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Dr Maria K. Houtchens: Assisted Reproductive Techniques
Assistant Professor Houtchens reviews the challenges involved in reproduction in the ‘Western World’. About 6% of the general population in the United States have infertility issues—a figure that may be slightly higher in women with MS.
Efforts to become pregnant must be balanced with minimising the time a woman is not taking a disease-modifying therapy. The standard timeframe for the general population to attempt to conceive via regular intercourse is 12 months, but Assistant Prof Houtchens shortens this to 6 months in her MS patients. Her patients are then referred to fertility specialists who understand the need to see them quickly. In the past few years, IVF has received attention due to unsuccessful IVF cycles triggering a relapse after a miscarriage.
Assistant Prof Houtchens briefly reviews 5 studies done in Europe looking at the relapse rate following failed IVF cycles. Three of these studies suggest that GnRH-agonist protocols are slightly more likely to trigger a relapse post-failed cycle and the other two studies suggest that relapse can be triggered no matter which ovarian-stimulating protocol is used. These findings can potentially be correlated to the natural fall in hormone levels after giving birth.
Assistant Prof Houtchens stressed the importance of helping MS patients make well-informed decisions by educating them about the risk of relapse during assisted reproduction.
The interview was recorded at the annual ECTRIMS meeting from 14-17 September 2016 in London, United Kingdom.
Dr Maria K. Houtchens, MD, Assistant Professor of Neurology, Brigham and Women’s Hospital, Massachusetts, USA