By: Diana Barnes-Brown for Uterus1
| If you are a woman receiving interferon beta1-A or beta1-B drug therapies for MS, and if you are considering becoming pregnant, here are some important questions to consider with your doctor or healthcare specialist before making the decision to conceive or to continue or stop drug therapy:|
Given the progression of the disease, what are the pros and cons of continuing drug treatment? What improvements in my condition or other benefits have we noticed in my case? What about negative effects?
Given the progression of the disease, what are the pros and cons of stopping drug treatment to become pregnant? Is a relapse likely for me?
What form of MS do I have, and are there any specific drawbacks to stopping drug therapy with my form of MS? (There are four forms, also known as clinical courses, of MS: Relapsing-Remitting, Primary-Progressive, Secondary-Progressive, and Progressive-Relapsing)
If I do choose to stop drug therapy while pregnant and breastfeeding, what potential symptoms or signs of danger to myself or my pregnancy should I be aware of?
After reviewing these questions, what is the best decision for my health and for the health of my future pregnancy? Am I comfortable with the risks, or would I prefer to become a parent in another way, such as by adoption or with the help of a surrogate mother?
For those stricken by Multiple Sclerosis (MS), drug therapies using interferion drugs such as interferon beta-1a and interferon beta-1b (marketed under the brand names Avonex, Rebif, and Betaferon) can make a huge difference in the rate and severity of the disease’s progression. But, until recently, women were advised to refrain from taking MS drugs while pregnant, because the effects of the drugs on women and their developing pregnancies were not known.
Women who became pregnant while taking the drugs often felt abortion was the best option to prevent the potential for devastating birth defects or other problems often connected to potent drug therapies administered during pregnancy.
But two studies published in 2005 offered a first glimpse into whether risks to mother and baby actually exist, and what those risks might be.
One study examined the data for 69 women who were involved in trials for interferon beta-1a or 1b and became pregnant at some point during the trial period. Of the 69 women, 41 were receiving the drug therapy when they became pregnant and 22 had stopped receiving active therapy before becoming pregnant. A total of 20 women in each group carried the pregnancies to full term and had healthy, live births.
Nine women in the group receiving active drug therapy at conception suffered miscarriages, while the remaining women chose to have abortions.
In the second study, 64 pregnancies, 24 of which occurred during interferon drug therapy, were examined by researchers at the Hospital for Sick Children at the University of Toronto. The group, led by Dr. Gideon Koren, director of the hospital’s Motherisk Program, found that 55 percent of the women receiving interferon therapy had healthy pregnancies, compared to 81 percent who stopped taking the drugs. The remainder of the pregnancies resulted in miscarriage.
Because both the studies were fairly small in scale, it is hard to determine whether the results are representative for all women, or potentially due to other co-factors. Also, since MS affects many parts and functions of the body, it was unclear whether the disease or the treatment may have been at the root of pregnancies that were not successful.
Further, forgoing treatment during pregnancy can have consequences for expecting mothers: Studies on MS and pregnancy have shown that there is a higher risk of relapse or periods of degeneration after pregnancy, and keeping up with treatment regimens may help to prevent such relapses. The effects of MS drugs on MS itself during pregnancy has yet to be studied, but part of why the drugs work when they do is that they can forestall destructive relapse periods, preserving the brain and other affected structures for as long as possible, rather than repairing damage after it occurs.
While the results were not conclusive, they represent an important step forward in MS care. Women compose two-thirds of all MS patients, and most are diagnosed during the childbearing years.