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Abstract：
OBJECTIVE: To compare the ovarian reserve and the results of infertility treatment, as well as to investigate the relapse rate in the first year after the assisted reproductive technology (ART) cycle in patients with multiple sclerosis (MS) referred to Royan Institute.
METHODS: This retrospective study was carried out to evaluate all women diagnosed with MS and referred to Royan Institute for assessment and treatment of possible infertility between 2011 and 2022. The control group consisted of randomly selected healthy women with tubal factor infertility who were referred for treatment during the same time period and matched in terms of age. A comparison was made between groups in terms of ovarian reserve and infertility treatment outcomes. Additionally, patients with MS who met the criteria were monitored via telephone to evaluate the symptoms, disability and relapse rate both pre- and post-ART.
RESULTS: Over the course of a decade, the database documented a total of 60 cases diagnosed with MS. Upon examination of the records, it was found that in 27 patients only admission was done without any hormonal assessment or infertility treatment cycle and 5 patients proceeded with the intrauterine insemination cycle. Eventually, 28 women with MS underwent the ART cycle and all of them were treated with interferon beta, glatiramer acetate, or some oral disease modifying therapies. No statistically significant difference in terms of the basal levels of luteinizing hormone, follicle-stimulating hormone and anti-Müllerian hormone was found between the MS and control groups (P > 0.05). Two groups were comparable in terms of menstrual status. The study revealed that both groups exhibited similarities in terms of the controlled ovarian stimulation protocol and duration, the dosage of gonadotropin administered, as well as the ovarian response type, clinical pregnancy rate, and live birth rate (P > 0.05). After follow up, only 2 patients (9.5%) reported relapse of symptoms within one year after ART.
CONCLUSIONS: The ovarian reserve and ovarian stimulation cycle and pregnancy outcomes following the ART cycle in MS patients were similar to the age-matched control group. The relapse rate of multiple sclerosis did not show a significant increase within a year following the ART cycle.
METHODS: This retrospective study was carried out to evaluate all women diagnosed with MS and referred to Royan Institute for assessment and treatment of possible infertility between 2011 and 2022. The control group consisted of randomly selected healthy women with tubal factor infertility who were referred for treatment during the same time period and matched in terms of age. A comparison was made between groups in terms of ovarian reserve and infertility treatment outcomes. Additionally, patients with MS who met the criteria were monitored via telephone to evaluate the symptoms, disability and relapse rate both pre- and post-ART.
RESULTS: Over the course of a decade, the database documented a total of 60 cases diagnosed with MS. Upon examination of the records, it was found that in 27 patients only admission was done without any hormonal assessment or infertility treatment cycle and 5 patients proceeded with the intrauterine insemination cycle. Eventually, 28 women with MS underwent the ART cycle and all of them were treated with interferon beta, glatiramer acetate, or some oral disease modifying therapies. No statistically significant difference in terms of the basal levels of luteinizing hormone, follicle-stimulating hormone and anti-Müllerian hormone was found between the MS and control groups (P > 0.05). Two groups were comparable in terms of menstrual status. The study revealed that both groups exhibited similarities in terms of the controlled ovarian stimulation protocol and duration, the dosage of gonadotropin administered, as well as the ovarian response type, clinical pregnancy rate, and live birth rate (P > 0.05). After follow up, only 2 patients (9.5%) reported relapse of symptoms within one year after ART.
CONCLUSIONS: The ovarian reserve and ovarian stimulation cycle and pregnancy outcomes following the ART cycle in MS patients were similar to the age-matched control group. The relapse rate of multiple sclerosis did not show a significant increase within a year following the ART cycle.
摘要：
目的：比较卵巢储备功能与不孕症治疗结果，以及调查转诊至Royan研究所的多发性硬化症（MS）患者辅助生殖技术（ART）周期后第一年的复发率。
方法：进行了这项回顾性研究，以评估所有诊断为MS的女性，并在2011年至2022年间转诊至Royan研究所以评估和治疗可能的不孕症。对照组由随机选择的输卵管因素性不孕症健康女性组成，她们在同一时间段接受治疗，年龄相匹配。在卵巢储备和不孕症治疗结果方面进行组间比较。此外,符合标准的MS患者通过电话进行监测，以评估症状，ART前后的残疾和复发率。
结果：十年来，该数据库记录了总共60例确诊为MS。在检查记录后，研究发现,在27例患者中,仅入院时没有进行任何激素评估或不孕症治疗周期,5例患者进行了宫腔内授精周期.最终,28名MS患者接受ART周期，所有患者均接受干扰素β治疗，醋酸格拉替雷,或者一些口腔疾病改善疗法。黄体生成素基础水平无统计学差异,MS组和对照组之间存在卵泡刺激素和抗苗勒管激素（P>0.05）。两组月经状态具有可比性。研究表明，两组在控制性卵巢刺激方案和持续时间方面表现出相似性，促性腺激素的剂量，以及卵巢反应类型，临床妊娠率,活产率(P>0.05)。跟进后,只有2例患者(9.5%)在ART后1年内报告症状复发.
结论：MS患者的卵巢储备和卵巢刺激周期以及ART周期后的妊娠结局与年龄匹配的对照组相似。在ART周期后的一年内，多发性硬化症的复发率没有显着增加。
方法：进行了这项回顾性研究，以评估所有诊断为MS的女性，并在2011年至2022年间转诊至Royan研究所以评估和治疗可能的不孕症。对照组由随机选择的输卵管因素性不孕症健康女性组成，她们在同一时间段接受治疗，年龄相匹配。在卵巢储备和不孕症治疗结果方面进行组间比较。此外,符合标准的MS患者通过电话进行监测，以评估症状，ART前后的残疾和复发率。
结果：十年来，该数据库记录了总共60例确诊为MS。在检查记录后，研究发现,在27例患者中,仅入院时没有进行任何激素评估或不孕症治疗周期,5例患者进行了宫腔内授精周期.最终,28名MS患者接受ART周期，所有患者均接受干扰素β治疗，醋酸格拉替雷,或者一些口腔疾病改善疗法。黄体生成素基础水平无统计学差异,MS组和对照组之间存在卵泡刺激素和抗苗勒管激素（P>0.05）。两组月经状态具有可比性。研究表明，两组在控制性卵巢刺激方案和持续时间方面表现出相似性，促性腺激素的剂量，以及卵巢反应类型，临床妊娠率,活产率(P>0.05)。跟进后,只有2例患者(9.5%)在ART后1年内报告症状复发.
结论：MS患者的卵巢储备和卵巢刺激周期以及ART周期后的妊娠结局与年龄匹配的对照组相似。在ART周期后的一年内，多发性硬化症的复发率没有显着增加。
