Exploring Reproductive Decision-Making Among Women With Multiple Sclerosis

September 18, 2026 updated by: Doneez Amir Adly Eskander, Assiut University

Exploring Reproductive Decision-Making Among Women With Multiple Sclerosis in Assiut Governorate: Mixed-Methods Study

Multiple sclerosis (MS) is a chronic disease that mainly affects young adults, including women during their reproductive years. Women with MS may face important questions and concerns related to marriage, fertility, pregnancy, childbirth, breastfeeding, motherhood, and family planning. These decisions may be influenced by concerns about MS symptoms and disability, pregnancy-related changes in the disease, medications, possible effects on the baby, and the availability of appropriate reproductive health counseling and support.

This study aims to explore reproductive decision-making among women of reproductive age living with multiple sclerosis in Assiut Governorate, Egypt. The study will examine their experiences, concerns, fertility intentions, childbearing preferences, family planning practices, and experiences related to marriage, pregnancy, breastfeeding, and motherhood. It will also assess factors that may influence reproductive decisions, including disease-related characteristics, social and demographic factors, reproductive autonomy, and partner support among married women.

The study will use a sequential explanatory mixed-methods design. The quantitative component will include eligible married women with multiple sclerosis attending selected multiple sclerosis clinics in Assiut Governorate. Information will be collected through face-to-face interviews using structured questionnaires and validated assessment tools. The quantitative findings will be used to identify important patterns and factors associated with reproductive decision-making.

A qualitative component will then be conducted through in-depth interviews with selected women with multiple sclerosis to provide a deeper understanding of their experiences and concerns. Single women will be explored qualitatively to understand their perspectives regarding marriage, fertility, and future reproductive plans, while married women who participate in the quantitative component may also be invited for qualitative interviews. Participants will be selected to obtain a range of experiences and characteristics, and interviews will continue until sufficient information is obtained.

The study will provide a better understanding of the reproductive needs and concerns of women living with multiple sclerosis in Assiut Governorate. The findings may help identify gaps in reproductive health counseling and support and may contribute to the development of more patient-centered reproductive health services for women with multiple sclerosis

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Detailed Description

Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system that predominantly affects individuals during their reproductive years. The increasing availability of effective disease-modifying therapies and improvements in the management of MS have allowed many women living with MS to consider marriage, pregnancy, and parenthood. However, reproductive decision-making may remain complex because women may have concerns about disease progression, disability, pregnancy and postpartum disease activity, effects of medications on pregnancy and breastfeeding, possible health risks to the child, and their ability to fulfil maternal and family responsibilities.

Reproductive decisions among women with MS may also be influenced by factors beyond the clinical characteristics of the disease. These may include age, marital status, educational and socioeconomic circumstances, family and social expectations, partner support, reproductive autonomy, previous reproductive experiences, access to appropriate counseling, and perceptions of the impact of MS on family life. Women may therefore make reproductive decisions within a complex interaction of medical, psychological, interpersonal, social, and demographic factors.

Despite the importance of reproductive health in women with chronic diseases, there is limited information about how women with MS in Egypt experience and make reproductive decisions, particularly within the social and cultural context of Upper Egypt. Understanding women's perspectives is important for identifying unmet reproductive health needs and improving counseling and support provided by healthcare professionals.

This study will use a sequential explanatory mixed-methods approach to explore reproductive decision-making among women of reproductive age living with MS in Assiut Governorate. The study will initially collect quantitative information from eligible married women with MS. The quantitative component will assess reproductive decision-making and related factors, including reproductive intentions and preferences, reproductive autonomy, partner support, and relevant sociodemographic and disease-related characteristics.

The quantitative findings will subsequently inform the qualitative component. In-depth interviews will be conducted with selected women with MS to provide a deeper understanding of the experiences, concerns, perceptions, and contextual factors underlying reproductive decisions. Married women participating in the quantitative component may be invited to participate in the qualitative interviews. Single women will be explored separately through the qualitative component to capture their perspectives regarding marriage, fertility intentions, future childbearing, and concerns related to reproductive life that cannot be adequately assessed through the quantitative component.

The qualitative sampling will use purposive maximum-variation sampling to include women with diverse sociodemographic, marital, and disease-related characteristics. These may include age, residence, educational level, employment, disease duration, disability severity, disease-modifying treatment, fertility intentions, motherhood status, and pregnancy experience after MS diagnosis. Interviews will continue until sufficient depth and diversity of information are achieved and thematic saturation is reached.

The qualitative interviews will explore women's experiences of living with MS and its perceived influence on marriage and intimate relationships, fertility intentions and timing of childbearing, desired family size, pregnancy and childbirth, breastfeeding, motherhood and childcare, and family planning and contraceptive decision-making. Participants will also be asked about their experiences of receiving reproductive health counseling and information related to pregnancy, contraception, breastfeeding, MS treatment, and potential risks to themselves or their children. The interviews will further explore the roles of partners, families, healthcare professionals, and the broader social context in shaping reproductive decisions.

Quantitative and qualitative findings will be interpreted together to develop a comprehensive understanding of reproductive decision-making among women living with MS. The qualitative findings will help explain and contextualize important quantitative patterns and may identify experiences or factors that are not captured by structured questionnaires.

The study is intended to generate evidence about the reproductive concerns, needs, and decision-making experiences of women living with MS in Assiut Governorate. The findings may help identify gaps in reproductive health information and counseling and may support the development of more responsive, patient-centered reproductive health services for women with MS. The study may also provide a basis for future research and interventions addressing reproductive health and family planning needs among women living with chronic neurological diseases.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
272

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

  • Name: Doaa Mohamed Osman, assistant professor

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 49 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Sampling Method

Probability Sample

Study Population

The quantitative study population will include married women aged 18-49 with confirmed multiple sclerosis who attend the selected study sites during the study period. On the other hand, the qualitative population will include single, currently married, divorced and widowed/ever-married women aged 18-49 years with confirmed MS, as appropriate to the study sites and the qualitative sampling plan.

Description

o Inclusion criteria

Women who are:

  • Within reproductive age group (18-49 years).

  • With confirmed diagnosis of multiple sclerosis according to the 2024 Revised McDonald Criteria (31).

  • Able to communicate, agree to participate in the study and provide informed consent.

    • Exclusion Criteria

Women with:

  • Severe cognitive impairment or psychiatric illness affects their ability to participate in the study.
  • Acute medical or neurological deterioration at the time of recruitment makes participation inappropriate or burdensome.
  • Any condition judged by the clinical team or research team to make participation unsafe or to compromise the validity of the interview.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: OTHER
  • Time Perspectives: CROSS_SECTIONAL

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
The quantitative study population will include married women aged 18-49 with confirmed MS

The quantitative study population will include married women aged 18-49 with confirmed multiple sclerosis who attend the selected study sites during the study period. On the other hand, the qualitative population will include single, currently married, divorced, or widowed/ever-married women aged 18-49 years with confirmed MS, as appropriate to the study sites and the qualitative sampling plan.

Eligibility criteria:

  • Inclusion criteria Women who are

    • Within the reproduct age group (18-49 years).
    • With a confirm diagnosis of multiple sclerosis according to the 2024 Revised McDonald Criteria (31).
    • Able to communicate, agree to participate in the study and provide informed consent.

  • Exclusion Criteria

Women with:

  • Severe cognitive impairment or psychiatric illness affects their ability to participate in the study.
  • Acute medical or neurological deterioration at the time of recruitment makes participation inappropriate or burdensome.
  • Any condition judged by the clinical team or

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Motherhood/Pregnancy Choice and Worries Questionnaire (MPWQ) score
Time Frame: At baseline (during the study interview)

The Motherhood/Pregnancy Choice and Worries Questionnaire (MPWQ) will be used to assess women's experiences, choices, and worries related to motherhood and pregnancy in the context of multiple sclerosis, including concerns about pregnancy, motherhood, fertility, breastfeeding, childcare, and the potential effects of MS on reproductive decisions. The outcome will be reported as the total MPWQ score according to the scoring instructions of the instrument. The minimum and maximum possible scores and the direction of interpretation will be reported according to the validated version used in this study.
At baseline (during the study interview)
Reproductive Concerns Scale score
Time Frame: At baseline (during the study interview)

The Reproductive Concerns Scale will be used to assess reproductive concerns related to multiple sclerosis, including concerns about fertility, pregnancy, maternal and fetal health, disease-related risks, treatment-related reproductive issues, and future reproductive plans. The outcome will be reported as the total Reproductive Concerns Scale score according to the scoring instructions of the instrument. The minimum and maximum possible scores and the direction of interpretation will be reported according to the validated version used in this study.
At baseline (during the study interview)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Assiut University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Director: Prof. Dr. Etemad El-shereef, professor, Assiut University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 1, 2027

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 1, 2029

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
October 1, 2031

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
September 14, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 18, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
September 21, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 21, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 18, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • Reproductive Decision-Making

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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