Inflammatory bowel disease may seem like a big obstacle for young couples hoping to start a family, but there may be little cause for concern.
A recent study found that there was no biological evidence of reduced fertility in patients with inflammatory bowel disease (IBD) — a condition in which all or part of the digestive tract becomes inflamed.
In other words, lower numbers of children among IBD patients were due to the patients voluntarily choosing to not have children, and not because they were physically unable to have children.
The study authors noted that it is important to inform IBD patients that having IBD does not appear to affect their ability to have children.
This study was led by C. Gower-Rousseau, PhD, of the Epidemiology Unit at the University Lille Nord de France. The research team reviewed studies that examined the relationship between IBD — specifically Crohn's disease and ulcerative colitis — and fertility among men and women.
In people with inflammatory bowel disease, the immune system mistakenly attacks the tissues of the digestive tract.
Crohn's disease and ulcerative colitis are both inflammatory bowel diseases that affect different parts of the digestive tract. Crohn's disease typically causes inflammation in the lower part of the small intestine (ileum) while ulcerative colitis affects the lining of the large intestine.
IBD can cause a number of different symptoms including abdominal pain and cramping, diarrhea, fever, loss of appetite, fatigue and rectal bleeding. The study authors noted that IBD typically affects younger patients during the reproductive years, so fertility (the ability to have children) can be of major concern for them.
For this study, the researchers reviewed three research databases, along with abstracts from international conferences, to find studies that looked at the relationship between fertility and IBD (both Crohn's disease and ulcerative colitis).
The researchers also looked at rates of voluntary childlessness for IBD patients. Voluntary childlessness occurs when patients are physically capable of having children but choose not to.
A total of 11 studies were included in this analysis, with eight studies looking at fertility of female IBD patients and three studies looking at fertility of male IBD patients.
The researchers found that for female patients with Crohn's disease, there was a reduction rate of fertility ranging from 17 to 44 percent when compared to females without Crohn's disease. In 66 percent of the studies, an increase in voluntary childlessness was seen among female IBD patients.
For male patients with Crohn's disease, there was a reduction rate of fertility ranging from 18 to 50 percent when compared to men without Crohn's disease. There was no reduction in fertility among male patients with ulcerative colitis compared to men without ulcerative colitis.
Studies did not look at voluntary childlessness for males, but the one study that looked at biological capability of having children found that there was no difference in capability between male IBD patients and men without IBD.
As the study authors noted, these findings suggest that female patients diagnosed with IBD were less fertile because they voluntarily chose not to have children, and not because they were biologically unable to.
While there were no studies looking at voluntary childlessness in men, the study authors suggested that a similar pattern occurred among men as well.
The authors concluded that it is important to inform IBD patients of their ability to have children.
This article was published on September 4 in Alimentary Pharmacology and Therapeutics.
The study authors reported no competing interests.