Increase in multiple sclerosis relapse rate following in vitro fertilization

The immune and hormonal systems are closely linked. In several animal models of immune diseases as well as in multiple sclerosis (MS), sex hormones have been shown to modulate clinical course.1,2 Some women followed for MS may have infertility resulting in treatment for in vitro fertilization (IVF). In this regard, the type of drugs used, which modify hormonal status, might affect disease activity in patients with MS. By matching MS and IVF databases from the University Hospital of Nantes, France, we found four patients with MS who had undergone six IVF cycles over the past 10 years. All patients met the McDonald criteria for MS.3 Two additional patients who underwent four IVF cycles were also reported by their referring neurologist. One of them had a clinically isolated syndrome after IVF with the presence of all the Barkhof criteria on MRI. This patient developed a clinically definite MS over the course of the 1-year follow-up period. Once the list of patients had been obtained, their clinical files were reviewed to compare the number …