Fertility Treatment Linked to Multiple Sclerosis Worsening

Changes in immune function linked to reproductive hormones

WEDNESDAY, Oct. 3 (HealthDay News) -- Fertility treatment is associated with a higher risk of multiple sclerosis (MS) exacerbations, which is linked to the increase in reproductive hormones affecting immune function, according to a study published online Oct. 3 in the Annals of Neurology.

Jorge Correale, M.D., from the Foundation Against Neurological Disease in Childhood in Buenos Aires, Argentina, and colleagues assessed the risk of exacerbations in MS in 16 patients with relapsing-remitting MS undergoing assisted reproduction technology (ART) infertility treatment. As controls, 15 matched MS patients in remission not undergoing infertility treatment and 15 matched healthy volunteers were also examined.

The researchers found that 75 percent of the MS patients had exacerbations after infertility treatment. ART correlated with a seven-fold higher risk of exacerbation and a nine-fold higher risk of enhanced disease activity on magnetic resonance imaging. Worsening correlated with increased production of pro-inflammatory cytokines known to be mediated through gonadotropin-releasing hormone. An ART-linked increase in 17-β estradiol was associated with elevated production of antibodies against a myelin protein as well as a B-cell activating factor and an anti-apoptotic molecule from B cells. Lastly, infertility treatment facilitated the migration of peripheral blood mononuclear cells across the blood-brain barrier, mediated by pro-inflammatory cytokines.

"Results indicate a significant increase in MS disease activity in patients receiving ART, a risk that neurologists should be aware of," Correale and colleagues conclude. "Reproductive hormones appear to exert an important role in regulating immune responses during the course of autoimmune diseases."

One author disclosed numerous consultant and financial relationships with pharmaceutical companies.

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