Woman with Multiple Sclerosis Has Successful Pregnancies with Help from Duke Neurology

Olivia Bellido was 26 when she was diagnosed with MS, a chronic autoimmune disease that causes nerve damage. Her first concern was managing her symptoms, but after getting married a few years later, Bellido, of Durham, wanted to get pregnant.

Bellido talked to her doctor, Duke Health neurologist, Mark Skeen, MD, who recommended she switch her care to Dr. Shah because she specializes in women's health and pregnancy. Dr. Shah worked closely with Dr. Skeen so she and Bellido knew each other. “There was already a good doctor-patient bond there,” Dr. Shah said.

At the time, Bellido’s doctors recommended she stop taking her MS medication while she tried to get pregnant. Her symptoms remained stable, but she had difficulty conceiving and testing at the Duke Fertility Center revealed Bellido had a low egg count. Dr. Shah collaborated with the fertility experts at the Duke Fertility Center while Bellido went through intrauterine insemination. Unfortunately, Bellido had to stop treatment after a debilitating MS flare. "I've never felt pain like that in my entire life,” she said.

Bellido recovered a few months later, and tried in vitro fertilization (IVF). She got pregnant, but miscarried. “When we lost the baby, my husband said, ‘We need a break.’" said Bellido. 

Bellido went back on her MS medication and took a break from trying to get pregnant. Then Dr. Shah recommended a new medication that is given by infusion twice a year and can be considered for use around pregnancy. “It was different than anything else she'd tried before,” said Dr. Shah. Because the medication had just been approved by the FDA, Bellido checked in with Dr. Shah regularly to monitor how she felt. “It’s always my goal to use the science we have to give people the best treatments available,” Dr. Shah said.

Bellido responded positively to the medication. With her symptoms stabilized, she became pregnant after another round of IVF. 

Bellido said she felt great throughout her whole pregnancy. “I felt really healthy and I had lots of energy.” This is very common among people with MS. “Being pregnant means you're growing a whole different person,” Dr. Shah explained. “Your immune system dials it down as a measure to protect the foreign being that is growing.’”

In the months after giving birth to her daughter, Hadley, in 2020, Bellido stayed in close contact with Dr. Shah. MS relapses after pregnancy are two-to-three-times higher than before pregnancy, particularly in the first three months postpartum, explained Dr. Shah. “It was very important to make sure that there was an open line of communication,” she said. Bellido breastfed while on the new medication, and hasn’t had any MS flares or symptoms since. “I’d say that I’m in a state of full remission,” said Bellido.

After thinking she couldn’t get pregnant naturally, Bellido was pleasantly surprised when she became pregnant a second time without any medical intervention. Her first call was to Dr. Shah because she’d received an infusion a few weeks earlier and was concerned it would impact the baby. “I reassured her,” said Dr. Shah. “We reviewed what we know about the medication and its effects in pregnancy and made a plan for safe monitoring.”

Bellido had a healthy baby boy, Jeremiah, in August 2023. Now with her family of four, 41-year-old Bellido is grateful to Dr. Shah for finding a medication that works for her and her MS. “To live like you don't have MS is the most amazing thing ever,” she said.