Getting Pregnant

There are many factors to consider when starting a family with Multiple Sclerosis.

Your medication plan and how your MS is being controlled are some of the factors you may need to consider prior to conception. Your doctor can help provide you with a timeline and medication plan that are well suited for you.

MS does not reduce fertility. Many people find that the physical and emotional symptoms of MS can effect sexual mood, interest and activity, which can affect fertility indirectly.

Women with MS are no more likely to have high risk pregnancies than other women. Having MS should not limit your birthing options or management of delivery.

Pre-pregnancy Counselling

  • 01

    Pre-pregnancy Counselling

    All women of child-bearing age with MS should receive pre-pregnancy counselling, ideally soon after an MS diagnosis.

  • 02

    Planning for Pregnancy

    Women considering pregnancy are advised to plan with their gynacologist before trying to conceive.

  • 03

    Timing is Essential

    Pregnancy should be planned.

  • 04

    Medication Management

    Women should not defer taking a Double Marker Test if considering pregnancy in the future. There is no research that indicates DMT affects pregnancy.

  • 05

    Pregnancy Monitoring

    During pregnancy, you will need close monitoring to keep track of the disease and the health of the fetus.

  • 06

    MS & Male Fertility

    There is currently no data that suggest any effect of DMTs on male fertility.

There’s good news:

  • 01

    There is no evidence that MS causes infertility; contraception should be used if pregnancy is undesirable.

  • 02

    Pregnancy itself does not increase the risk of worsening disability.

  • 03

    Studies have shown that pregnancy, delivery, and rate of congenital disabilities are not any different in women with MS compared with those without MS.

Contraception with Multiple Sclerosis

No known drug-drug interactions between currently available Disease Modifying Therapies (DMTs) and contraceptives have been reported. Women with MS can take contraceptive pills or use other hormone-based contraception.

Assisted reproduction in Multiple Sclerosis studies assessing the impact of assisted reproductive therapy on Multiple Sclerosis disease activity have consistently demonstrated an increased risk of relapse, potentially due to changing hormone levels, cessation of Multiple Sclerosis therapy, and stress.

In particular, the use of pulses of gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide acetate (rather than GnRH antagonists), was found to increase Multiple Sclerosis relapse in the three months following assisted reproductive therapy both in women who did and did not become pregnant.

Prenatal Advice

Women with MS should be given the same prenatal advice as women without MS, including advice about healthy living and not smoking.

  • Supplements

    Women who are planning pregnancy should take prenatal supplements, including Vitamin D and folic acid.

  • DMTs

    Women with MS currently receiving a DMT should consult with their neurologist about whether to continue taking it or when to stop; the decision will depend on the level of disease activity, the individual safety profile of their DMT, and the risk of relapse.

    A woman who plans to stop taking her DMT prior to conceiving should understand the potential impact of this on her MS and also be aware of the average length of time from trying to conceive to conception in women of her age.

Intimacy & Relationships

MS can have an impact on sexual function, and the symptoms of MS can affect mood, interest, and activity. Your MS team and doctor can help you address these issues.

MS disease modifying drugs and cancer

The link between MS and disease-modifying drugs and cancer is still under research, but some of the newer drugs may have been implicated in small populations. Still, ongoing real-world evidence has not shown it as a greater risk than in the normal population. However, prescribing neurologists should discuss this with you further, and regular checks may be facilitated.

Finding support

More on Women’s Health & Family

Explore more resources addressing women’s health and family planning considerations for people living with MS.