Assisted reproduction treatment in severe myasthenia gravis.

Objective: To report a case of a patient with a severe myasthenia gravis (MG) who underwent controlled ovarian hyperstimulation for assisted conception.
Design: Case report and literature review.
Setting: Tertiary infertility center.
Patient(s): A 40-year-old woman affected by severe MG.
Intervention(s): Controlled ovarian hyperstimulation, oocyte retrieval, intracytoplasmic sperm injection (ICSI) procedure for severe oligoastenozoospermia.
Main Outcome Measure(s): Short- and long-term effects of assisted reproduction treatment (ART) on the clinical course of MG.
Result(s): A total of four ICSI cycles were performed. In the third cycle, a pregnancy was achieved, but a spontaneous abortion occurred. No changes in MG therapy were necessary, neither before nor after the treatment. All procedures were well tolerated and no exacerbations of symptoms occurred. By contrast a little, but persistent, improvement of clinical disease course was observed.
Conclusion(s): This is the first report of a patient with severe MG who underwent ART cycles. Although more patients need to be evaluated, the present case suggests that MG patients should not be excluded a priori from ART.