Colectomy with ileorectal anastomosis preserves female fertility in ulcerative colitis

Mortier, Pierre-Eugène; Gambiez, L; Karoui, M.; Cortot, Antoine; Paris, J; Quandallé, P; Colombel, Jean–Frédéric

doi:10.1016/s0399-8320(06)73233-x

Cited by 72 publications

(26 citation statements)

References 13 publications

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“…A meta-analysis evaluating IPAA in UC patients suggested that the risk of infertility increased 3-fold post-IPAA [23] . PCL [24] with IPAA has a more pronounced effect on fertility compared to the laparoscopic approach, which produces fewer adhesions [18,19,[23][24][25][26] . Studies involving laparoscopic IPAA indicate that women undergoing these procedures have significantly higher pregnancy rates as compared to open field IPAA [27] .…”

Section: Fertilitymentioning

confidence: 99%

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Hosseini‐Carroll¹,

Mutyala²,

Seth³

et al. 2015

WJGPT

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Manas K made critical revisions of the manuscript; Becker F and Alexander JS contributed equally as senior authors. Conflict-of-interest statement:There are no known conflicts of interest. The authors (Pegah Hosseini-Carroll, Monica Mutyala, Abhishek Seth, Shaheen Nageeb, Demiana Soliman, Moheb Boktor, Ankur Sheth, Jonathon Chapman, James Morris, Paul Jordan, Kenneth Manas, Felix Becker, and J Steven Alexander) have no relevant financial considerations related to this proposal, and the study was not supported by any corporate entity. There is no known intellectual property associated with this report. AbstractInflammatory bowel diseases (IBD) are chronic idiopathic inflammatory conditions characterized by relapsing and remitting episodes of inflammation which can affect several different regions of the gastrointestinal tract, but also shows extra-intestinal manifestations. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While IBD therapy has improved dramatically with enhanced surveillance and more abundant and powerful treatment options, IBD disease can have important effects on pregnancy and presents several challenges for maintaining optimal outcomes for mothers with IBD and the developing fetus/neonate. Women with IBD, the medical team treating them (both gastroenterologists and obstetricians/gynecologists) must often make highly complicated choices regarding conception, pregnancy, and post-natal care (particularly breastfeeding) related to their choice of treatment options at different phases of pregnancy as well as post-partum. This current review discusses current concerns and recommendations for pregnancy during 157November 6, 2015|Volume 6|Issue 4| WJGPT|www.wjgnet.com Hosseini-Carroll P et al . Pregnancy and inflammatory bowel diseases IBD and is intended for gastroenterologists, general practitioners and IBD patients intending to become, (or already) pregnant, and their families. We have addressed patterns of IBD inheritance, effects of IBD on fertility and conception (in both men and women), the effects of IBD disease activity on maintenance of pregnancy and outcomes, risks of diagnostic procedures during pregnancy and potential risks and complications associated with different classes of IBD therapeutics. We also have evaluated the clinical experience using "top-down" care with biologics, which is currently the standard care at our institution. Post-partum care and breastfeeding recommendations are also addressed. Core tip: Inflammatory bowel diseases (IBD) are chronic inflammatory conditions characterized by relapsing and remitting episodes of intestinal inflammation. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While therapies have improved dramatically, IBDs have important effects on pregnancy and present challenges for maintaining optimal outcomes for mothers and their developing fetus/ neonate. Women with IBD and physician...

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Section: Fertilitymentioning

confidence: 99%

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Hosseini‐Carroll¹,

Mutyala²,

Seth³

et al. 2015

WJGPT

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“…Indeed, interventions that produce relatively fewer abdominal and pelvic adhesions, such as ileorectal anastomoses (IRA) and laparoscopic surgery, are associated with higher fertility rates. Two studies looking at IRA -one with familial adenomatous polyposis patients, another with UC patients -found pregnancy rates after IRA were similar to controls and greater than rates after IPAA [14,18]. Building off of a recent study showing fewer adhesions with laparoscopic IPAA technique [19], a recent cross-sectional study by Bartels et al suggests pregnancy rates are significantly higher among women who have undergone laparoscopic IPAA versus open IPAA [20].…”

Section: Fertilitymentioning

confidence: 99%

Management of inflammatory bowel disease in pregnancy

Ng¹,

2013

Expert Review of Clinical Immunology

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“…Despite this risk, some patients with minimal rectal disease who are interested in future fertility may be candidates for this less aggressive approach. 47,48 Additional strategies for fertility preservation in these patients include intraoperative interventions to displace the ovaries outside of the surgical field (but still accessible for subsequent oocyte retrieval in the context of in vitro fertilization [IVF]), use of adhesion barriers to prevent adhesions, and use of minimally invasive surgical techniques, although the efficacy of these approaches remains unproven. 44 Endometriomas are the result of endometriotic lesions on the ovary that form cystic structures.…”

Section: Postsurgical Etiologiesmentioning

confidence: 99%

Nonmalignant Diseases and Treatments Associated with Primary Ovarian Failure: An Expanded Role for Fertility Preservation

Hirshfeld-Cytron

Gracia

Woodruff

2011

Journal of Women's Health

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Cancer treatments can be detrimental to fertility; recent literature has focused on the efforts of fertility preservation for this patient population. It should be recognized, however, that several nonmalignant medical conditions and therapeutic interventions could be similarly hazardous to fertility. Some of these nonmalignant diseases and their treatments that can adversely impact the reproductive axis are gastrointestinal diseases, rheumatologic disorders, nonmalignant hematologic conditions, neurologic disorders, renal disorders, gynecologic conditions, and metabolic diseases. Their negative effects on reproductive function are only now being appreciated and include impaired ovarian function, endocrine function, or sexual function and inability to carry a pregnancy to term. Complications and comorbidities associated with certain diseases may limit the success of established fertility preservation options. Recent advances in fertility preservation techniques may provide these patients with new options for childbearing. Here, we review several fertility-threatening conditions and treatments, describe current established and experimental fertility preservation options, and present three initiatives that may help minimize the adverse reproductive effects of these medical conditions and treatments by raising awareness of the issues and options: (1) increase awareness among practitioners about the reproductive consequences of specific diseases and treatments, (2) facilitate referral of patients to fertility-sparing or restorative programs, and (3) provide patient education about the risk of infertility at the time of diagnosis before initiation of treatment.

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Colectomy with ileorectal anastomosis preserves female fertility in ulcerative colitis

Cited by 72 publications

References 13 publications

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Management of inflammatory bowel disease in pregnancy

Nonmalignant Diseases and Treatments Associated with Primary Ovarian Failure: An Expanded Role for Fertility Preservation

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