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Wpływ nieswoistych zapaleń jelit na rozrodczość

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Author(s): Irena Jałocha | Marian Stanisław Gabryś

Journal: Polish Gastroenterology
ISSN 1232-9886

Volume: 17;
Issue: 5;
Start page: 333;
Date: 2010;
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Keywords: fertility | pregnancy | inflammatory bowel diseases | Crohn disease | ulcerative colitis

ABSTRACT
Inflammatory bowel disease (IBD) affects mainly the young population and therefore fertility and pregnancy-related issues are important clinical considerations. Overall, male and female fertility are not affected by IBD – except for the active Crohn’s disease, which seems to reduce fertility in females. Despite this, studies demonstrate a reduced birth rate amongst patients with IBD which cannot be attributed to reduced ability to conceive, suggesting that this results from patients’ active avoidance of pregnancy. Sulphasalzine and possibly corticosteroids reduce male fertility. No other drugs used in IBD affect significantly fertility in humans. An ileal pouch anal anastomosis reduces fertility in both women and men but, overall, the effect of abdominal surgery on fertility is not clearly documented. The risk of pregnancy-related complications and the disease behaviour during pregnancy depend mainly on disease activity at time of conception. Proactive treatment for maintenance of disease remission during gestation is recommended. Except for methotrexate and thalidomide, drugs used in IBD appear safe in pregnancy. Surgery should be delayed if possible, although pregnancy is not a contraindication for surgical procedures. The management of IBD in reproductive age and pregnant women remains still controversial because literature data comes mostly from retrospective studies. Further studies are needed to guide clinicians in decision making.

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