Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr 28:12:620772.
doi: 10.3389/fneur.2021.620772. eCollection 2021.

Family Planning Decision Making in People With Multiple Sclerosis

Simona Bonavita  1   2 , Luigi Lavorgna  1 , Hilary Worton  3 , Susan Russell  4   5 , Dominic Jack  5
Affiliations

Family Planning Decision Making in People With Multiple Sclerosis

Simona Bonavita et al. Front Neurol. .

Abstract

Introduction: 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. Methods: A total of 332 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 80-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 2016 US and 2010 UN census data. Results: pwMS were more likely to have no children than the general population, particularly in the subgroup of patients aged 36-45 years. A total of 56% of pwMS reported that the disease affected, with different degrees of impact, their family planning decision making. Of these, 21% significantly changed their plans for timing of pregnancy and the number of children, and 14% decided against having children. Participants indicated that healthcare professionals were the primary source of information on family planning (81% of responses). The timing of planned pregnancy was not considered when selecting treatment by 78% of participants. Conclusion: 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: disease-modifying drugs; family planning; multiple sclerosis; pregnancy; survey.

PubMed Disclaimer

Conflict of interest statement

SB received speaker honoraria and/or travel grants and/or Advisory board fees from Teva, Merck-Serono, Sanofi-Genzyme, Novartis, Biogen, and Roche. LL received speaker honoraria and travel grants from Teva, Merck KGaA (Darmstadt, Germany), Sanofi, Novartis, Biogen, Roche, and Bayer. HW is an employee of Aequus Research. SR is an employee of EMD Serono Research & Development Institute Inc., a business of Merck KGaA, Darmstadt, Germany. DJ is an employee of Merck KGaA, Darmstadt, Germany. The authors declare that this study received funding from EMD Serono Research & Development Institute, Inc., Billerica, MA, USA; a business of Merck KGaA, Darmstadt, Germany. The funder had the following involvement with the study: data interpretation and manuscript preparation. Medical writing assistance was provided by Joseph Ward of inScience Communications, Springer Healthcare Ltd., Chester, UK, and was funded by Merck KGaA, Darmstadt, Germany.

Figures

Figure 1
Figure 1
Time since diagnosis of multiple sclerosis, by age group.
Figure 2
Figure 2
Proportion of participants with multiple sclerosis (MS) from each country aged 26–45 years with no children, compared with general population findings. (A) 26–35 years of age subgroup. (B) 36–45 years of age subgroup.
Figure 3
Figure 3
Participants who were significantly impacted by multiple sclerosis (MS) on having children, by country.
Figure 4
Figure 4
Patients who were significantly impacted by multiple sclerosis (MS) on having children, by gender.
Figure 5
Figure 5
Primary sources of information on family planning. MS, multiple sclerosis.
Figure 6
Figure 6
Discussion of family planning with the doctor responsible for management of the participant with multiple sclerosis (MS).
See this image and copyright information in PMC

Comment in

References

    1. Kamm CP, Uitdehaag BM, Polman CH. Multiple sclerosis: current knowledge and future outlook. Eur Neurol. (2014) 72:132–41. 10.1159/000360528 - DOI - PubMed
    1. Pozzilli C, Pugliatti M, Paradig MSG. An overview of pregnancy-related issues in patients with multiple sclerosis. Eur J Neurol. (2015) 22(Suppl.2):34–9. 10.1111/ene.12797 - DOI - PubMed
    1. Vukusic S, Marignier R. Multiple sclerosis and pregnancy in the “treatment era”. Nat Rev Neurol. (2015) 11:280–9. 10.1038/nrneurol.2015.53 - DOI - PubMed
    1. Canibaño B, Deleu D, Mesraoua B, Melikyan G, Ibrahim F, Hanssens Y. Pregnancy-related issues in women with multiple sclerosis: an evidence-based review with practical recommendations. J Drug Assessment. (2020) 9:20–36. 10.1080/21556660.2020.1721507 - DOI - PMC - PubMed
    1. Barry B, Erwin AA, Stevens J, Tornatore C. Fingolimod rebound: a review of the clinical experience and management considerations. Neurol Ther. (2019) 8:241–50. 10.1007/s40120-019-00160-9 - DOI - PMC - PubMed

LinkOut - more resources