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 Researchers studied more than 1,300 women with inflammatory bowel
disease (IBD), which involves chronic or recurring inflammation of
the gastrointestinal tract. Ulcerative colitis and Crohn’s disease
are the most common forms of IBD. People with Crohn’s have
inflammation throughout the entire digestive tract, while in
ulcerative colitis, only the large intestine is inflamed.
Almost one in six women were voluntarily childless, often because
they were older, had worse IBD symptoms or were unaware of options
that might improve their odds of having a baby, the study found.
“Poor knowledge is one of the drivers of voluntary childlessness,”
said lead author Dr. Christian Selinger, a gastroenterologist at the
University of Leeds in the U.K.
While IBD doesn’t necessarily reduce fertility, medications to treat
these conditions can impact the odds of conception and are also
linked to certain birth defects. Surgical treatments can also lead
to scarring that limits fertility, and many patients with IBD also
experience sexual dysfunction.
Despite these challenges, many women can still conceive through in
vitro fertilization (IVF) and other reproductive technologies.
For the current study, Selinger and colleagues surveyed female
members of the patient support group Crohn’s and Colitis U.K. who
were between 18 and 45 years old.
Participants were 33 years old on average. Almost 59 percent were
diagnosed with Crohn’s, while 38 percent had ulcerative colitis.
While 14 percent of the women had kids before they got an IBD
diagnosis, 26 percent had kids afterwards and another 36 percent
said they planned to in the future.
The women who said they didn’t want kids tended to have more
hospitalizations and were more likely to have had surgeries for IBD
than their peers who were mothers or planned to start a family at
some point. The voluntarily childless women were also more likely to
be single and unemployed.
Some women with no plans to have children also said they were
concerned their baby might inherit IBD or that the disease might
make pregnancy difficult, and they expressed concerns about raising
a child while coping with their disease.
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Because the study only included people in a patient support group
for IBD, it’s possible the women surveyed were more knowledgeable
about their medical issues and fertility options than women in the
general population might be, the authors note in the Journal of
Crohn’s and Colitis. In addition, the study relied on self-reported
health information that wasn’t verified with the women’s doctors or
medical records.
The study also doesn’t assess exactly how women who opted not to
conceive decided that they didn’t want to have children, Dr. C.
Janneke van der Woude, a researcher at Erasmus Medical Center in
Rotterdam, The Netherlands, who wasn’t involved in the study said by
email.
Symptom severity may very well come into play, said Dr. Yvette
Leung, a researcher at the University of Calgary in Canada who
wasn’t involved in the study.
“The vast majority of treatments for Crohn’s and ulcerative colitis
are completely safe for a female to take when she is conceiving and
equally safe during pregnancy and breastfeeding,” Leung said by
email.
“For patients who are acutely ill, however, from their Crohn’s or
ulcerative colitis, there may be multiple good reasons not to have
children including depression, malnutrition, amenorrhea (lack of
menstruation), and general poor quality of life,” Leung added.
Still, women who get acute symptoms under control and ensure their
specific medications are safe during pregnancy shouldn’t necessarily
be deterred from trying to conceive, said Dr. Jane Andrews, head of
the IBD service and education at Royal Adelaide Hospital in
Australia.
“The news is almost all good,” Andrews, who wasn’t involved in the
study, said by email. “Very few women should be advised not to go
ahead with a family due to IBD.”
SOURCE: http://bit.ly/1ULlG1d Journal of Crohn’s and Colitis, online
March 17, 2016.
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