Infertility treatments may significantly increase multiple sclerosis activity

October 3, 2012

Researchers in Argentina report that women with multiple sclerosis (MS) who undergo assisted reproduction technology (ART) infertility treatment are at risk for increased disease activity. Study findings published in Annals of Neurology, a journal of the American Neurological Association and Child Neurology Society, suggest reproductive hormones contribute to regulation of immune responses in autoimmune diseases such as MS.

According to a 2006 report from the (WHO), MS affects 2.5 million individuals worldwide and is more common among women than men. While previous research found that up to 20% of couples in Western countries experience infertility, women with MS typically do not have diminished fertility except in those treated with cyclophosphamide or high-dose corticosteroids. Medical evidence shows and those involved in ovulation (gonadotrophin-releasing hormone (GnRH)) play an important role in the development of autoimmune disorders.

"When MS and infertility coincide, patients seek ART to achieve pregnancy," explains Dr. Jorge Correale with the Raúl Carrea Institute for in Buenos Aires. "Given the role of some in , those with MS receiving infertility treatments are at particular risk of exacerbating their disease."

To further understand the impact of on MS disease activity, researchers analyzed clinical, radiological, and immune response data in 16 MS patients who were subject to 26 ART cycles. The team recruited 15 healthy volunteers and 15 MS patients in remission not receiving ART to serve as controls.

Results show that 75% of MS patients experienced disease exacerbation following infertility treatment. MS relapses were reported in 58% of the cycles during the three month period following ART treatment. Furthermore, ART was associated with a seven-fold increase in risk of MS exacerbation and a nine-fold increase of greater MS disease activity on magnetic resonance imaging (MRI). The authors noted that 73% of exacerbations were new symptoms and 27% were attributed to a worsening of pre-existing symptoms.

Worsening was associated with three different mechanisms: 1) increase in the production of certain pro-inflammatory molecules known as cytokines (IL-8, IL-12, IFN-γ, and TGF-β by CD4+ T a GnRH-mediated effect); 2) increase in the production of antibodies against de myelin protein MOG, as well as B cell survival factor BAFF and antiapoptotic molecule Bcl-2 levels from purified B cells, these effects were a consequences of the rise of 17-β estradiol production induced by ART; and 3) authors demonstrated using an in vitro model of the blood-brain-barrier that ART facilitated the penetration of deleterious peripheral blood cells into the central nervous system, an effect mediated by the induction of the molecules IL-8, VEGF and CXCL-12.

"Our findings indicate a significant increase in MS disease activity following infertility treatment," concludes Dr. Correale. "Neurologists should be aware of possible disease exacerbation so they may discuss the benefits and risks of ART with ."

Explore further: In vitro fertilization linked to multiple sclerosis relapse

More information: "Increase in Multiple Sclerosis Activity after Assisted Reproduction Technology." Jorge Correale, Mauricio F Farez, María C Ysrraelit. Annals of Neurology; Published Online: October 3, 2012 ( DOI:10.1002/ana.23745 ).

Related Stories

In vitro fertilization linked to multiple sclerosis relapse

June 13, 2012
(HealthDay) -- Women with multiple sclerosis (MS) who undergo in vitro fertilization (IVF) are at greater risk of relapse after treatment, particularly if they receive gonadotrophin releasing hormone (GnRH) agonists or if ...

Past pregnancies linked to reduced MS risk in women

March 7, 2012
Women who have multiple pregnancies may have a lower risk of developing multiple sclerosis (MS), according to research published in the March 7, 2012, online issue of Neurology, the medical journal of the American Academy ...

Recommended for you

Study reveals breakthrough in decoding brain function

September 25, 2017
If there's a final frontier in understanding the human body, it's definitely not the pinky. It's the brain.

Overturning widely held ideas: Visual attention drawn to meaning, not what stands out

September 25, 2017
Our visual attention is drawn to parts of a scene that have meaning, rather than to those that are salient or "stick out," according to new research from the Center for Mind and Brain at the University of California, Davis. ...

A brain system that builds confidence in what we see, hear and touch

September 25, 2017
A series of experiments at EPFL provide conclusive evidence that the brain uses a single mechanism (supramodality) to estimate confidence in different senses such as audition, touch, or vision. The study is published in the ...

Brain guides body much sooner than previously believed

September 25, 2017
The brain plays an active and essential role much earlier than previously thought, according to new research from Tufts University scientists which shows that long before movement or other behaviors occur, the brain of an ...

The rat race is over: New livestock model for stroke could speed discovery

September 25, 2017
It is well-known in the medical field that the pig brain shares certain physiological and anatomical similarities with the human brain. So similar are the two that researchers at the University of Georgia's Regenerative Bioscience ...

Touching helps build the sexual brain

September 21, 2017
Hormones or sexual experience? Which of these is crucial for the onset of puberty? It seems that when rats are touched on their genitals, their brain changes and puberty accelerates. In a new study publishing September 21 ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.