Husband has MS where trying to get pregnant

[borinegra]

My husband is on Betatseron and has been for the following two years. We would like to have a baby but it just hasn't happened. I went to a doctor and they said I was fine. So we figured we just let it run its course and let it happened. Now his symptoms of MS are getting worse and there now going to switch him to Gilenya I was reading the forums on this medicine which states it can be harmful to a fetus. Im assuming that the medicine can pass through sperm as well. Does he have to stop taking medicines so we can actively start trying to get pregant?

[MrsPeebles04]

My first husband was on interferon treatments for 3 months to treat malignant melanoma in his lung. I became pregnant and had a normal pregnancy and happy and healthy bouncing baby boy. 9 years later my son suffers from crippling migraines and has since he was two. I'm curious if the fact that his father was taking interferon when I became pregnant has anything to do with headaches. Thoughts.

[Quixotic1]

Hi, and another welcome to the forum.

You have received some good advice, but I would like to clarify some other things.  Above, when Bob brought up birth defects you need to know that he was speaking of when "women" take the interferons.  He did comment that male sterility is another matter, but I saw the potential for you being unecessarily frightened.  

The study that Bob speaks about is quite far away from making a direct leap to what the interferon will do in men.  For one, the study is done using specifically bred mice.  Studies in mice might suggest things to study in humans, but their results DO NOT EVER tell you what will happen in humans.  Also, the type of interferon used is different than that in Betaseron.  Betaseron is interferon beta-1b NOT interferon beta 2-b.  These little points are important.

Also, in discussing male sperm counts and motility one must consider many, many factors - not just the most notable med the person is on.  A man's sperm count and activity may be affected by things we don't even think about like temperature, alcohol, depression, meds like anti-depressants or antihypertensives.

Your best bet are those things listed above.

Welcome again to the forum.

Quix, MD

[borinegra]

Ya'll are awesome for your advise. I made an appointment with his doctor and I am determined to get to the bottom of this!! I'll keep you updated and share anything I learn!

[twopack]

I think more attention is being paid these days to the damage done to sperm directly when men ingest alcohol or drugs or are exposed to toxins.  Of course there is great competition amongst sperm to win the rolling egg race.  Those hampered in any way aren't heavily favored as winners anyway.

I believe the danger to the fetus is always greater when the mother has exposure during gestation.  Both mother and father can pass questionable DNA.  Only the environment of a mother's body can have a direct effect on how a child develops (or doesn't) in utero.

The additional hurdle with Gilenya is that it is still very, very new.  I doubt ANY newly approved drugs are considered safe for use during pregnancy.  Some side effects don't become apparent until a drug begins to be used outside the structure of clinical studies and trials.  We won't have a great idea about how safe or unstable Gilenya is for PwMS or during pregnancy for at least 5-10 years-probably longer.

Keep in mind that we are glad to offer our opinions but there are no experts on this community forum (although we have great respect for any opinion Dr. Quix weighs in with).  Please be sure to return and share anything you find out.

All the best to you both.  Try to be sure you remember the fun parts of starting a family as well as the worry and striving for perfection parts.

Mary

[rendean]

Welcome and thanks for coming to our Forum!

The summation of the advice given above seems to be
1) Discuss this with your OB and/or a fertility specialist
2) Betaseron (beta interferon) causes a decrease in effective and healthy sperm that are viable to make the long trip to reproduction.
3) Stay informed and let us know when you get pregnant!!! We love happy endings!!

Ren

[Lulu54]

Thanks for that clarification, Bob.  I try my best to put answers in terms that everyone can understand, regardless of training or background.  I had not a clue what that word meant, and I would venture to guess that most everyone else here didn't either.  

L

[COBOB]

INF is known to harm the fetus (teratogenic - know to effect development or cause birth defects) Male sterility is a different case.

Interferon alpha-2b may impair testicular histology including spermatogenesis in a rat model.

http://www.ncbi.nlm.nih.gov/pubmed/15551753

"The hyperexpression of a- and  beta IFN in the testes of transgenic mice has been found to lead to male infertility, probably because high levels of IFN are harmful to spermatogenesis. Although the inhibitory effect of IFN on cell growth is not usually cytocidal, degenerating spermatocytes are present in the testis when IFN is hyperexpressed."

http://onlinelibrary.wiley.com/doi/10.1111/j.1442-2042.1997.tb00317.x/pdf

Again, not much data on human males, but it does seem that alpha, beta and gamma INFs can cause sterility in nude male mice.

The search string that worked best for me is:
beta interferon spermatogenesis

Bob

[sllowe]

sorry.... that's "interferon beta 1b mediated reproduction in men"

[sllowe]

Hi Borinegra,

Thanks for joining us. Just popping in to say hello, and wish you well with a future pregnancy.

Lulu describes best the problem with the literature in the field on this. And, while there are mounds of information regarding pregnancy of women on DMDs, there is little in terms of reproduction in men while on DMDs.

The advise to talk specifically to your doc by Lu is spot on. If you would like to do some digging on your own try using these specific (or variations of) words in your search injection "interferon beta 1b mediated reproduction in med"

Please let us know what you learn from this. Wishing you and your husband well :)
Welcome to the forum,
-Shell

[Lulu54]

Hi and welcome.  What a good question.  I have no idea what is a teratogenic agent and can't  investigate that this morning because I have to get ready for work. But I don't want you waiting for more replies until later today.  

What I do know is I have heard this discussion before- most of the time in reference to the woman being on treatment.  The topic of the man on MS disease modifying drugs has also been discussed but the answers are much less clear.

There is little research into the topic of men and fathering children while the man is on these drugs.  You probably already know that MS is more likely to occur in women than in men, and the research interest in fertility questions mainly goes that way as well.  I am remembering that ideally women need to be off Betaseron for several months before attempting conception.  

What you do need to do is talk with several doctors, and I think I would begin the discussion with your husband's MS doctor and the manufacturer of Betaseron and get the facts from them.  There may be a time he should be off Betaseron before attemping this.  

If your husband decides to make this drug switch you need to also have this discussion with the makers of Gilenya (novartis) and again the MS doc.

Then take that information to your OB doc and discuss this drug(s) with them.

Having healthy babies is very possible for people with MS, and you obviously know to do your homework.  

Good luck and come back and let us know your progress, ok?
Lulu

[Sumanadevii]

Hummm...I, of course, agree with Cobob.  However, if money is not available to see a specialist, I would call my pharmacist and see what information he/she could dig up.  I also would check with my OB on his or her findings

[COBOB]

Teratogenic agents and medication are usually a concern for the female and are considered in utero risks and effect the developing fetus.  While male sperm in sensitive to some medications, the medications typically change the sperm count, motility, or morphology (shape.)  

You may want to consult a fertility specialist.  If there are any concerns, you can always put some semen "on ice." for future use.

Bob