Mavenclad, whose active ingredient is cladribine, is a medication primarily used to treat multiple sclerosis (MS). One important concern for women considering or undergoing treatment with Mavenclad is whether it affects fertility. The answer is nuanced and requires understanding how Mavenclad works, its impact on reproductive cells, and the precautions recommended for women of childbearing potential.
Mavenclad works by targeting and reducing certain immune cells that contribute to the progression of MS. It interferes with DNA synthesis, which means it can affect rapidly dividing cells, including those involved in reproduction. Because of this, Mavenclad has the potential to impact fertility in both women and men.
For women, the key points about Mavenclad and fertility are:
– **Pregnancy Prevention:** Women who are capable of becoming pregnant are strongly advised to use effective contraception during treatment with Mavenclad and for at least six months after the last dose. This is because Mavenclad can harm a developing fetus, and pregnancy during treatment is contraindicated. Women are required to have a negative pregnancy test before starting each treatment course.
– **Potential Impact on Ovarian Function:** While direct evidence on long-term fertility effects in women is limited, the mechanism of action of cladribine suggests it could affect ovarian cells. Since it targets DNA synthesis, it might reduce the number or quality of eggs, potentially leading to temporary or permanent fertility issues. However, this effect is not fully characterized, and individual responses may vary.
– **Treatment Scheduling:** Mavenclad is given in treatment courses spaced over time rather than continuously. This dosing schedule may help limit prolonged exposure and reduce the risk of lasting damage to reproductive cells.
– **Risk of Birth Defects:** Because of the risk to a fetus, women who become pregnant during treatment must discontinue Mavenclad immediately. The medication is known to be teratogenic, meaning it can cause birth defects.
– **Fertility Preservation:** Women who are concerned about their fertility before starting Mavenclad may consider fertility preservation options, such as egg freezing, although this should be discussed with a healthcare provider.
– **Monitoring and Counseling:** Healthcare providers typically counsel women on the risks related to fertility and pregnancy before initiating Mavenclad. Regular monitoring and pregnancy testing are part of the treatment protocol.
In summary, Mavenclad can potentially affect fertility in women due to its action on DNA synthesis and rapidly dividing cells. Women of reproductive potential must use effective contraception during and for six months after treatment to avoid pregnancy. While the exact extent of fertility impact is not fully established, caution is warranted, and fertility preservation discussions are recommended before starting therapy. Women who become pregnant during treatment should stop Mavenclad immediately to prevent harm to the fetus.
