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immunosuppressants and pregnancy

in by heather_erin
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Hello! I am a 28 year old newly wed who was also recently diagnosed with neurosarcoidosis, which is an inflammatory autoimmune disease that attacks my optic nerves. My doctors have been treating me with relatively high doses of prednisone which I respond well to, but they have been unable to ween me down to a low enough dose, so now they want to start immunosuppressant therapy. Both my husband and myself desperately want children and I want to know what medications others have used during their pregnancies. Thank you all for your time!


About heather_erin

Conditions: Gluten sensitivity, Not sure right now

Doctors seen: MD – primary care, MD – specialist, Naturopath, Acupuncturist

Treatment: Prescription medication/shots, Vitamins, herbs, and/or supplements, Acupuncture, massage, and/or other homeopathic, Diet, Gluten free

Age: 25-34

heather_erin
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1 Answer

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First off, I would like to acknowledge that this is a difficult and frustrating situation to be in and can be very challenging for a family, especially one hoping to expand in the near future. To answer your question, a majority of immunosuppressive therapies that are used for neurosarcoidosis (such as Mycophenolate, Methorexate, Azathioprine, Cladribine, Cyclophosphamide and Chlorambucil) should be absolutely avoided in pregnancy. Many immunosuppressive medications are known to cause fetal abnormalities and can greatly increase complications during pregnancy or loss of the fetus. With that said, there are more mild immunosuppressants such as cyclosporine and Infliximab that are considered safer than most immunosuppressants and can be considered for use as long as constant monitoring of both the mother and baby are done through the full term of pregnancy and afterwards as well.

This situation warrants a serious talk with your physician about your desire to have children while being treated for this condition. Most physicians will keep women on corticosteroids (even at high doses) throughout pregnancy because the effects on the fetus can be less than those of a majority of the immunosuppressants. In my personal practice, I have seen several women successfully give birth to healthy babies while on medications for serious autoimmune diseases, so it is possible. But communication with each of your physicians about your desires and concerns should definitely be the first step.

Jenny Bennett, ND LAc
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Answered on November 1, 2014

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