Assessing the Risk of Relapse After In Vitro Fertilization in Women With Multiple Sclerosis.

IF 7.8 1区 医学 Q1 CLINICAL NEUROLOGY
Marie Mainguy, Romain Casey, Sandra Vukusic, Christine Lebrun-Frenay, Eric Berger, Anne Kerbrat, Abdullatif Al Khedr, Bertrand Bourre, Jonathan Ciron, Pierre Clavelou, Jerome De Seze, Gilles Defer, Ines Doghri, Amélie Dos Santos, Karolina Hankiewicz, Pierre M Labauge, Emmanuelle Le Page, Laurent Magy, Elisabeth Maillart, Eric Manchon, Laure Michel, Thibault Moreau, Solène Moulin, Jean Pelletier, Corinne Pottier, Aurélie Ruet, Mariana Sarov, Bruno Stankoff, Eric Thouvenot, Abir Wahab, Helene Zephir, Emmanuelle Leray, David Axel Laplaud
{"title":"Assessing the Risk of Relapse After In Vitro Fertilization in Women With Multiple Sclerosis.","authors":"Marie Mainguy, Romain Casey, Sandra Vukusic, Christine Lebrun-Frenay, Eric Berger, Anne Kerbrat, Abdullatif Al Khedr, Bertrand Bourre, Jonathan Ciron, Pierre Clavelou, Jerome De Seze, Gilles Defer, Ines Doghri, Amélie Dos Santos, Karolina Hankiewicz, Pierre M Labauge, Emmanuelle Le Page, Laurent Magy, Elisabeth Maillart, Eric Manchon, Laure Michel, Thibault Moreau, Solène Moulin, Jean Pelletier, Corinne Pottier, Aurélie Ruet, Mariana Sarov, Bruno Stankoff, Eric Thouvenot, Abir Wahab, Helene Zephir, Emmanuelle Leray, David Axel Laplaud","doi":"10.1212/NXI.0000000000200371","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Older studies reported an increased risk of relapse after in vitro fertilization (IVF) in women with multiple sclerosis (MS), which has not been confirmed by more recent works. All these studies had several limitations, such as small sample sizes, absence of a control population, or lack of neurologic validation of the relapses. The aim of this study was to determine the risk of relapse after IVF in women with MS.</p><p><strong>Methods: </strong>This retrospective cohort study included all women with MS who underwent IVF between 2009 and 2019 and a control group of women with MS who did not undergo IVF matched on age, MS duration, number of relapses, and MS-specific treatments in the previous year. Data on MS (disease duration, treatments, and relapses) were from the French MS Registry (OFSEP), whereas data on IVF (number of procedures, stimulation protocol type, and outcomes) were from the French national health insurance database. For this, the 2 databases were linked by indirect matching.</p><p><strong>Results: </strong>In total, 115 women with MS underwent 199 IVF procedures (mean age at first IVF: 33.9 ± 4.0 years; 45.2% had ≥2 IVF procedures), and 175 IVFs (88.0%) could be matched to specific patients. The risk of relapse in the 3 months after index date was the same in both IVF group and control group (0.06 relapse per patient-year), as confirmed also by the before-after analysis in the IVF group (0.06 vs 0.08).</p><p><strong>Discussion: </strong>This study, using a 10-year clinical and administrative dataset, did not find any increased risk of relapse after IVF. The maintenance of disease-modifying therapies until IVF was a determining factor in reducing the risk of relapse.</p>","PeriodicalId":19472,"journal":{"name":"Neurology® Neuroimmunology & Neuroinflammation","volume":"12 2","pages":"e200371"},"PeriodicalIF":7.8000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11820809/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurology® Neuroimmunology & Neuroinflammation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1212/NXI.0000000000200371","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/11 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background and objectives: Older studies reported an increased risk of relapse after in vitro fertilization (IVF) in women with multiple sclerosis (MS), which has not been confirmed by more recent works. All these studies had several limitations, such as small sample sizes, absence of a control population, or lack of neurologic validation of the relapses. The aim of this study was to determine the risk of relapse after IVF in women with MS.

Methods: This retrospective cohort study included all women with MS who underwent IVF between 2009 and 2019 and a control group of women with MS who did not undergo IVF matched on age, MS duration, number of relapses, and MS-specific treatments in the previous year. Data on MS (disease duration, treatments, and relapses) were from the French MS Registry (OFSEP), whereas data on IVF (number of procedures, stimulation protocol type, and outcomes) were from the French national health insurance database. For this, the 2 databases were linked by indirect matching.

Results: In total, 115 women with MS underwent 199 IVF procedures (mean age at first IVF: 33.9 ± 4.0 years; 45.2% had ≥2 IVF procedures), and 175 IVFs (88.0%) could be matched to specific patients. The risk of relapse in the 3 months after index date was the same in both IVF group and control group (0.06 relapse per patient-year), as confirmed also by the before-after analysis in the IVF group (0.06 vs 0.08).

Discussion: This study, using a 10-year clinical and administrative dataset, did not find any increased risk of relapse after IVF. The maintenance of disease-modifying therapies until IVF was a determining factor in reducing the risk of relapse.

评估多发性硬化症妇女体外受精后复发的风险。
背景和目的:较早的研究报告了多发性硬化症(MS)妇女体外受精(IVF)后复发的风险增加,但最近的研究尚未证实这一点。所有这些研究都有一些局限性,如样本量小,缺乏对照人群,或缺乏对复发的神经学验证。本研究的目的是确定多发性硬化症女性体外受精后复发的风险。方法:本回顾性队列研究包括2009年至2019年期间接受体外受精的所有多发性硬化症女性,以及一组未接受体外受精的年龄、多发性硬化症持续时间、复发次数和前一年的多发性硬化症特异性治疗相匹配的多发性硬化症女性。MS的数据(病程、治疗和复发)来自法国MS登记处(OFSEP),而IVF的数据(手术次数、刺激方案类型和结果)来自法国国家健康保险数据库。为此,通过间接匹配将两个数据库连接起来。结果:115例MS患者接受了199次体外受精(首次体外受精平均年龄:33.9±4.0岁;45.2%的患者接受过2次以上试管婴儿(IVF)手术),175例(88.0%)试管婴儿可与特定患者匹配。在指标日期后3个月内,IVF组和对照组的复发风险相同(每患者-年复发0.06次),IVF组的前后分析也证实了这一点(0.06 vs 0.08)。讨论:这项研究使用了10年的临床和管理数据集,没有发现体外受精后复发的风险增加。在试管婴儿之前维持疾病改善疗法是降低复发风险的决定性因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
15.60
自引率
2.30%
发文量
219
审稿时长
8 weeks
期刊介绍: Neurology Neuroimmunology & Neuroinflammation is an official journal of the American Academy of Neurology. Neurology: Neuroimmunology & Neuroinflammation will be the premier peer-reviewed journal in neuroimmunology and neuroinflammation. This journal publishes rigorously peer-reviewed open-access reports of original research and in-depth reviews of topics in neuroimmunology & neuroinflammation, affecting the full range of neurologic diseases including (but not limited to) Alzheimer's disease, Parkinson's disease, ALS, tauopathy, and stroke; multiple sclerosis and NMO; inflammatory peripheral nerve and muscle disease, Guillain-Barré and myasthenia gravis; nervous system infection; paraneoplastic syndromes, noninfectious encephalitides and other antibody-mediated disorders; and psychiatric and neurodevelopmental disorders. Clinical trials, instructive case reports, and small case series will also be featured.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信