Additional theories behind worsening MS activity following ART include discontinuation of DMT, stress related to infertility, rapidly changing hormone levels inducing pro-inflammatory changes, and ART-mediated increases in immune cell movement across the blood-brain-barrier via induction of interleukin-8 (IL-8), vascular endothelial growth factor (VEGF), and CXC chemokine ligand 12 (CXCL-12) [27]. Here, VEGFA is linked to Infertility.