One of the major issues is whether to continue or suspend a background treatment during pregnancy and the postpartum period, and the solution very much depends on the medication used, which may in some cases be continued during pregnancy and breastfeeding, and in other cases has to be discontinued prior to conception or as soon as there has been a positive pregnancy test. In yet other cases, after being discontinued during pregnancy, treatment must be resumed immediately after childbirth to prevent postpartum flare-ups. Professor Brigitte Capron supplies a summary of this complex issue, with the advantages and drawbacks of all medications currently used to treat MS.

Dr Barbara Willekens has also contributed a reassuring article showing that pregnancy does not adversely affect the progress of MS in the long term. The disease does not significantly worsen or progress faster in women who have been pregnant, whether before or after the appearance of MS. 

An excellent American study analysed the proportion of pregnant women with or without MS between 2006 and 2015, and it is comforting to see that this proportion increased from 7.91% to 9.47% in MS patients and decreased from 8.83% to 7.75% in MS-free women. With remarkable resilience, MS patients were determined to live normal lives and start a family, to the point that they carried their pregnancies to term more often than the control population. This is also a sign that our medications are increasingly effective in terms of reducing disability and enabling self-reliance.