Live Birth Rates By Infertility Treatment in Women with and without Multiple Sclerosis

Background: Data regarding live birth rates (LBRs) of women with multiple sclerosis (MS) receiving infertility treatment compared with LBRs of women without MS receiving infertility treatment are lacking. 

Objectives: To use US retrospective commercial claims data to compare LBRs between women with and without MS receiving either oral infertility medications only (defined as clomiphene and/or letrozole and no gonadotropin [Gn]) or injectable medications for controlled ovarian stimulation (COS; defined as ≥1 Gn and an ovulation trigger, either human chorionic Gn or Gn-releasing hormone agonist). 

Methods: A cohort of US women with MS (International Classification of Diseases, Ninth Revision, Clinical Modification code: 340.xx), aged 18–55, with a minimum of 1 year of continuous insurance eligibility from 1/1/2006 to 12/31/2015 were identified from the IMS Health Real World Data Adjudicated Claims – US database. A total of 672 women with MS treated with oral infertility medications met the eligibility criteria. A comparator group of 11,982 women without MS treated with oral infertility medications met the same 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 meeting the eligibility criteria and treated with injectable COS medications was 281 with MS and 4868 without MS. The number of patients in each group after propensity score matching was 268. LBRs between the matched samples were compared.

Results: The mean (standard deviation [SD]) duration of follow-up available for women treated with oral infertility medications was 4.41 (2.53) years for women with MS and 4.48 (2.60) years for women without MS. LBRs for women treated with oral infertility medications was similar in women with and without MS (32.18% vs 31.53%, respectively; p=0.8536). The mean (SD) duration of follow-up available for women treated with injectable COS medications was 4.29 (2.49) years for women with MS and 4.24 (2.46) years for women without MS. The difference in LBRs for women treated with injectable COS medications of 5.22% (44.03% vs 49.25% for women with and without MS, respectively; p=0.2603) did not reach statistical significance.

Conclusions: LBRs did not statistically significantly differ between women with MS receiving infertility treatments compared with women without MS receiving infertility treatments. Validation of these findings in a larger patient population may be useful to confirm findings.