Frequently Asked Questions
Can I have children?
The decision to have a family should be considered carefully when one or both partners has MS. Many couples are concerned about the risk that their children will also get MS. It is important to remember that while there is a slightly increased risk of MS in the offspring where one of the parents has MS compared to the general population, that risk is still very low.
Inheriting MS
While the heredity of MS is not clear-cut, close relatives of people with MS have an increased risk compared with the general population of people who do not have any family link. Results from family studies on MS suggest that the lifetime risk for a child of a parent with MS to also develop MS ranges from 3-5%, if the MS parent is the only family member with the disorder. The risk figure will vary if there are several family members with MS and/or MS occurs on both the maternal and paternal side.1
Long-term consequences
The long-term consequences of the decision to have children should be considered as well. Factors such as current and future level of disability, the ability of partners to contribute to the care and development of children, support potential from family and friends, and financial security should be appraised.
In pregnancy there does not appear to be an increased risk of relapse. There appears to be a reduced relapse rate during pregnancy followed by an increased rate in the first six months following the birth of the baby. There is no evidence that MS impairs fertility or that it leads to an increased risk of miscarriages, birth defects and still births.2
Although there are no specific medications used by all persons with MS, various medications are used to treat exacerbations and MS symptoms. Some of these (or combinations thereof) may be harmful to a developing foetus (e.g. interferons are contraindicated during pregnancy). In addition, some people follow special diets and/or various other treatments (medically supervised or unsupervised) reported to be beneficial in MS. Prospective parents should always discuss all treatments and medications with their physician prior to conception to assess whether any of these might be potentially harmful to a developing foetus.
Pregnancy appears to have no disadvantageous effect on long-term disability nor on the long-term course of the disease.3,4 Breast feeding does not appear to be related to the increased relapse rate after delivery, but might be associated with considerable fatigue.5
The decision to have a child should not be made without considering all possible implications. MS may affect family functioning and the wellbeing of children must be a prime consideration in the accommodations made. It is very important to remember that child-rearing is a long-term commitment, and couples must think about the impact of MS over the 18 years or so during which they will actively be involved in raising a child and not concentrate just on pregnancy and the newborn period. You must understand MS and appreciate that a support system might be more necessary in the long-term outlook than in another family without MS. The decision to become a parent should be based primarily on the desire to have a family and while MS should dictate some extra considerations, it should not be in itself a restriction.
References
1 Paty DW, Ebers GC (Editors). Multiple Sclerosis. F.A Davis Co, Philadelphia, 1998:572 p
2 Lorenzi AR, Ford HL. Multiple sclerosis and pregnancy. Postgraduate Medical Journal 2002;78:460-464.
3 Elenkov IJ, Wilder RL et al. IL-12, TNF-α, and Hormonal Changes during Late Pregnancy and Early Postpartum: Implications for Autoimmune Disease Activity during These Times. Journal of Clinical Endocrinology & Metabolism 2001;86(10):4933-4938.
4 Confavreux C, Hutchinson M et al. Rate of pregnancy-related relapse in multiple sclerosis. The New England Journal of Medicine 1998;339(5):285-291.
5 Pisacane A, et al. Breastfeeding and multiple sclerosis, British Medical Journal 1994;308:1411-1412.
Text is based on information of www.msif.org
