Pregnancy outcomes in multiple sclerosis patients previously treated with cyclophosphamide

Background Cyclophosphamide ( C yc) can induce ovarian failure and can have teratogenic effect. Few case reports of successful pregnancies after C yc treatment in women with autoimmune diseases and malignancies have been described. To date, there are no data about C yc effect on pregnancy outcomes in MS patients. Aim of the study To describe pregnancy outcomes in multiple sclerosis ( MS ) patients treated with C yc before conception. Methods We reviewed retrospectively the medical records of all MS patients who received C yc from 1st of J anuary 1997 to 31st of M arch 2012, referring to the MS centre of the U niversity of C atania. All pregnancies, occurred during the follow‐up period after C yc treatment, were recorded according to a computerized and standardized protocol (i MED ). Results We found a total of 105 MS women of childbearing age; eleven patients experienced a pregnancy (10.4%); 10 of them had a successful delivery; and one experienced a voluntary abortion. Five women had a preterm delivery. One child was small for gestational age. Conclusions Although the favourable pregnancy outcomes, C yc should be avoided in young women planning a pregnancy. However, C yc might be considered as a possible alternative to licensed therapies in few selected cases of very aggressive MS , including women of childbearing age.