Department of Neurology, St. Josef Hospital Bochum, Ruhr University Bochum, Germany.
Clin Immunol. 2013 Nov;149(2):219-24. doi: 10.1016/j.clim.2013.02.001. Epub 2013 Feb 15.
Fertility does not seem to be impaired to a larger extent in women with MS. However, infertility and MS might just come coincidentally together and, therefore, MS patients might undergo assisted reproductive treatment (ART). Thus, during the last years different studies evaluating the effects of ART on MS relapses have been published. All of them reported an increase in annualized relapse rate after ART. Furthermore, in a recent study clinical worsening was associated with an increase in MRI activity. Putative mechanisms involved in MS worsening after ART include: temporary interruption of disease modified therapies, stressful events associated with infertility, and immunological changes induced by hormones such as increase in pro-inflammatory cytokines and anti-MOG antibodies, as well as an increase in immune cell migration across the blood-brain-barrier. Overall, neurologists should be aware of this risk and discuss the pros and cons of the procedures with MS patients.
生育能力似乎不会在患有 MS 的女性中受到更大程度的损害。然而，不孕和 MS 可能只是偶然同时出现，因此 MS 患者可能需要接受辅助生殖治疗（ART）。因此，在过去的几年中，已经发表了不同的研究来评估 ART 对 MS 复发的影响。所有这些研究都报告说，ART 后年度复发率增加。此外，在最近的一项研究中，临床恶化与 MRI 活动增加有关。ART 后 MS 恶化涉及的潜在机制包括：疾病修饰治疗的暂时中断、与不孕相关的应激事件，以及激素引起的免疫变化，如促炎细胞因子和抗 MOG 抗体增加，以及免疫细胞向血脑屏障迁移增加。总的来说，神经科医生应该意识到这种风险，并与 MS 患者讨论这些程序的利弊。
