Abstract

Abstract Study question Is the prevalence of infertility among multiple sclerosis female patients higher compared to the general population? Summary answer The prevalence of infertility among women with multiple sclerosis is similar to the matched general population What is known already Multiple sclerosis (MS) is an autoimmune disease predominant in women (1:3 ratio) during childbearing years. Studies addressing the question of infertility among multiple sclerosis patients are inconclusive and whether fertility is impaired in this population is debatable. Study design, size, duration Data regarding multiple sclerosis diagnosis and treatment and data about infertility and ART treatments was collected for patients during childbearing years (18-45) between the years 2005 to 2020 from the health service computerized database. Participants/materials, setting, methods The prevalence of infertility among women with MS was analyzed and compared to healthy controls (1:5) matched for age. Association between multiple sclerosis and the different ART treatments: in vitro fertilization (IVF) versus controlled ovarian hyperstimulation (COH) were analyzed. Main results and the role of chance 1,570 women with multiple sclerosis were compared to 7,851 healthy women matched for age. Mean age of both groups was 32 years old. The prevalence of infertility was 34.1% (534) in the MS population compared to 33.3% (2,601) in the matched general population (p = 0.4). 299 of the 536 MS patients were diagnosed with infertility after they were diagnosed with multiple sclerosis. The prevalence of the different ART treatments was similar between MS patients and healthy women matched for age: (IVF: 7.1% vs 7% p = 0.813 and COH: 5.7% vs 6% p = 0.6; respectively). Limitations, reasons for caution The major limitation of our study is its retrospective nature. Furthermore, we were not able to evaluate for confounding factors possibly contributing to postponed family planning. Wider implications of the findings To date this is the largest study evaluating the prevalence of infertility and ART treatment among MS patients during childbearing years. Our findings may reassure patients with MS that their risk for infertility and need for ART treatments is comparable to the health general population. Trial registration number not applicable

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