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For the first of his two presentations on pregnancy in MS, Prof. Centonze considered issues around pre-pregnancy. His first case study involved a 29-year-old woman looking to start a family, but worried about how MS may affect her fertility. This reflects the reality of many patients of child-bearing age who have many concerns around what pregnancy may mean for their disease progression as well as the risk to the unborn child.

It is important to discuss the genetic risk of a child being born with MS, but it should be emphasised that the risk is very low. Patients should also be counselled about environmental factors, such as smoking and vitamin D levels when considering starting or growing a family. Of course, contraception choice is also an important consideration for women of child-bearing age. Conversely, many patients ask about assisted fertility and whether hormone-based approaches to fertility could affect the disease course or their response to DMTs.