Determinants of Fertility and Family Planning Choices Among Women Diagnosed with Multiple Sclerosis

Background: Multiple Sclerosis (MS) is a chronic neurological disease that commonly affects women during their reproductive years, influencing fertility and family planning decisions. This study explores the psychological, social, and medical factors associated with reproductive choices in women with MS. Objectives: To identify factors influencing reproductive choices in women with MS and assess the role of psychological, social, and disease-related variables in fertility decision. Methods: A cross-sectional study was conducted among 103 women diagnosed with MS, recruited from specialized clinics and support groups. Participants completed validated questionnaires assessing social support, psychological well-being, relationship dynamics, reproductive motivation, and quality of life. Binary logistic regression was performed to identify independent predictors of childbearing. Results: Women with relapsing-remitting MS (73.9%) were significantly more likely to have children than those with progressive forms (p = 0.001), while those using fingolimod (100%) remained childless (p = 0.008). Higher mental health scores (p = 0.035) and fatalistic motivation (p = 0.005) were associated with childbearing, while increased health-related concerns (p = 0.006) were more prevalent among mothers. Marital status (p = 0.001) was a significant factor, with all unmarried women being childless. However, logistic regression analysis did not identify any single independent predictor of childbearing (p > 0.05), suggesting that reproductive decisions are influenced by multiple interrelated factors rather than a single dominant variable. Conclusions: This study highlights the complex interplay of disease progression, psychological resilience, and treatment choices in reproductive decisions among women with MS. Findings emphasize the need for individualized reproductive counseling, considering both medical and psychosocial factors. Future research should incorporate longitudinal studies to better understand the evolving reproductive trajectories of women with MS.