Multiple sclerosis (MS), a rare and incurable disease that affects women of childbearing age between 20 and 40, is characterized by invading the central nervous system, such as the brain and spinal cord, and damaging the nerves, resulting in various symptoms and worsening with repeated relapses.

MS can lead to serious conditions, the most common of which is cerebral infarction. Still, patients can live without major difficulties if it is detected early and treated successfully to prevent relapses.

However, is pregnancy a good idea for women with MS?

"In most cases, the disease itself (MS) does not affect pregnancy or lactation," said Dr. Min Joo-hong, a professor of neurology at Samsung Medical Center, on the Samsung Medical Center's YouTube channel. “Having MS does not make it difficult to get pregnant."

However, depending on the medications they take, some women with MS may need to use contraception. "Depending on the type of disease-modifying drugs (relapse prevention drugs) you are using, you may need to use contraception," Professor Min said. “You should talk to your doctor about how soon after stopping the medication you can get pregnant."

The decision to discontinue relapse prevention medications before pregnancy and when to become pregnant should be made carefully for both the mother and fetus.

"None of the drugs have been deemed safe by the U.S. Food and Drug Administration, but some studies have shown that interferon and Copaxone are safe up to and during pregnancy," Min said. "In addition, strong immunomodulatory drugs have been known to cause sudden relapses when discontinued for pregnancy, so the timing of pregnancy after discontinuation should be carefully determined."

In recent years, safer pregnancies and births have become possible for women with MS.

"Longer-acting second-line medications, which were not previously FDA-approved for pregnancy, have recently been shown to be safe for pregnancy and childbirth, so some women with severe inflammation and relapses may choose to try to conceive after treatment with these longer-acting medications," Professor Min said.

He continued, "In general, it is known that pregnancy is associated with fewer relapses. In the unlikely event of a relapse during pregnancy, especially in the second or third trimester, steroids unharmful to the fetus can be considered, so there is no need to worry in advance."

Professor Min added that patients don't have to worry too much about medical care or breastfeeding during childbirth.

"The anesthesia or method of delivery does not affect the disease," he said. “Recurrence may increase in the first three months after delivery, but breastfeeding is known to lower recurrence."

Also, if MS flares up during lactation, it can be treated with steroids. However, breastfeeding should be stopped. This is because the medication can pass into breast milk, Professor Min advised.

"Most disease-modifying drugs are not recommended during lactation," he added.