle, PK. Management of women with multiple sclerosis through pregnancy and after childbirth. Ther Adv Neurol Disord. 2016;9(3):198–210.CrossRefGoogle ScholarPubMed
Kubik-Huch, RA, Gottstein-Aalame, NM, Frenzel, T, et al. Gadopentetate dimeglumine excretion into human breast milk during lactation. Radiology. 2000;216(2):555–8.CrossRefGoogle ScholarPubMed
Goischke, HK. Safety assessment of gadolinium-based contrast agents (GBCAs) requires consideration of long-term adverse effects in all human tissues. Mult Scler J Exp Transl Clin. 2017;3(2):2055217317704450.Google Scholar
Sandberg-Wollheim, M, Neudorfer, O, Grinspan, A, et al. Pregnancy outcomes from the branded glatiramer acetate pregnancy database. Int J MS Care. 2018;20(1):9–14.CrossRefGoogle ScholarPubMed
Vaughn, C, Bushra, A, Kolb, C, Weinstock-Guttman, B. An update on the use of disease-modifying therapy in pregnant patients with multiple sclerosis. CNS Drugs. 2018;32(2):161–78.CrossRefGoogle ScholarPubMed
Lu, E, Wang, BW, Alwan, S, et al. A review of safety-related pregnancy data surrounding the oral disease-modifying drugs for multiple sclerosis. CNS Drugs. 2014;28(2):89–94.CrossRefGoogle ScholarPubMed
Karlsson, G, Francis, G, Koren, G, et al. Pregnancy outcomes in the clinical development program of fingolimod in multiple sclerosis. Neurology. 2014;82(8):674–80.Google Scholar
Hemat, S, Vidal-Jordana, A, Guger, M, et al., eds. Disease activity during pregnancy after fingolimod withdrawal due to planning a pregnancy in women with multiple sclerosis. Poster session presented at the 34th annual meeting of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS); 2018.Google Scholar
Kieseier, BC, Benamor, M. Pregnancy outcomes following maternal and paternal exposure to teriflunomide during treatment for relapsing-remitting multiple sclerosis. Neurol Ther. 2014;3(2):133–8.CrossRefGoogle ScholarPubMed
Genzyme, S. European Public Assessment Report (EPAR) for Aubagio. 2013 [updated 2018]. www.ema.europa.eu/en/medicines/human/EPAR/aubagio.Google Scholar
Kleerekooper, I, van Kempen, ZLE, et al. Disease activity following pregnancy-related discontinuation of natalizumab in MS. Neurol Neuroimmunol Neuroinflamm. 2018;5(1):e424.Google Scholar
Friend, S, Richman, S, Bloomgren, G, et al. Evaluation of pregnancy outcomes from the Tysabri (natalizumab) pregnancy exposure registry: a global, observational, follow-up study. BMC Neurol. 2016;16(1):150.CrossRefGoogle ScholarPubMed
Ebrahimi, N, Herbstritt, S, Gold, R, et al. Pregnancy and fetal outcomes following natalizumab exposure in pregnancy: a prospective, controlled observational study. Mult Scler. 2015;21(2):198–205.CrossRefGoogle ScholarPubMed
Haghikia, A, Langer-Gould, A, Rellensmann, G, et al. Natalizumab use during the third trimester of pregnancy. JAMA Neurol. 2014;71(7):891–5.CrossRefGoogle ScholarPubMed
Coles, AJ, Cohen, JA, Fox, EJ, et al. Alemtuzumab CARE-MS II 5-year follow-up: efficacy and safety findings. Neurology. 2017;89(11):1117–26.CrossRefGoogle ScholarPubMed
Das, G, Damotte, V, Gelfand, JM, et al. Rituximab before and during pregnancy: a systematic review, and a case series in MS and NMOSD. Neurol Neuroimmunol Neuroinflamm. 2018;5(3):e453.CrossRefGoogle Scholar
Achiron, A, Kishner, I, Dolev, M, et al. Effect of intravenous immunoglobulin treatment on pregnancy and postpartum-related relapses in multiple sclerosis. J Neurol. 2004;251(9):1133–7g.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×