So, you have MS and you want to get pregnant…

I was thrilled to be able to attend the teaching course on Pregnancy and MS during the 2014 Joint Meeting of the American and European Committee for Treatment and Research in Multiple Sclerosis.

I wanted to see if there was any new information – not for myself, since I do not plan to have any more children, but to see if things have progressed from “go ahead and try and we’ll see what happens.” When I conceived my twins 9 years ago, there were many fewer therapies available and some docs were still recommending that women with MS not have children. I figured that by now, there would be concrete recommendations and a flow chart to tell women exactly what they should do to make sure all things went smoothly. While there are still no concrete guidelines on how a woman with MS should be guided through pregnancy, enough data has been gathered that the following recommendations were presented:

Before trying to conceive:

  • It is important to discuss with your doctor and your family some of the MS-related factors impacting parenthood, including the impact that the MS will have on your ability to parent and the support system that you can call on. In addition, many people are very anxious that they may pass MS along to their children. To clarify this risk: If just one parent has MS, the risk is still very low (about 1-2%) that the child will develop MS.
  • There is no evidence that MS impairs fertility. However, some women (or their partners) experience sexual dysfunction, which can limit frequency of sex. While it is common sense, remember that you need to have sex to conceive a baby (unless you are undergoing some form of assisted reproduction technology treatment). If you are doing it the “old fashioned way,” and struggling with sexual dysfunction, you may want to consider finding a therapist that can help.
  • If you are on disease modifying therapies, ask your doctor what the recommended “wash out” period (a period of time without active treatment) is for your medication. Based on data, many docs are recommending a very short amount of time, such as one to two months off medications (three for mitoxantrone, four for alemtuzumab), before trying to get pregnant. Importantly, it is recommended that men on mitoxantrone and teriflunomide also stop these meds before trying to father a child. NOTE: Please talk to your doctor about when to stop your meds, as different medications carry different recommendations. 
  • If you are having relapses, it is recommended to try and stabilize this for 6 to 12 months before trying to conceive. Your doc may want to put you on Tysabri for that time (although this may increases your risk that you will have a relapse when you stop). Other approaches are pulse steroid therapy, where a woman is given Solu-medrol when she is menstruating (knowing she won’t conceive during this time), then trying to conceive during the following month.

When trying to conceive:

  • It is very important that you get pregnant as soon as possible after you terminate your disease modifying therapy. One recommendation is that women practice methods for predicting ovulation (taking basal temperature, monitoring cervical mucous, etc.) before stopping meds, so they know when their optimal times for trying to conceive are. If you do not get pregnant within 3 to 6 months, your doctor may recommend that you seek fertility treatment (as opposed to waiting the usual 12 months).

While pregnant:

  • If you get pregnant while taking disease modifying therapy, DO NOT PANIC! I cannot stress this enough. Data is showing that most of the therapies do NOT increase the risk of miscarriage or birth defects. If you become pregnant while on one of the MS medications, immediately contact your doctor to find out what he or she recommends.
  • If you have a relapse during pregnancy, you can be treated with Solu-medrol or IVIG, as these do not appear to present any danger to the baby.

After delivery/while breastfeeding:

  • Be aware that women with MS are at a higher risk for postpartum depression. If you feel sad or have little interest in your newborn, I strongly suggest you seek professional help.
  • If a woman has not had a relapse in the year before getting pregnant (or during pregnancy), she can certainly breastfeed. A recent meta-analysis showed that women who breastfed had slightly fewer relapses.
  • If a woman had high disease activity before getting pregnant or during pregnancy, it is recommended that she begins taking MS medication within 10 days of delivery.

Bottom line: Things have become much clearer and less scary since I was pregnant. Your neurologist should be your partner when you are considering trying to start or expand your family, with the goal of making sure that you have the safest pregnancy possible for you and your child.


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Julie

Julie Stachowiak, PhD

Julie is the author of the Multiple Sclerosis Manifesto, the winner of the 2009 ForeWord Book of the Year Award in the Health Category. She is an epidemiologist who is also a person living with MS, Julie has an in-depth understanding about current research and scientific developments around MS. She also has first-hand knowledge of the frustrations and anxiety surrounding the disease, as she had MS for at least 15 years before receiving a diagnosis in 2003 and has had several relapses since her diagnosis.

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    21 Comments

  • unogem  Sep 11, 2014 7:13 PM
    I was diagnosed 6 months before I got married, and the prospect of having children was daunting. However, my neurologist was very supportive of us having children. She gave me the facts (many which you discuss above) and recommended fertility treatments when it didn't happen after several months. She said that, even after 16 years, she uses me as an example of a success story. My pregnancy was happily uneventful, despite becoming pregnant with twins. I did have a flare within three weeks of delivering my children, but it was no worse than any of the other flares I experienced before becoming pregnancy. Thank you for sharing this with us!
  • Sasha   Sep 12, 2014 2:48 AM
    I have rrms I've been diagnosed since 2012. I am 35yrs old & now 5mths pregnant, With my 1st child.
    I didn't take any of the medication that was on offer except strong pain killers & smoked weed every day.
    Since becoming pregnant I haven't smoked or taken any meds. I still have pains in my legs & feet but the pregnancy is goin very well. I can not wait to see & hold my baby it's all I ever wanted. I will except the pain that ms causes as all I've ever wanted is to be a mom. I know I may have some tuff days after the birth, but for me it's worth it. I will have help from family & friends I am sure I we will be ok.
    If having a child is what u want then I say go for it!!!
  • Aragono  Sep 12, 2014 1:38 PM
    Thank you for sharing your stories, we're planning on trying next month and honestly I'm scared shitless. It is really comforting to hear from moms that have gone through it or who are pregnant now. THANK YOU!
  • ellie   Sep 13, 2014 12:04 PM
    I was diagnosed in 2012 and recently my husband and I have been trying to conceive. I found out I was pregnant last month and a week later miscarried. We don't know why but its not discouraging us from trying again. Thank you for all the insight on getting pregnant with MS. Here's to hoping for a viable pregnancy!
  • Kristina   Sep 18, 2014 8:09 AM
    I was diagnosed with MS in 2009 and gave birth to my daughter in July 2014. I stopped my medication a month after discovering I was pregnant. I didn't have any problems throughout the pregnancy and not until my daughter was two months old and I was breast feeding did I have an issue due to MS. I haven't been on medication since October of 2013 and since I am still currently breast feeding have not gone back on medication. I am dealing with a flare up now.......steroids did not help and still waiting the optic neuritis to heal, but I have a beautiful daughter who makes me very happy!
  • jensequitur   Oct 24, 2014 5:11 PM
    I was diagnosed with RRMS in 2007, and spent the next five years going through flares and recovering from them. I had wanted to have a child before my diagnosis, but because I felt so awful I decided it would be a bad idea. In 2012 we decided to go ahead and try for a kid. I felt much better, and hadn't had a flare since 2009. I discontinued my DMD, and eliminated all medications that weren't safe for pregnancy. Because of my age (41) and being a first-time mother, we weren't able to get pregnant right away. I got an IUI in April of this year, and I am now 25 weeks pregnant. Being pregnant at 43 is no problem - I'm taking heparin to reduce the risk of miscarriage, and supplements so the child will be healthy and normal. What I worry about what will happen at birth, and afterwards. I have lesions in the pons and medulla that could cause some autonomic dysfunction. My high risk doctor plans to administer IV steroids or IVIG to reduce the risk of a flare, and I will need to be on heparin for three months after birth. So far everything has been perfectly normal. I just started feeling him kick on Sunday, which is exciting!
  • Brandy   Nov 28, 2014 11:04 AM
    i am doing a kit from conceiveeasy - came with a prenatal type supplement, the basal body thermometer, chart and ovulation tests.
  • MELISSA   Nov 16, 2016 11:29 PM
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  • Alyssa   Nov 27, 2016 10:16 PM
    Thank you so much Sarah for sharing your beautiful wonderful story. My name is Alyssa, I am 39 years of age and am TTC for the first time, I take a natural supplement from china, which was suppose to boost/help fertility and have also started to listen to binaural beats/frequency for fertility, and yoga exercises to boost fertility. I see some of you people who are talking about Dr abacha herbs pregnancy medicine, and It was simply amazing, after 2 HSGs and 4 negative IUIs including 6 induction Clomid cycles and laparscopy, i finally got pregnant after using the herbs you send to me through the UPS delivery service at the age of 40, I am writing this message to every women out there who are at the stage I was,depressed with no light at the end of the tunnel to give Dr abacha a try to help them solve their pregnancy problem, and hopefully you’ll all have the same success that I have had. Here is his website and email address abachasolutiontemple367@gmail.com, and his website http:/abachasolutiontemple.webs.com/ God bless you Dr.
  • Alyssa   Dec 11, 2016 3:36 PM
    Thank you so much Sarah for sharing your beautiful wonderful story. My name is Alyssa, I am 39 years of age and am TTC for the first time, I take a natural supplement from china, which was suppose to boost/help fertility and have also started to listen to binaural beats/frequency for fertility, and yoga exercises to boost fertility. I see some of you people who are talking about Dr abacha herbs pregnancy medicine, and It was simply amazing, after 2 HSGs and 4 negative IUIs including 6 induction Clomid cycles and laparscopy, i finally got pregnant after using the herbs you send to me through the UPS delivery service at the age of 40, I am writing this message to every women out there who are at the stage I was,depressed with no light at the end of the tunnel to give Dr abacha a try to help them solve their pregnancy problem, and hopefully you’ll all have the same success that I have had. Here is his website and email address abachasolutiontemple367@gmail.com, and his website http:/abachasolutiontemple.webs.com/ God bless you Dr.
  • Margaret   Dec 11, 2016 3:43 PM
    Please know this is completely honest, and no one has forced me to write this. I am a 37 year old woman who has been trying for 9 years to get pregnant I finally got pregnant 2 weeks after I contacted Dr abacha on his website http:/abachasolutiontemple.webs.com/ It was simply amazing. I had history of recurrent miscarriages and was also diagnosed with genetic problems but using your system I got pregnant naturally at age 37& after 2 HSGs and 4 negative IUIs including 6 induction Clomid cycles and laparscopy. I had zero side effects.. God bless you and reward you. I HIGHLY recommend this product!"
    Margaret From USA
  • stacy   Jan 10, 2017 4:28 AM
    you need help to get pregnant? contact Dr Aboki on this email (pregnancysolutionhome@gmail.com) I am singing with joy today because of what God has use DR Aboki to do in my life,can you believe i got pregnant at the age of 40 year,i have be looking for a baby of my own that will call me mother for the past 21years,i contacted some many people who try their best but there was no solution to my problem, but when i came in contact with DR Aboki my story change from worst to the best,so many people think that i will never have a baby of my own,but when DR Aboki did his prayer for me i became pregnant all i did for him was to get the items which he told me to get and now i have a child i could call my own,i am so happy, you can contact him via email pregnancysolutionhome@gmail.com
  • stacy   Jan 10, 2017 7:45 AM
    you need help to get pregnant? contact Dr Aboki on this email (pregnancysolutionhome@gmail.com) I am singing with joy today because of what God has use DR Aboki to do in my life,can you believe i got pregnant at the age of 40 year,i have be looking for a baby of my own that will call me mother for the past 21years,i contacted some many people who try their best but there was no solution to my problem, but when i came in contact with DR Aboki my story change from worst to the best,so many people think that i will never have a baby of my own,but when DR Aboki did his prayer for me i became pregnant all i did for him was to get the items which he told me to get and now i have a child i could call my own,i am so happy, you can contact him via email pregnancysolutionhome@gmail.com
  • sandra   Jan 23, 2017 5:55 PM
    Gooday everybody my name is Mrs Sandra Smith am here to share with you my life experience how this great man called prophet kalito saved me and my marriage.I have been barren for for 10years i had no child since my marriage i have never been pregnant i was a subject of laughter from my neigbours and i almost lost my marriage i was so confused did not know what to do untill i came across this great prophet online and i contacted him at first i was scared weather it was going to work but i just told my self let me give it a try and i did all what the prophet told me and today to my greatest surpise i took in the first time and i gave birth to twins and they were boys and i took in again and another twins this time a boy and a girl
    i want to tell all the women out there who have a similar situatio like that the world is not over that the should dry up theirs tears and contact this great man and their problem will be gone or are you also having other problems you can also contact this great prophet here is how you can contact him prophetkalito@gmail.com
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    Sandra Smith
  • rose adams   Jan 24, 2017 2:50 PM
    To every woman its always a joy that after marriage the next should be
    holding her child, I did gave birth to mine but after 4 months I lost her
    and since then I have not been able to conceive again for the past 7 years
    after I lost my child. I have been to so many hospitals and I have done
    series of tests. Though I have a very supporting and understanding husband
    but I was always thinking about it. It became my major problem every time I
    see children calling their mommy .i was willing to do any thing and willing
    to pay any price at all just to have a child of mine own. So one day I came
    across a post of this man and how he has been helping people of the same
    problem, I told my husband about it and he said will should give him a try
    and this is the last, I immediately contacted him on the address I found on
    the net and I got to he. I told him all that I have been facing and if
    there is any solution to mine to my greatest surprise he told me to calm
    down that I was going to have a child soon I did not believe it. He told me
    that he was going to send me medicine which he did and advice that I should
    meet with my husband which I did. After some weeks I was feeling really
    weak I told my husband about it. The next morning I went for a check up
    after the test I was told by my doctor that I am pregnant I could not
    believe it I was happy in side but I could not control it so I have to show
    it out with a tears. Am so happy now because he has restore my life and my
    home. if you are reading this comment and you have the same problem or you
    know any one of the same problem please contact him. Here are his contacts
    drsunshinesolutioncenter12@gmail.com or call/ whatsapp him on +2349038790901
  • marie boyden   Jan 28, 2017 9:51 AM
    hi everyone i had been married since 3 and half years ago, since then i am trying to conceive. my age is 34 years now, my hormonal reports including FSH,LH,estrogen and thyriod function tests are normal, my diagnostic laproscopy is also normal and my husbands semen analysis is also normal. my serum prolactin levels are normal, but i have got breast tenderness and secretion after ovulation upto my periods. i have underwent three cycles of IUI without any success. now i am worried what to do? please give me possible reasons for this delay and what should be the future course of action. how can i have a baby for my husband that was my question. so a friend introduce me to this native iya basira so i contacted her, after using her herbs she sent, to my believe i was tested pregnant, it was an amazing miracle. when i showed my husband the result i could see the joy in his eyes, thank iya basira once again for your help, may the lord continue to bless you for the fertility help you are giving we women in need, this is her email contact, for you guys that need her help, she is a wonderful mother. nativeiyabasira@yahoo.com
  • marie boyden   Feb 6, 2017 4:11 AM
    hi everyone i had been married since 3 and half years ago, since then i am trying to conceive. my age is 34 years now, my hormonal reports including FSH,LH,estrogen and thyriod function tests are normal, my diagnostic laproscopy is also normal and my husbands semen analysis is also normal. my serum prolactin levels are normal, but i have got breast tenderness and secretion after ovulation upto my periods. i have underwent three cycles of IUI without any success. now i am worried what to do? please give me possible reasons for this delay and what should be the future course of action. how can i have a baby for my husband that was my question. so a friend introduce me to this native iya basira so i contacted her, after using her herbs she sent, to my believe i was tested pregnant, it was an amazing miracle. when i showed my husband the result i could see the joy in his eyes, thank iya basira once again for your help, may the lord continue to bless you for the fertility help you are giving we women in need, this is her email contact, for you guys that need her help, she is a wonderful mother. nativeiyabasira@yahoo.com
  • glory okhida   Feb 21, 2017 3:36 PM
    To every woman its always a joy that after marriage the next should be
    holding her child, I did gave birth to mine but after 4 months I lost her
    and since then I have not been able to conceive again for the past 7 years
    after I lost my child. I have been to so many hospitals and I have done
    series of tests. Though I have a very supporting and understanding husband
    but I was always thinking about it. It became my major problem every time I
    see children calling their mommy .i was willing to do any thing and willing
    to pay any price at all just to have a child of mine own. So one day I came
    across a post of this man and how he has been helping people of the same
    problem, I told my husband about it and he said will should give him a try
    and this is the last, I immediately contacted him on the address I found on
    the net and I got to he. I told him all that I have been facing and if
    there is any solution to mine to my greatest surprise he told me to calm
    down that I was going to have a child soon I did not believe it. He told me
    that he was going to send me medicine which he did and advice that I should
    meet with my husband which I did. After some weeks I was feeling really
    weak I told my husband about it. The next morning I went for a check up
    after the test I was told by my doctor that I am pregnant I could not
    believe it I was happy in side but I could not control it so I have to show
    it out with a tears. Am so happy now because he has restore my life and my
    home. if you are reading this comment and you have the same problem or you
    know any one of the same problem please contact him. Here are his contacts
    drsunshinesolutioncenter12@gmail.com or call/whatsapp him on +2349038790901
  • OLIVER ELEANOR   Apr 3, 2017 11:39 AM
    Po několika letech se snaží otěhotnět nakonec jsem otěhotněla během 6 týdnů, tak bych se chtěl podělit o radostnou zprávu ostatním ty, kteří hledají otěhotnět v přírodním způsobem.
    Pokud se snažíte otěhotnět, ale stále nejsou otěhotnění, nezoufejte, ale je tu dobrá zpráva, může být stanovena: Použil jsem jeden z online průvodce otěhotnět a byla úspěšná, i doporučit všem, pokud máte hledá otěhotnět přirozenou cestou, jsem dal e-mailovou adresu zde, kteří mě k otěhotněla emailem dr.ogonisolutiontemple@gmail.com.
  • lena   Apr 12, 2017 6:47 AM
    It was like a dream after 4 years of marriage, i couldn't not conceive0f a child. I was so stranded and confused in life until a lady in my school gave where i teach, give me a brief story about Dr Khalija and his natural root and herbs. I quickly contacted him and he said that i should not listen to the doctors report about my condition that there is powers in root and herbs, so i got a full dose and he gave me prescriptions on how and when to take them.That was exactly how i got pregnant even the doctors that said i will never conceive in life are still shock of the wonders of this great man. if you know you are suffering from infertility problems and all others, do contact him on his email i will drop here.
    spiritualdoctorkhalija@yahoo.com
  • shirley   May 2, 2017 5:35 PM
    Life has been filled with challenges ever since my husband left me and move on with another woman. Most times i had thought of ending it all. Things became worst when I lost my home, family and all to Hurricane Matthew and I became a refugee in my own country, Haiti. The only property I had left was an Internet-enabled phone in my pocket. One faithful day, i found one Doctor Lucky on the Internet, on Face-book to be precised. Someone from the US had testified of many great things that Doctor Lucky had done for her and her family. I contacted him and the rest they say is history.Today i am happily married to a soldier I met in camp, and i am getting my happiness back again. I cannot keep this happiness to myself because i am not selfish. You too can contact Doctor Lucky on E-mail: homeofnaturalremedy@gmail.com or call him on phone +2349050606649 also available on whatsapp.