Q: I am a 29-year-old lady suffering from multiple sclerosis since the last 12 years. I am currently taking Interferon 1a and Baclofen, and once a week I take Methotrexate 10 mg. Can I think of conceiving if these medicines are reduced slowly and then stopped? Will the baby be normal and healthy?

A:One needs to carefully consider both clinical issues and the effects of drugs on conception, maintenance of pregnancy, effects on the foetus and problems of breast-feeding. Interferon reduces fertility and has toxic effects on the reproductive system. If a female patient is on methotrexate, she is obliged to take effective contraceptive measures not only during therapy but for at least, six months afterwards. In other words, a patient must not conceive for a minimum of six months after stopping methotrexate. Furthermore, it cannot be given to nursing mothers because of adverse effects on the baby. This means that in actual practice one would need to be without medication for a minimum of two years, if not more. This is not possible in the case of multiple sclerosis. If a female patient becomes pregnant and a situation arises where medicines must be given, then there will be more serious problems. In advanced pregnancy, it would be tantamount to abortion. Also there is grave danger to the foetus because methotrexate is a folic acid antagonist while folic acid is to be taken compulsorily during pregnancy. Such a situation can lead to defects in the baby. I am awfully sorry but it would be a mistake to plan a family.