The majority of patients with inflammatory bowel disease (IBD) are affected during their peak reproductive years. While initial concerns focus on attaining a durable remission and avoiding the side effects of medications, once in remission the focus often shifts to the effect of disease and the medications used to treat it on fertility and the ability to conceive a healthy child. This paper summarises the existing literature on the effects of ulcerative colitis (UC) and Crohn’s disease (CD) and the medications used to treat it on fertility and pregnancy outcomes.
In general, women with IBD are as likely to flare during pregnancy as they are when not pregnant. Nielsen et al reported an exacerbation rate of 34% per year during pregnancy and 32% per year when not pregnant in women with UC.33 Pregnant women with CD also had similar rates of disease exacerbation