THIS WEBSITE IS CURRENTLY UNDER CONSTRUCTION.
This information is not intended as a substitute for professional healthcare and is not intended to replace the evaluation of a healthcare professional. No responsibility is accepted for clinical decisions arising from use of this tool. Always consult with a healthcare provider for advice concerning your health. Only your healthcare provider can determine the medical recommendations for your neurological condition. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.
We are still learning about treating multiple sclerosis (MS) before, during and after pregnancy. A diagnosis of MS should not affect your ability to get pregnant. People who have MS can safely get pregnant. In fact, your risk of having an MS relapse is lower when you are pregnant. The first 3 months after you deliver are higher risk for relapses.
Some drugs used to treat MS may need to be stopped before or during pregnancy. The best time to stop depends on your medicine. Some should be stopped months to weeks before trying to get pregnant, and others may be stopped at the time of a positive pregnancy test. Some medications can be continued during pregnancy, but this depends on the medicine and your MS such as how often and bad your relapses have been and how many lesions you have on MRI. MS medicines can be restarted after the baby is born, but it depends on whether you are breastfeeding, and whether the medication is safe for your baby while breastfeeding.
Some things to consider if you have MS and are planning a pregnancy:
-If you are planning a pregnancy, which drugs need to be stopped before or during pregnancy
-If you have an unplanned pregnancy, will any drugs harm the pregnancy
-When to restart MS treatments after the baby is born
-When to restart MS treatments if you choose to breastfeed
Women with MS should discuss these questions with their doctor in advance.
This tool can help guide the questions you ask your doctor about MS medicines before and during pregnancy. The safety of breastfeeding on MS medicines is not currently included in this tool.
Medicines for MS symptoms may also have to be stopped before trying to get pregnant (like fatigue, spasticity, and bladder medicines). These medicines are not included in this tool. Speak with your doctor before stopping these medicines and to review different treatment strategies for MS symptoms.
Disclaimer: Safety considerations and recommendations provided in this web-based tool are based on limited studies and current evidence. This web-based tool must not be used as the sole basis for decision making in the use of medicines during pregnancy. You should talk to your doctors which may include MS specialists, neurologists, obstetricians, and/or family doctors throughout the process, as decisions should be based on your own specific circumstances.
Often the Health Canada approved drug label suggests stopping a drug longer before trying to get pregnant than recommended by MS pregnancy experts. This means use of medicines before or during pregnancy may be off label. Resources are below:
Pregnancy - MS Society of Canada, https://mssociety.ca/managing-ms/womens-health/pregnancy.
“Reproductive Health.” National Multiple Sclerosis Society, https://www.nationalmssociety.org/For-Professionals/Clinical-Care/Managing-MS/Reproductive-Health#section-3.
Krysko, Kristen M., et al. “Treatment of Women with Multiple Sclerosis Planning Pregnancy.” Current Treatment Options in Neurology, vol. 23, no. 4, 2021, https://doi.org/10.1007/s11940-021-00666-4.
Bandoli, Gretchen, et al. “A Review of Systemic Corticosteroid Use in Pregnancy and the Risk of Select Pregnancy and Birth Outcomes.” Rheumatic Disease Clinics of North America, vol. 43, no. 3, 2017, pp. 489–502., https://doi.org/10.1016/j.rdc.2017.04.013.