Q&A 51 - IVF, DMTs and relapses

My partner and I are undergoing fertility treatment at the moment and I have a few questions .....

Case history 

Dear Prof G

I am 38 years of age and have relapsing-remitting MS. I started ocrelizumab six years ago. I have been NEIDA (no evident inflammatory disease activity) for several years and have no other signs of the disease worsening. My partner and I are undergoing fertility treatment at the moment and need to plan my next ocrelizumab infusion around the fertility treatment. You have previously said it is probably safe to become pregnant soon after an infusion, but both the ocrelizumab and the fertility hormones knock me out, so I would prefer not to do them both at the same time. My question is whether you see any risk with taking ocrelizumab early, at five months, to accommodate my fertility schedule. Alternatively, I would probably wait until after the treatment, which would be month eight since the last ocrelizumab infusion. 

Q1: What would you advise? 

Q2: Does fertility treatment increase my chances of having MS disease activity? 

Thanks

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Prof G’s answer