The onset of MS typically occurs in the early adult years, when life choices about family planning are a key focus. At the time of diagnosis, about 80% of people are in a relapsing remitting stage of the disease. The majority of people contemplating parenthood will fall into the category of relapsing remitting MS. This is also true for the majority of unplanned pregnancies.
Preconception topics for discussion should include: current and past symptoms (severity, duration, recovery) the possibility of MS course changing to become secondary progressive, the importance of establishing and maintaining a good support system, perceptions of the individual’s role in the parenting process, the importance of establishing financial stability or emergency funding in the event of a function-impairing relapse. See section on effects of pregnancy on MS symptoms. Wherever possible, reproductive counseling should include both partners. This is especially true for a couple living with MS as the disease course is likely to impact both partners at some point along the way.
All prescription and non-prescription (over the counter OTC) medications and health supplements require assessment of their potential to cause impaired fertility and/or harm to a developing fetus. See section on medications
A discussion of sexual functioning should be initiated by the health care provider. The health care professional who knows the MS patient is in the best position to determine whether issues about cognitive problems should be raised with the couple at this time. See Conception and Sexual Dysfunction
