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This will probably be different for everyone on the process you choose in your decision making. For me I really wanted another child, but it also scared me to death, I didn't want to jeopardize my health or life because I already had a daughter that depended on me. I talked to my rheumatologist about it and he was very against it, he told me to talk with my neurologist and he said he was sure my neurologist would back his opinion up. My neurologist was all for me getting pregnant if that's what I wanted. I did a lot of research and joined a pregnancy group on Facebook for Tm/NMO and pregnancy. They helped a lot hearing successful stories. All my research said to at least be stable a year before trying for a baby and to be off rituxan for 3-5 months before trying. I made sure my labs were good, worked to make my back stronger in the pool in physical therapy. I tried after being stable for 2 years, was off rituxan for 5 months and went off my other medicine for a month before getting pregnant with my daughter. I had a lot of family upset and worried that I would try for a baby much less get pregnant. My husband and I decided this would be our last one as we didn't want to push our luck.