Spontaneous Conception Following High-dose Intravenous Corticosteroid Treatment for Multiple Sclerosis Exacerbation: A Case Report

Objective NA. Background Multiple sclerosis (MS) is a chronic autoimmune condition that is characterized by relapsing episodes of acute demyelination within the central nervous system that can lead to neurological deficits The first-line treatment for acute MS exacerbations is intravenous (IV) glucocorticoids, most commonly methylprednisolone. Design/Methods We present the case of a 32-year-old woman with a history of infertility who had previously required three rounds of in vitro fertilization (IVF) to conceive. The patient presented with new-onset neurologic and ophthalmologic symptoms consistent with a MS flare. T2 weighted magnetic resonance imaging (MRI) confirmed hyperintense lesions consistent with active MS, and the patient was hospitalized for three days for treatment with IV methylprednisone. Results At follow up, the patient reported natural conception following several years of infertility and prior use of in-vitro fertilization six years prior to achieve conception. Conclusions Although steroid-associated fertility changes are not well characterized, this finding suggests that further research is warranted to explore the effects of exogenous glucocorticoids used in MS treatment on ovarian reserves, follicular responses, uterine receptiveness and other factors influencing female fertility.