Abstract:
Background: Multiple sclerosis (MS) is a disease that affects young people of reproductive age (20-40 years old), predominantly women. Therefore, almost
every patient has questions about pregnancy and breastfeeding. Family planning is one of the key issues in the choice of treatment tactics. Despite the
growing number of therapeutic options for individualized treatment, it is still a question how to manage women with MS who become pregnant while
taking disease-modifying drugs or want to become pregnant after starting this treatment.
Conclusions: Women with MS should not be discouraged from pregnancy due to their illness. It is necessary to proactively discuss pregnancy planning
with all women with MS of childbearing age. Based on available data, interferon beta and glatiramer acetate appear to be most suitable for use up until the
time of confirmed pregnancy. A large amount of data (more than 1000 cases) obtained from registries shows that use of interferon beta before conception
and during pregnancy suggests no evidence of increase in the rate of congenital anomalies or spontaneous abortions. For women with persistent high
disease activity, pulsed immune reconstitution therapy gives additional opportunity for family planning after the last dose. The choice between available
options for pulsed immune reconstitution therapy should be based on efficacy balanced against the risks.
