Q&A 47: ocrelizumab and pregnancy

Given the desire to start a family soon, would it be wiser to hold off on the next dose of ocrelizumab until after starting a family? What about breastfeeding?

Case history 

I have relapsing-remitting multiple sclerosis (MS). I presented with double vision in 2017, with no other significant symptoms. Monitoring MRIs have shown new lesions, and a lumbar puncture in 2021 revealed the presence of locally synthesised oligoclonal IgG bands or OCBs. I began treatment with ocrelizumab this year, with the first course in split doses in March 2024. The next dose is scheduled for September. I am currently 35 and hoping to start a family, ideally getting pregnant soon.

The questions are:

Q1: Given the desire to start a family soon, would it be wiser to hold off on the next dose until after starting a family?

Q2: If the September dose is taken as planned, how long should I wait before trying to conceive? There is a lot of conflicting information around at present. 

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Prof G’s answer