Desire to have children and multiple sclerosis: Preparation is everything! (Video)
The cute little feet; the big, curious eyes; the lively life that comes with a child – for many people, having their own children is perhaps the most important emotional decision of their life. But people with MS in particular often feel fear alongside anticipation: Will pregnancy and motherhood affect the development of the disease? Can I master the challenges of parenthood? And are there any risks for the offspring? To be clear: There is nothing wrong with wanting children if you have MS – you just need to prepare well. We will answer the most important questions for you. In the video, psychotherapist Sally Schulze also looks at how the desire to have children and MS can be psychologically compatible.
Does MS affect fertility?
The good news: MS does not limit fertility - neither in men nor in women. Nevertheless, MS patients have fewer children on average than healthy women. The reasons for this are not entirely clear, but very strong disease activity seems to lead to temporary deviations in the amount of sex hormones. This could temporarily limit fertility. So it may depend on the timing. In principle, however, people with MS can have children just as easily as healthy people, which means: with the same opportunities, risks and challenges.
Can fertility treatment trigger relapses?
During fertility treatment, medication is used that is intended to influence the fertility hormones. Women who stopped ongoing MS therapy early or who have never received therapy can experience a relapse during fertility treatment - especially if pregnancy does not occur despite treatment. This is at least what studies suggest. After successful stimulation therapy, however, the risk of a relapse is minimal. It may therefore be advisable not to stop MS therapy during fertility treatment, but only after a positive pregnancy test. You should discuss with your reproductive medicine specialist and your neurologist which type of hormonal treatment makes sense in your individual case and is as low-risk as possible.
Do I have to stop MS therapy during pregnancy?
Some medications used in immunomodulatory therapy can have a negative effect on the baby. If you want to have a child, you must stop taking these medications in good time. It is important to note that some medications take several months to be completely eliminated from the body. If you want to have a child, you should speak to your neurologist as early as possible to adjust your current therapy and switch to alternative medications. This also applies to men with MS. If therapy has to be stopped completely despite an active disease, it should be resumed as soon as possible after the birth to reduce the risk of a relapse. Regardless of whether you are healthy or have MS, women should start taking folic acid when planning their pregnancy - ideally three months beforehand.
A pregnant woman sits on the bed and puts her hands on her stomach.
Can pregnancy trigger MS attacks?
During the course of pregnancy, a protective system against disease flare-ups even appears to develop. Many women report a decreasing rate of flare-ups. In the last trimester, this rate even drops by up to 80 percent - that is more than can be achieved with medication. The severity of flare-ups during pregnancy also depends on how active the disease was before pregnancy. Therefore, especially in the case of highly active MS, consultation with the treating neurologist should be sought. In most cases, the rate of flare-ups does not increase after pregnancy either.
Do MS patients have to pay attention to anything during childbirth?
There are no significant differences in childbirth compared to a healthy woman giving birth. All birth processes are possible for women with MS. Spontaneous birth is not excluded or restricted by MS. The development of the disease after birth is also completely independent of the type of delivery. A Caesarean section is therefore not necessary unless there are other medical reasons for it. Pain management also has no influence on the disease: neither epidural anesthesia (PDA), spinal anesthesia or even general anesthesia have any influence on the attacks. Women with MS are free to decide how they want to give birth and what type of anesthesia they want to use.
A newborn child rests in the arms of its mother.
Can I breastfeed as a mother with MS?
Breast milk is the best nutrition for a baby, and breastfeeding has no effect on the rate of relapses. However, this applies to women who have paused their MS therapy during pregnancy and who do not experience severe relapse activity. With the exception of beta interferons, medications are not approved for use during breastfeeding in Germany. The decision to breastfeed during MS therapy should only be made after an intensive risk-benefit analysis in consultation with doctors. The potential risk to the infant must be taken into account, as must the risk of a severe relapse. Women with high disease activity during and before pregnancy are recommended to resume MS therapy promptly in the first two weeks after birth.
Can I pass MS on to my child?
Despite intensive research in this area, the causes of MS are not yet fully understood. However, it is certain that hereditary factors have at most a very small influence on the likelihood of the disease occurring. Nevertheless, some sufferers experience an accumulation of the disease within their families. In this case, the risk for children of also developing MS increases by three percent compared to the population average. This means that an increased predisposition is simply passed on. Some hospitals offer genetic counseling. Even if MS is not a hereditary disease, a consultation can help to dispel any doubts.
As an MS patient, can I do justice to my child?
The desire to have children is often accompanied by parental concern that they will not be able to live up to their own expectations of successful parenthood. Can I offer my child everything it needs for optimal development? Can I protect it and prepare it for life as a role model? These worries are completely normal - people with MS experience them to a particularly high degree. After all, the disease is often accompanied by symptoms that affect physical or mental performance. But to be a role model, you don't have to be able to run a marathon or climb a mountain. Everyone, whether sick or healthy, can be good parents if they love their children and show them that life is beautiful and that all challenges can be overcome. Nevertheless, it is particularly worthwhile for MS patients to build up a network of supporters early on. These can be friends or relatives who help out in everyday life. Contact with other young parents can also be helpful in exchanging ideas about problems and their solutions. Initiatives such as “Plan Baby for MS” by the German Multiple Sclerosis Society (DMSG) round off the range of support available.
