Findings from a register-based, nationwide cohort study published in the journal Fertility and Sterility revealed that women who underwent ART had a comparable risk for developing MS as women who conceived without the use of ART.
The primary objective of the study was to compare the incidence of MS among women who had undergone ART with the women who had conceived a child without previous ART treatment.
The study population included women with a first ovarian stimulation cycle before in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI; i.e., ART treatment) recorded in the Danish IVF register between 1996 and 2018 and women recorded in the Danish Medical Birth Register with the birth of their first child where date of conception was between 1996 and 2018. The cohort was observed until March 10, 2021.
The primary outcome was a diagnosis of MS recorded in the Danish Multiple Sclerosis Registry. Crude and adjusted hazard ratios (aHRs) with 95% CIs were calculated.
The study cohort included 585,716 women, of which 63,791 (11%) were exposed to at least one initiated IVF or ICSI cycle during the study period. Cycles with oocyte donation were excluded.
The results revealed that the average follow-up time for the entire cohort was 12.4 years. Compared with women conceiving without previous ART, ART-treated women were older (31.8 years vs. 27.5 years), more often had a university degree (45% vs. 36%), and more frequently had received other fertility treatments than IVF or ICSI before cohort entry (26% vs. 3%).
The authors indicated that they found no correlation between incident MS and exposure to ART compared with non-ART pregnancy (aHR = 1.08; 95 % CI, 0.93-1.25). Moreover, an evaluation following intention-to-treat principle on a propensity score matched sub cohort confirmed their results.
In subgroup evaluation including all ART cycles among the ART treated women, they did not find an augmented risk of MS within 2 years of ART cycle start for successful ART cycles (pregnancy) compared with failed ART cycles (no pregnancy) (aHR = 1.01; 95% CI, 0.58-1.76). Additionally, the authors found a nonsignificant trend toward heightened risk of MS with increasing numbers of ART cycles, although based on small numbers.
The authors wrote, “In conclusion, results from this large, nationwide cohort study showed that ART treatment does not seem to pose any major risk factor for developing multiple sclerosis compared with the exposure to a pregnancy without previous ART treatment. This is reassuring for women and couples considering ART.”
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