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Fertility in non-surgically treated inflammatory bowel disease

October's issue of the Alimentary Pharmacology & Therapeutics evaluated the impact of IBD on fertility in both women and men with IBD who had no history of surgical treatment for IBD.

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Inflammatory bowel diseases (IBD) typically affect young patients during the reproductive years, and reproductive issues are of key concern to them.

Dr Gower-Rousseau and colleagues from France evaluated the impact of IBD on fertility in both women and men with IBD who had no history of surgical treatment for IBD.

The team searched MEDLINE, Cochrane Library, EMBASE and international conference abstracts, and included all controlled observational studies that evaluated fertility in Crohn's disease, and/or ulcerative colitis in women and/or men.

The research team included 11 studies.

In women with Crohn's disease, there was a 17–44% reduction in fertility as compared with controls.

In women with Crohn's, there was a 17–44% reduction in fertility
Alimentary Pharmacology & Therapeutics

The team found that reduction in fertility was linked to voluntary childlessness, while there was no evidence of physiological causes of infertility.

Most studies did not find any reduction in fertility in women with ulcerative colitis as compared with controls.

In men with Crohn's disease, there was an 18–50% reduction in fertility as compared with controls with no difference in reproductive capacity.

The researchers observed no evidence of reduced fertility in men with ulcerative colitis.

Dr Gower-Rousseau's team concludes, "The infertility observed in both women and men with CD is due to voluntary childlessness as opposed to involuntary infertility."

"This voluntary childlessness is often based on incorrect beliefs about the impact of the disease on fertility and pregnancy outcomes."

"Our results reinforce the need to increase awareness among male and female patients that IBD does not itself lead to reduced fertility."

Aliment Pharmacol Ther 2013: 38(8): 847–853
27 September 2013

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