Challenging historical associations and reassuring women: an updated meta-analysis of multiple sclerosis relapse risk following assisted reproductive technology.
Mohamed I Mohamed, Monica Youssef Thabet, Nada Nasr et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and random-effects meta-analysis examined whether assisted reproductive technology (ART) is associated with multiple sclerosis (MS) relapses in women with MS or incident MS in previously healthy women. Twelve studies were included: ten assessed relapse risk and two assessed incident MS. Overall, ART was not associated with a significant increase in relapse risk, with minimal heterogeneity (95% CI 0.85-1.39; I²=4.6%). Women who became pregnant after ART had fewer relapses (aRR 0.50, 95% CI 0.29-0.84), while ART was not associated with increased incident MS risk.
Key findings
- Across ten studies (n = 680), ART was not associated with a significant increase in relapse risk (95% CI 0.85-1.39; I²=4.6%).
- Among women achieving pregnancy after ART, relapse risk was lower (aRR 0.50, 95% CI 0.29-0.84).
- Failed ART showed a nonsignificant trend toward increased relapse risk (aRR 1.31, 95% CI 0.96-1.79).
- Two studies found no association between ART and incident MS among previously healthy women.
Why it matters
Historical concerns about ART and MS relapse may influence fertility decisions. This synthesis of contemporary evidence is reassuring that ART does not independently increase relapse risk or appear to raise the risk of developing MS. The lower relapse rate among women who achieved pregnancy is an observed association and should not be interpreted as evidence that ART itself prevents relapses.
What to keep in mind
The evidence is based on observational cohorts, case-control studies, and case series rather than randomised trials; only two studies assessed incident MS.