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Any person considering pregnancy and parenthood has a lot to think about. While multiple sclerosis requires some additional considerations, planning, and preparation, an MS pregnancy can be just like any other pregnancy.
Parenthood can come quicker than you think and can change your life drastically. So, when trying to wrap your head around this big decision, think through the conversations you need to have to feel confident.
Does MS Affect Fertility?
No, multiple sclerosis has no direct effect on fertility. MS does not affect the production of eggs or sperm or the ability for healthy embryos to form. However, in men, MS may affect erectile function or ejaculation, which can interfere with conception. This can be managed through consultation and treatment from a urologist.
Contraception and Birth Control
Since multiple sclerosis does not affect fertility and your ability to have kids, finding the birth control that is right for you is a crucial aspect of the treatment plan you make with your doctor. Some medications used to treat MS or its symptoms can reduce the effectiveness of contraceptives. In these cases, couples are advised to use additional forms of birth control to ensure effectiveness.
How Will Having MS Affect My Pregnancy?
There is no evidence that having MS impacts conception, pregnancy, delivery, or breastfeeding.
However, it’s important to discuss your plans with your MS healthcare provider because a woman’s or man’s medications may need to be scheduled around your conception and pregnancy plans.
How Might My Pregnancy Affect My MS?
During pregnancy, women with multiple sclerosis generally feel at their best because the pregnancy hormones reduce the inflammation that causes MS relapses.
During the first few months following the end of the pregnancy, however, a woman’s risk of an MS relapse goes up as her hormones return to pre-pregnancy levels. Your MS provider will help you manage the relapse and any symptoms you may experience.
The Risk of MS in Your Children
If you live with MS and are considering having kids, your first concern may be passing on the disease. While certain genes play a role in the risk of developing MS, the disease is not directly inherited. It is not passed down through generations. The risk of MS in the general population is about 1 in 750-1000. The risk for an identical twin of someone with MS is 50%, which means that many other factors besides genetics play a role. The risk for a child with one parent who has MS is much lower than for an identical twin. The risk with two parents is closer to the risk for an identical twin. While the risk is there, it is much lower than many other things that we worry about for our children.
Communicating With Your Doctor
When planning for a family with multiple sclerosis it is important to start talking openly with your doctor early and often. The conversation could start as early as your first follow up visit after your diagnosis. Granted plans can and most likely will change over time but opening the door of communication early will allow you and your care team to approach this decision with care.
Disease Modifying Therapy Planning and Pregnancy
Most MS care providers will counsel you to stop your medications before you begin trying to conceive, as none of the MS DMTs and symptom management medications are recommended for use during pregnancy or breastfeeding. This consideration is important for men with multiple sclerosis as well for those who are taking teriflunomide (Aubagio®) must stop the medication up to two years before trying to conceive.
The key to success is planning ahead to ensure that you have the help and support you need during this time and know what to expect. Our article Planning for Pregnancy | Decision to Deliver to Parenthood provides a great starting point for questions to ask yourself, your partner, and your doctor when considering expanding your family.
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