L26/P-429 Reproductive Health Education for Young Multiple Sclerosis Patients: A Survey Study

M. Bellon; N. Mahendru; L. Krupp; G. Quinn

doi:10.1093/humrep/deag083.763

Abstract Study question How is counseling conducted for young Multiple Sclerosis (MS) patients and what are their unmet needs regarding family building and reproductive health? Summary answer Most patients consulted their neurologist about having a child with respect to their MS diagnosis, but the reproductive health counseling they received was not standardized. What is known already MS has implications for family-building and reproduction, including teratogen risk from disease-modifying therapies (DMTs), fear of interrupting a DMT, and avoidance of parenthood for fear of MS relapse. People with MS between the ages of 36 and 45 are less likely to have children than the general population and experience insufficient support from clinicians regarding reproductive concerns. Most do not have access to high-risk care (MFM) in the case of pregnancy. Neurologists want to refer women to OB/GYNs for contraceptive guidance and family planning, but there often lacks coordinated care, or such care occurs in a separate clinic. Study design, size, duration An anonymous cross-sectional survey was administered at a single MS Center over a 2-month period; completed by 132 participants. Participants/materials, setting, methods A 45-item survey addressing MS diagnosis, reproductive health education (contraceptive and fertility knowledge), and family building goals was designed using RedCap© and administered to patients via in-person and email recruitment at an MS Center. Eligibility criteria were age between 18 and 39 years, and a diagnosis of MS. Results were analyzed using descriptive statistics and cross-tabulations. Main results and the role of chance Participants (79.2%) identified as women. Most patients had the relapsing-remitting MS subtype, and over 90% were on a DMT; the most common being infusions with B-cell depleting therapy. The majority (90.9%) obtained their MS information from their neurologist, and 53.8% reported using the internet or social media for their MS information. Most consulted their neurologist (69.7%) about family building (having a child), whereas only 31.1% consulted an OB/GYN. Most (72.5%) said their neurologist did not discuss contraception. Some (24.5%) were either unsatisfied with or would have liked more information than they received on MS and fertility, and 58.8% felt their MS diagnosis negatively impacted their plans for children. Some (35.4%) reported never using contraception, and 25.8% of those who had a prior pregnancy while on a long-term DMT said they would change their approach to contraception in the future. Unplanned pregnancy occurred in 11.5% of participants, with 7.5% of these undergoing a medical or surgical termination. Recommendations regarding switching to, switching from, and general therapy advice when seeking pregnancy were highly variable across participants. Patients desired additional reproductive health (RH) information than what they received, especially regarding pregnancy planning and management. Limitations, reasons for caution This recruitment process was subject to inclusion bias, as the survey may have disproportionately attracted patients with prior experience in this topic. Because participants were recruited through a patient portal, a response rate could not be calculated, as some patients may not have received the link to respond. Wider implications of the findings Bolstering information about MS and family planning on clinical practice sites for neurologists, updating practice guidelines, and creating curricula for neurology trainees are tangible steps that can help ensure RH discussions are prioritized. Future avenues of research include assessing clinicians’ perceived roles with respect to RH counseling for MS patients. Trial registration number No

L26/P-429 Reproductive Health Education for Young Multiple Sclerosis Patients: A Survey Study

Files and links (1)

Abstract

Metrics

Details

L26/P-429 Reproductive Health Education for Young Multiple Sclerosis Patients: A Survey Study

Files and links (1)

Abstract

Metrics

Details

Drexel University Social media