Severe multiple sclerosis reactivation after gonadotropin treatment

Several reports indicate increased disease activity in patients with multiple sclerosis (MS) undergoing assisted reproductive techniques (ART), in the form of gonadtopin releasing hormone (GnRH) agonists. Other forms of ART treatments, like gonadotropin-treatment, have therefore been considered a safer option for MS-patients. We present a patient who despite being completely clinically and radiologically stable for eight years during disease modifying therapy experienced a nearly fulminant disease course almost immediately after starting gonadotropin- treatment, indicating that this form of follicle stimulating treatment could also be a major risk factor for MS disease activity.