Live Birth Rates Are Similar in Women With and Without Multiple Sclerosis Who Received Infertility Treatment
By Jill Stein
PARIS -- October 27, 2017 -- Women with multiple sclerosis (MS) who receive oral or injectable infertility medications for controlled ovarian stimulation (COS) appear to have the same live birth rates (LBRs) as women without MS receiving infertility treatments, according to a study presented here at the 7th Joint Meeting of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) and the American Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS).
Although MS is 3 times more common in women than in men and has a clinical onset that often occurs during childbearing years, data regarding infertility treatment and LBRs in women with MS compared with women without MS are scarce, said Maria K. Houtchens, MD, Harvard Medical School, Boston, Massachusetts, on October 27.
The researchers used a U.S. administrative claims database to compare LBRs between women with and without MS who received oral or injectable infertility medications for COS. The database includes a complete inventory of patient prescriptions, inpatient hospital claims, and outpatient medical claims and consists primarily of commercial preferred provider organisation plans.
In the current study, patients with MS were matched to a pool of patients without MS.
The researchers identified 672 women with MS and 11,982 without MS who were treated with oral infertility medications who met the eligibility criteria. Propensity score matching controlled for baseline age, geographic region, and index-year quarter (n = 609 patients in each group).
The number of women treated with injectable COS medications who met the eligibility criteria was 281 with MS and 4,868 without MS. After propensity matching, the number of patients in each group was 268.
The mean follow-up for treatment with oral infertility medications was 4.41 years in women with MS and 4.48 years in women without MS.
LBRs for women with and without MS who were treated with oral infertility medications were similar (32.18% vs 31.53%, respectively; P = .8536).
The mean follow-up periods for women with and without MS who were treated with injectable COS medications were 4.29 and 4.24 years, respectively.
The 5.22% (44.03% vs 49.25% for women with and without MS, respectively; P = .2603) difference in LBRs for women treated with injectable COS medications was not statistically significant.
Dr. Houtchens cautioned that claims data are not collected specifically for research, and diagnostic and drug use information may not always be validated. Thus, information may be missing, which limits the inferences that can be made from the data. Also, the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code for systemic MS does not distinguish among different MS types (eg, primary progressive, relapsing remitting, and secondary progressive).
Note that administrative claims databases provide information on patients with health insurance administered by regional health plans in the United States. Thus, the results of this study may not be generalizable to patients who self-pay or patients without employer-sponsored commercial health insurance.
The researchers emphasised that a larger study is needed to provide definitive conclusions.
[Presentation title: Infertility Treatment and Live Birth Rates in Women With and Without Multiple Sclerosis. Abstract 891]