A large-scale French study found no significant increase in relapse rates among women with multiple sclerosis following in vitro fertilization.

Published in Neurology: Neuroimmunology & Neuroinflammation, the retrospective cohort study included 115 women with MS who underwent 199 IVF procedures between 2009 and 2019. The annualized relapse rate (ARR) in the 3 months following IVF was 0.06 relapses per patient-year, identical to the matched control group (0.06) of women with MS who did not undergo IVF. Pregnancy following IVF showed a protective effect, with risk decreasing from 0.05 before IVF to 0.02 during pregnancy.

Subgroup analyses based on stimulation protocol—GnRH agonists versus antagonists—revealed no difference in relapse risk. The IVF success rate (24.6%) among women with MS was also comparable with that of the general population (27%–34.5%).

"It is essential to reassure women with MS about the absence of increased risk of relapse after IVF, whether performed with GnRH agonists or antagonists. ... Therapeutic advances in MS management might have contributed to a better disease control during the IVF time," said Marie Mainguy of EHESP, CNRS, of the University of Rennes, France.

Univariate analysis initially suggested that shorter MS duration and recent relapses could predict post-IVF relapse, but these associations were not significant in multivariate models.

The study’s strengths included the use of linked clinical and administrative datasets, providing validated relapse data and comprehensive IVF details. Limitations included its retrospective nature and potential overlap with previous studies, although sensitivity analyses confirmed the robustness of findings.

Disclosures by the authors are available in the published article.