SECTION E: Planned-Unplanned Pregnancy and Disease Modifying Treatments

Both men and women with RRMS must use birth control methods if they do not want an unplanned pregnancy. Women with RRMS and female sexual partners of men with RRMS are as likely to get pregnant as people without RRMS. RRMS does not affect women or men’s fertility. In women, some side-effects of RRMS medications can make the oral contraceptive pill less likely to work. For example, a stomach upset or sickness can mean the hormones from the contraceptive pill needed to stop a pregnancy are not taken into the blood stream in time.

Men and women with RRMS face the same problems and decisions about fertility, pregnancy and parenthood as people without RRMS. They can follow the usual advice for having a healthy conception and pregnancy, such as taking supplements, and not smoking or drinking alcohol. Women and men can take steroids to treat relapses without affecting their chances of conception, miscarriage and/or the baby’s health.

Studies describing the chance of people taking DMTs conceiving and miscarrying show DMTs do not affect women’s fertility. For men, the immune modulation treatment Teriflunomide can lower sperm count and make it more difficult for a couple to get pregnant. People who stop taking DMTs are more likely to get a severe relapse, sometimes known as a rebound [14].

MS professionals talk with men and women about how to manage their RRMS treatment and make fertility and pregnancy decisions.

Some studies tested how much, and how long, DMT chemicals stay in a body. DMT chemicals can stay in the body from weeks to 2 years after people stop taking them.

It is not known how harmful these chemicals are to a baby’s health. Some DMTs are safe enough for women to take when pregnant or breastfeeding. MS professionals talk with people planning to get pregnant, or already pregnant, about their views on keeping or ending a pregnancy when there are worries about how DMTs can affect a baby’s health.

If you or your partner have an unplanned pregnancy, or are planning to get pregnant, talk with your MS doctor about the best treatment to have for you or your partner’s RRMS, the pregnancy, and the baby.

For women, studies show taking the immune modulator treatment, Glatiramer Acetate and Beta-interferons, does not increase the chance of miscarriage or affect the baby’s health during pregnancy. Talk to your MS doctor about sticking with, or changing, your treatment regime.

Each pregnancy is different and some women relapse in one pregnancy but not another. Some women with RRMS are less likely to have a relapse during their pregnancy. After a baby is born, women with RRMS are more likely to have a relapse. Glatiramer Acetate and Betainterferons can be taken by women who decide to breast feed their baby. Women who decide to stop taking their DMT during pregnancy are advised to start taking their DMT soon after giving birth. It can take up to six months before the DMTs work at full strength again.

Comparison DMT Table