Risk higher with failed IVF or with use of gonadotrophin releasing hormone agonists
WEDNESDAY, June 13 (HealthDay News) -- 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 IVF fails, according to a study published online June 11 in the Journal of Neurology, Neurosurgery & Psychiatry.
Noting that pregnancy and treatment with sex steroids can affect the relapse rate in patients with MS, Laure Michel, M.D., from Hôpital Laennec in Nantes, France, and colleagues analyzed data from 32 women with MS who had undergone 70 IVF treatments during an 11-year study period: 48 with GnRH agonists and 19 with GnRH antagonists.
The researchers found that there were significantly more relapses in the three months after IVF (annualized relapse rate [ARR], 1.60), compared with one year before (ARR, 0.68) or three months before (ARR, 0.80). The increase in relapses was significantly associated with GnRH agonist use (P = 0.025) and failed IVF (P = 0.019).
"MS patients should be aware of a possible increased risk of MS relapse after IVF, particularly if the procedure does not result in a pregnancy," Michel and colleagues conclude. "Furthermore, because there is a reasonable doubt that GnRH agonists may make patients more prone to such an increase in relapse rate, GnRH antagonists might be preferred for IVF protocols."
Abstract (http://jnnp.bmj.com/content/early/2012/05/25/jnnp-2012-302235.short?g=w_jnnp_ahead_tab )Full Text (subscription or payment may be required) (http://jnnp.bmj.com/content/early/2012/05/25/jnnp-2012-302235.full )