By its very nature, MS adds to the usual uncertainty and unpredictability of life. Plans that had previously been taken for granted are suddenly called into question, and new fears and doubts can create a high degree of stress and anxiety.
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| MS And Infertility In Men |
Newly diagnosed individuals and their partners want to know how MS will affect their ability to have and raise children. The answer to this important question needs to be divided into two parts: one pertains to the immediate, short-term issues of planning, pregnancy, and childbirth, whereas the other pertains to those that are more relevant to the long-term issues of parenting and family stability.
Short-Term Issues
The Inheritability Of MS
POPULATION, FAMILY, AND twin studies suggest a genetic component in a person's susceptibility to developing MS. It has been estimated that children who have a parent with MS have approximately a 2-5/100 (about 3.0%) risk of developing MS. Because the lifetime risk of MS in the general population is approximately 1 / 750 (0.1%), this means that the child of a parent with MS has a 30 times greater risk of developing the disease. Although couples wishing to have children need to be aware of the increased risk, it is also important for them to bear in mind that the risk factor remains relatively small.
Fertility
FERTILITY IS, FOR the most part, unaffected by MS. This means that couples must make the same decisions regarding birth control as do individuals without neurologic problems. Any form of birth control is permissible with MS; choices should be made on the basis of ease and effectiveness. A woman who is experiencing weakness or tremor in her hands may find it difficult to insert a diaphragm.
Similarly, a man might find a condom too cumbersome. However, the sexual partner can learn to insert a diaphragm or put on the condom and make this an enjoyable part of sexual foreplay.
Oral contraceptives are a safe and effective option; they have not been shown to increase the risk of developing MS or to affect the disease course following diagnosis. The intrauterine device (IUD) is also an acceptable alternative, but its effectiveness and safety may be compromised by the long-term use of antibiotics or immuno-suppressive drugs that can lower a woman's resistance to infection.
The copper IUD currently available in the United States is 98-99% effective and safe. Once inserted by the physician (during an outpatient visit), IUDs can be used safely for a period of 5-10 years without being changed, depending on the type that is used.
Although MS does not have any negative impact on a woman's fertility, the erectile and/or orgasmic difficulties that some men experience as a result of MS can interfere with fertility. It is important for young couples in the family planning stage to be aware that the occurrence of these erectile and orgasmic problems depends on the location of the MS plaques and is unrelated to the man's age or to the length of time that he has had MS.
A variety of options are now available for the treatment of erectile problems. Problems with orgasm, which have been reported in a series of surveys by 44-77% of men with MS, may also respond to treatment. "Dry orgasms" occur when there is an absence of seminal emission or when semen is ejaculated in retrograde (backward) fashion into the bladder. Since either of these would impair fertility, men with dry orgasms who wish to have a child should not hesitate to speak to their physician. Treatments involving medication and/or electroejaculation have proved beneficial with these types of orgasmic difficulties.
It is important to keep in mind that couples with or without MS can experience infertility problems at any time, even if they have already had a child. The co-existence of MS should not interfere with a thorough infertility evaluation. Both members of the couple should be evaluated because 40% of infertility problems involve the male partner. A variety of treatments are available to assist with infertility problems. In addition, adoption remains a viable (although potentially costly) way to build a family. To find out more, you can check out MS And Infertility In Men.