There are many factors other than IBD that can affect fertility.  Speak with your family physician or gynecologist if any of these apply to you.

Fertility decreases with age . . .

  • Women’s fertility peaks in their late teens and early 20s7. After the age of 35 years, fertility declines sharply and by 45 years, pregnancy is uncommon7,8. Older women also have increased odds of abnormal embryos7.
  • Male fertility significantly decreases after the age of 35 years8. The viability of sperm in the female reproductive tract decreases with age.

Preconception health can affect fertility . . .

  • Body weight: Extremes of body weight can decrease fertility. Obesity has been associated with an increased risk of infertility because of decreased sperm concentration in men and higher incidences of miscarriages in women9-11.
  • Nutritional Status: It is essential that people who are trying to conceive are getting enough vitamins and nutrients9-11. This is especially true for IBD patients as their diets may be limited. The Health Canada Food Guide suggests that women take daily multivitamins with iron and folic acid10.
  • Habits (smoking, drinking): Smoking and alcohol consumption should be stopped prior to attempting to become pregnant as they can affect the eggs and sperm, and decrease fertility11.

Family and personal history before pregnancy can affect fertility . . .

  • Family history of fertility issues: A family history of fertility issues may suggest a genetic disorder12,13.
  • Personal history of fertility issues and other medical conditions: An individual’s medical history can suggest reasons for decreased fertility. For example, polycystic ovarian syndrome14 and uncontrolled diabetes9 are associated with infertility.

References

  1. Huang V et al. Does the level of reproductive knowledge specific to inflammatory bowel disease predict childlessness among women with inflammatory bowel disease. Can J Gastroenterol Hepatol 2015;29(2):95-103.
  2. Selinger CP et al. IBD and pregnancy: Lack of knowledge is associated with negative views. JCC. 2012 Sep;7:206-213.
  3. Habal F M & Huang V W. Review Article: a decision-making algorithm for the management of pregnancy in the inflammatory bowel disease patient. Aliment Pharmacol Ther. 2012 January;35:501-515.
  4. Ng S W & Mahadevan U. My Treatment Approach to Management of the Pregnant Patient With Inflammatory Bowel Disease. Mayo Clin Proc. 2014 March;89(3):355-360.
  5. Walijess A et al. Threefold increased risk of infertility: a meta-analysis of infertility after ileal pouch anal anastomosis in Ulcerative Colitis. Gut. 2006;55(11):1575-1580.
  6. Tulchinsky A et al. Restorative proctocolectomy impairs fertility and pregnancy outcomes in women with Ulcerative Colitis. Colorectal Dis. 2013;15:842-847.
  7. Craig B M et al. A Generation of Childless Women: Lessons from the United States. Women Health Iss. 2014;24-1:e21-e27.
  8. Dunson D B, Colombo B, & Baird D D. Changes with age in the level and duration of fertility in the menstrual cycle. Human Reproduction. 2002;17(5):1399- 1403
  9. Healthy Pregnancy webpage, Health Canada. http://www.hc-sc.gc.ca/hl-vs/preg-gros/index-eng.php. Accessed March 2015.
  10. Farhari N & Zolotor A. Recommendations for preconception counseling and care. Am Fam Physician. 2013. Oct 15; 88(8): 499-506
  11. Sharma R et al. Lifestyle factors and reproductive health: taking control of your fertility. Reprod Biol Endocrin. 2013;11:66.
  12. Shah K et al. The genetic basis of infertility. Reproduction. 2003;126:13-25.
  13. Shapira S K & Dolan S. Genetic Risks to the Mother and the Infant: Assessment, Counseling, and Management. Matern Child Health J. 2006;10:S143–S146.14.  Setji T L & Brown A J. Polycystic ovary syndrome: update on diagnosis and treatment. AMJ 2014.

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Preg.IBD@sinaihealth.ca