Impact of Assisted Reproductive Technologies (ART) on Relapse Risk in Women with Multiple Sclerosis (S31.005)

Abstract

<h3>Objective:</h3> To determine the impact of ART on the relapse risk in a cohort of 91 women with relapsing remitting MS, clinically isolated syndrome or radiologic isolated syndrome mainly treated with disease modifying treatment immunomodulatory treatment (DMT) during ART. <h3>Background:</h3> Several studies have shown an increased relapse risk after ART in MS patients, newer studies lead to different conclusions. <h3>Design/Methods:</h3> Women were prospectively recruited in an ART and MS sub-registry of the German Multiple Sclerosis and Pregnancy Registry (DMSKW). Stimulations were followed prospectively but these women-who had not contacted us before-were also asked for stimulations prior to the current stimulation and included into analysis. Information on stimulation protocols, pregnancy, disease course was collected with a standardized questionnaire in telephone interviews during stimulation and following months. <h3>Results:</h3> We analyzed data on 270 stimulations in 91 women, of which 49/270 (18,15%) were followed prospectively and 221/270 (81,85%) retrospectively. Most women with a mean age of 34,15 [±3.75] years and a median disease duration of 4,3 [0,15–18,64] years had relapsing remitting MS. 83/91 (93,41%), 6/91 (4,4%) clinically isolated syndrome and 2/91 (2,2%) RIS. 186/270 (68,90%) women continued their DMTs during ART, 84/270 (31,11%) stimulations were without DMTs. 92/270 (34,07%) stimulations resulted in pregnancy. Relapses occurred in 25/270 (9,26%) stimulations after three months, interestingly only with small differences between those who got pregnant (7/92 (7,61%)) and those who did not (18/178 (10,11%)) (p = 0.6519). Women who continued DMT during ART had fewer relapses per stimulation (11/186 (5,91%)) compared to women without DMT during ART (14/84 (16,67%)) (p = .009). Updated information including adjusted regression models will be presented at the time of the meeting. <h3>Conclusions:</h3> The maintenance of DMT during ART can be a determining factor in reducing the relapse risk. MS disease activity should be controlled and pregnancy compatible DMT treatment during ART continued. <b>Disclosure:</b> Miss Range has nothing to disclose. Ms. Thiel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer Healthcare . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for INC research . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche . Kerstin Hellwig has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Merck . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen . Kerstin Hellwig has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer . The institution of Kerstin Hellwig has received research support from Roche . The institution of Kerstin Hellwig has received research support from Merck . The institution of Kerstin Hellwig has received research support from Biogen. The institution of Kerstin Hellwig has received research support from Genzyme . The institution of Kerstin Hellwig has received research support from Novartis . The institution of Kerstin Hellwig has received research support from TEVA. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen . Dr. Gold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer Vital. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai Pharamaceuticals. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Gold has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for SAGE Publishers. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Novartis. Dr. Gold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Biogen. The institution of Dr. Gold has received research support from Novartis. The institution of Dr. Gold has received research support from Biogen.