Decreased fertility rates in 9639 women diagnosed with inflammatory bowel disease: a United Kingdom population‐based cohort study

Abstract

AimTo compare fertility rates in women with IBD to those in women without IBD and assess whether the relative fertility differed following IBD diagnosis, flares, and surgery. MethodsWomen aged 15 to 44 years in 1990-2010 were identified from a UK primary care database. We estimated overall and age-specific fertility rates by 5-year age bands for women with and without IBD.We used Poisson regression to calculate fertility rate ratios(AFRR), adjusted for age, smoking and socioeconomic deprivation. Results There ConclusionsWomen with Crohn's disease have marginally lower fertility rates. These rates decreased following flares and surgical interventions. Fertility rates returned almost to normal when women were not prescribed contraception but the reduction following surgical intervention remained. As the lifetime 4 effect of pouch versus non-pouch surgery on fertility is small, the reduction post pouch surgery should be interpreted with caution.

Systematic review: the consequences of psychosocial effects of inflammatory bowel disease on patients′ reproductive health

“…A large population‐based study with 9639 women with IBD and 2 131 864 women without IBD, found women with CD experienced slightly lower birth rates (45.3 live births per 1000 person‐years), compared to those with UC (47.6 live birth per 1000 person‐years), or women from the general population (49.3 live births per 1000 person‐years). These rates were further impaired following active disease or surgery …”

Inflammatory bowel disease and pregnancy

“…The fertility maybe impaired as consequence of tubal adhesions, hydrosalpinx, dysfunction of fimbriae, or fallopian tube obstruction. The adjusted fertility rate ratio for colitis ulcerosa is 0.92 (95% CI 0.86-1.00) while it is 0.87 (95% CI 0.82-0.94) for Crohn's disease [6]. Lower fertility in CD may be attrib-uted to inflammation of the fallopian tubes and ovaries and dyspareunia in cases where the disease affects the perianal area [2].…”

A 29-year-old woman with Crohn disease considering pregnancy

“…1,2 There is an increased risk of infertility with active Crohn disease (adjusted fertility rate ratio 0.70, 95% confidence interval 0.59-0.82). 3 A recent meta-analysis reported that patients with active disease before conception have a twofold increased risk of active disease during pregnancy. 4 A large registry cohort study involving 470 110 births confirmed that active Crohn disease during pregnancy is associated with an increased risk of stillbirth (adjusted odds ratio [OR] 4.48), preterm birth (adjusted OR 2.66) and low-birth weight infants (adjusted OR 3.30).…”