Should MS medication be stopped before pregnancy?

Question

Hello doctor,

I am a 28-year-old woman who was diagnosed with relapsing-remitting multiple sclerosis (MS) last month after experiencing vision problems and numbness in my legs. My MRI showed multiple lesions, and my neurologist has recommended starting either Ocrevus (Ocrelizumab) or Kesimpta (Ofatumumab) as my first disease-modifying therapy. I work as a kindergarten teacher and am engaged to be married next year.

My fiancé and I want to start a family within the next two to three years. I am concerned about how these medications might affect my fertility and whether I need to stop the medication before trying to conceive.

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Both Ocrelizumab and Ofatumumab are effective disease-modifying therapies for relapsing-remitting multiple sclerosis (MS), but they may have potential effects on fertility. Both medications are monoclonal antibodies that suppress the immune system, and while there is no conclusive evidence of direct fertility issues, they may affect immune function. Additionally, there is limited research on their effects during pregnancy, making it crucial to take a cautious approach when planning for a family.

It is generally recommended to discontinue these medications six months before trying to conceive to allow your immune system to return to normal. This waiting period helps ensure the medication is fully out of your system before pregnancy, reducing any possible risks to the baby during the important early stages of development.

You should talk to both your neurologist and gynecologist about your plans to have a baby. Together, you can make a plan that takes care of your MS while also helping you start a family. This might involve switching to different treatments or changing your care during the time before, during, and after pregnancy. It is important to stay in close contact with your doctors to make sure everything goes smoothly for both you and your baby.

I hope this helps you.

Thank you.