Study and analysis and evaluation of reproductive health in female patients with multiple sclerosis

Multiple sclerosis (MS) is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to transmit signals, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. Specific symptoms can include double vision, visual loss, muscle weakness, and trouble with sensation or coordination. MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms). In the relapsing forms of MS, between attacks, symptoms may disappear completely, although some permanent neurological problems often remain, especially as the disease advances.Multiple sclerosis (MS) is a neurological disease that typically affects young women of reproductive age. There are still many questions and heterogeneous clinical approaches partly due to the lack of consensus and guidelines. For many years, women with MS have been discouraged from getting pregnant for fears that the disease might negatively affect the fetus or increase their obstetric risk or for claims that the disease might decrease fertility. However, fertility does not seem to be impaired to a larger extent in women with MS. Therefore, all healthcare providers involved in the follow-up of multiple sclerosis patients must be prepared to discuss future fertility, pregnancy, and others matters, in addition to providing them with the best possible counseling. The majority of people diagnosed with MS are of childbearing or child fathering age, therefore family planning is an important issue for both women and men with MS. Fertility and the course of pregnancy are not affected by MS; however, people with MS (pwMS) may have concerns that there will be a greater risk of complications to the mother and/or adverse pregnancy outcomes either due to the disease or to ongoing medication. This survey aimed to understand family planning decision making in pwMS and related unmet educational needs.A total of ۳۳۲ pwMS across the USA, UK, France, Germany, Italy, and Spain were recruited from a specialist patient panel agency to participate in a smartphone-enabled standing panel. The ۸۰-question survey focussed on decision making and information sources for pwMS regarding family planning, as well as behavior during and after pregnancy. Male patients with MS did not respond to specific questions on pregnancy. Survey results were directly compared with the ۲۰۱۶ US and ۲۰۱۰ UN census data. pwMS were more likely to have no children than the general population, particularly in the subgroup of patients aged ۳۶–۴۵ years. A total of ۵۶% of pwMS reported that the disease affected, with different degrees of impact, their family planning decision making. Of these, ۲۱% significantly changed their plans for timing of pregnancy and the number of children, and ۱۴% decided against having children. Participants indicated that healthcare professionals were the primary source of information on family planning (۸۱% of responses). The timing of planned pregnancy was not considered when selecting treatment by ۷۸% of participants.MS was found to significantly impact family planning decision making, with pwMS significantly less likely to have children in comparison with the general population.

Keywords:

multiple sclerosis , pregnancy , fertility , systematic review