Fertility Planning and IBD

Fertility Planning and IBD - Crohn's & Colitis Awareness Week 2021

Infertility is a broad term. But it’s usually defined as not conceiving a pregnancy after a year of trying.

The good news is that for most people with Crohn’s disease or ulcerative colitis (inflammatory bowel disease, or IBD), fertility isn’t affected. The rates of infertility seem to be about the same as that for anyone else.

There are, however, some reasons why women with IBD may have lowered fertility.

Active Disease

Having a flare-up of IBD where the bowel is inflamed could lower fertility. That doesn’t mean conception is impossible, but it could be less likely in some women. Having anemia, malnutrition, or depression during a flare might also lower the ability to get pregnant. [1]

J-pouch Surgery

The surgery that’s done to treat ulcerative colitis might lead to fertility issues in some women. ileal pouch-anal anastomosis (IPAA), or j-pouch surgery, could cause scar tissue in the pelvis. However, that doesn’t happen to everyone.

Having the surgery done with less invasive methods (laparoscopically) can help. With laparoscopic surgery, which is done with small incisions, one small study showed 70% of women got pregnant without fertility treatments. [2]

Family Planning

It’s important for people with IBD to think about timing when starting a family. Being in remission for about 6 months is often recommended before attempting a pregnancy. Women with IBD will want to work closely with their team to get ready for a pregnancy.

One reliable resource available to IBD patients is the IBD Parenthood Project which has a variety of toolkits, visual guides and fact sheets for family planning through the fourth trimester.  These resources are a tangible pieces of information that are accessible electronically, making it easier to share with physicians, partners and other family planning participants.

Resources

If a person or partners are experiencing challenges with becoming pregnant, the burden of cost can be overwhelming and discouraging. It’s important to remember that there are resources and tools available to parents-to-be to help that will help alleviate some of these frustrations. Some women have joined FB groups where there are lots of shared information and resources, as well as connections made for housing if you must travel out of state for fertility treatments. However, the cost is the largest obstacle for many people on a fertility journey.

Here are some resources found on Verywell.com with more information:

Patience

As you walk down this path toward family planning, there will be highs and lows. It can be overwhelming and frustrating. It’s important that you find time for self care and take breaks. Be patient with yourself, your partner, and the process. Create a support group that will help encourage you and give you grace during moments of frustration. This group doesn’t have to be people you know, you can also seek out people who may be on the same path or who have completed their journey.

Reach out to advocates such as Heartfelt Beginnings by Amanda, who is a mother living with IBD and on a fertility journey. It’s important to know that there are others on the same path and that there are resources and support available to you.

Sources:

1. Martin J, Kane SV, Feagins LA. Fertility and Contraception in Women With Inflammatory Bowel Disease. Gastroenterol Hepatol (N Y). 2016;12(2):101-109.
2. Bartels SA, DʼHoore A, Cuesta MA, Bensdorp AJ, Lucas C, Bemelman WA. Significantly increased pregnancy rates after laparoscopic restorative proctocolectomy: a cross-sectional study. Ann Surg. 2012;256(6):1045-1048. doi:10.1097/SLA.0b013e318250caa9

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