Fertility and contraception in women with inflammatory bowel disease

Jason Martin, Sunanda V. Kane, Linda A. Feagins

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Inflammatory bowel disease (IBD) carries a high burden in women during their reproductive years, and family planning issues are often a significant cause of concern. Fertility is normal in women with nonsurgically treated ulcerative colitis and similar or slightly reduced in women with Crohn's disease. Women who undergo ileal pouch anastomosis have reduced fertility. Fertility is likely worsened by disease activity but unaffected by medications used to treat IBD. Infertile patients with IBD respond as well as non-IBD patients to in vitro fertilization (IVF). Despite normal fertility, patients with IBD have fewer children due to concerns regarding infertility, disease inheritance, congenital abnormalities, and disease-related sexual dysfunction. Patients rarely discuss these issues with a physician. When discussion does occur, it may lead to changes in decision-making. Contraceptives are an important part of family planning, particularly during times of high disease activity. All forms of contraceptives are acceptable in patients with IBD, although there are specific considerations. The risks of combined oral contraceptives outweigh the benefits in patients with active disease and patients with prior or high risk for thromboembolism. Oral contraceptives and IBD are independently associated with an increased risk for thromboembolism, although it is not known whether this effect is compounding. Depot medroxyprogesterone acetate injection should be avoided in patients with or at risk for osteopenia. Intrauterine devices and implants are the most effective form of contraception and should be a first-line recommendation. The use of oral contraceptives is associated with the development of IBD, although there is no increased risk of disease relapse with the use of any form of contraceptive.

Original languageEnglish (US)
Pages (from-to)101-109
Number of pages9
JournalGastroenterology and Hepatology
Volume12
Issue number2
StatePublished - Feb 1 2016

Fingerprint

Contraception
Inflammatory Bowel Diseases
Fertility
Contraceptive Agents
Thromboembolism
Family Planning Services
Oral Contraceptives
Contraceptives, Oral, Combined
Colonic Pouches
Medroxyprogesterone Acetate
Intrauterine Devices
Metabolic Bone Diseases
Fertilization in Vitro
Ulcerative Colitis
Crohn Disease
Infertility
Decision Making
Physicians
Recurrence
Injections

Keywords

  • Contraception
  • Contraceptive
  • Crohn's disease
  • Fertility
  • Inflammatory bowel disease
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Martin, J., Kane, S. V., & Feagins, L. A. (2016). Fertility and contraception in women with inflammatory bowel disease. Gastroenterology and Hepatology, 12(2), 101-109.

Fertility and contraception in women with inflammatory bowel disease. / Martin, Jason; Kane, Sunanda V.; Feagins, Linda A.

In: Gastroenterology and Hepatology, Vol. 12, No. 2, 01.02.2016, p. 101-109.

Research output: Contribution to journalArticle

Martin, J, Kane, SV & Feagins, LA 2016, 'Fertility and contraception in women with inflammatory bowel disease', Gastroenterology and Hepatology, vol. 12, no. 2, pp. 101-109.
Martin, Jason ; Kane, Sunanda V. ; Feagins, Linda A. / Fertility and contraception in women with inflammatory bowel disease. In: Gastroenterology and Hepatology. 2016 ; Vol. 12, No. 2. pp. 101-109.
@article{0b7e2b16c6a64078baea564c96fcc73f,
title = "Fertility and contraception in women with inflammatory bowel disease",
abstract = "Inflammatory bowel disease (IBD) carries a high burden in women during their reproductive years, and family planning issues are often a significant cause of concern. Fertility is normal in women with nonsurgically treated ulcerative colitis and similar or slightly reduced in women with Crohn's disease. Women who undergo ileal pouch anastomosis have reduced fertility. Fertility is likely worsened by disease activity but unaffected by medications used to treat IBD. Infertile patients with IBD respond as well as non-IBD patients to in vitro fertilization (IVF). Despite normal fertility, patients with IBD have fewer children due to concerns regarding infertility, disease inheritance, congenital abnormalities, and disease-related sexual dysfunction. Patients rarely discuss these issues with a physician. When discussion does occur, it may lead to changes in decision-making. Contraceptives are an important part of family planning, particularly during times of high disease activity. All forms of contraceptives are acceptable in patients with IBD, although there are specific considerations. The risks of combined oral contraceptives outweigh the benefits in patients with active disease and patients with prior or high risk for thromboembolism. Oral contraceptives and IBD are independently associated with an increased risk for thromboembolism, although it is not known whether this effect is compounding. Depot medroxyprogesterone acetate injection should be avoided in patients with or at risk for osteopenia. Intrauterine devices and implants are the most effective form of contraception and should be a first-line recommendation. The use of oral contraceptives is associated with the development of IBD, although there is no increased risk of disease relapse with the use of any form of contraceptive.",
keywords = "Contraception, Contraceptive, Crohn's disease, Fertility, Inflammatory bowel disease, Ulcerative colitis",
author = "Jason Martin and Kane, {Sunanda V.} and Feagins, {Linda A.}",
year = "2016",
month = "2",
day = "1",
language = "English (US)",
volume = "12",
pages = "101--109",
journal = "Gastroenterology and Hepatology",
issn = "1554-7914",
publisher = "Gastro-Hep Communications, Inc.",
number = "2",

}

TY - JOUR

T1 - Fertility and contraception in women with inflammatory bowel disease

AU - Martin, Jason

AU - Kane, Sunanda V.

AU - Feagins, Linda A.

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Inflammatory bowel disease (IBD) carries a high burden in women during their reproductive years, and family planning issues are often a significant cause of concern. Fertility is normal in women with nonsurgically treated ulcerative colitis and similar or slightly reduced in women with Crohn's disease. Women who undergo ileal pouch anastomosis have reduced fertility. Fertility is likely worsened by disease activity but unaffected by medications used to treat IBD. Infertile patients with IBD respond as well as non-IBD patients to in vitro fertilization (IVF). Despite normal fertility, patients with IBD have fewer children due to concerns regarding infertility, disease inheritance, congenital abnormalities, and disease-related sexual dysfunction. Patients rarely discuss these issues with a physician. When discussion does occur, it may lead to changes in decision-making. Contraceptives are an important part of family planning, particularly during times of high disease activity. All forms of contraceptives are acceptable in patients with IBD, although there are specific considerations. The risks of combined oral contraceptives outweigh the benefits in patients with active disease and patients with prior or high risk for thromboembolism. Oral contraceptives and IBD are independently associated with an increased risk for thromboembolism, although it is not known whether this effect is compounding. Depot medroxyprogesterone acetate injection should be avoided in patients with or at risk for osteopenia. Intrauterine devices and implants are the most effective form of contraception and should be a first-line recommendation. The use of oral contraceptives is associated with the development of IBD, although there is no increased risk of disease relapse with the use of any form of contraceptive.

AB - Inflammatory bowel disease (IBD) carries a high burden in women during their reproductive years, and family planning issues are often a significant cause of concern. Fertility is normal in women with nonsurgically treated ulcerative colitis and similar or slightly reduced in women with Crohn's disease. Women who undergo ileal pouch anastomosis have reduced fertility. Fertility is likely worsened by disease activity but unaffected by medications used to treat IBD. Infertile patients with IBD respond as well as non-IBD patients to in vitro fertilization (IVF). Despite normal fertility, patients with IBD have fewer children due to concerns regarding infertility, disease inheritance, congenital abnormalities, and disease-related sexual dysfunction. Patients rarely discuss these issues with a physician. When discussion does occur, it may lead to changes in decision-making. Contraceptives are an important part of family planning, particularly during times of high disease activity. All forms of contraceptives are acceptable in patients with IBD, although there are specific considerations. The risks of combined oral contraceptives outweigh the benefits in patients with active disease and patients with prior or high risk for thromboembolism. Oral contraceptives and IBD are independently associated with an increased risk for thromboembolism, although it is not known whether this effect is compounding. Depot medroxyprogesterone acetate injection should be avoided in patients with or at risk for osteopenia. Intrauterine devices and implants are the most effective form of contraception and should be a first-line recommendation. The use of oral contraceptives is associated with the development of IBD, although there is no increased risk of disease relapse with the use of any form of contraceptive.

KW - Contraception

KW - Contraceptive

KW - Crohn's disease

KW - Fertility

KW - Inflammatory bowel disease

KW - Ulcerative colitis

UR - http://www.scopus.com/inward/record.url?scp=84958957680&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84958957680&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:84958957680

VL - 12

SP - 101

EP - 109

JO - Gastroenterology and Hepatology

JF - Gastroenterology and Hepatology

SN - 1554-7914

IS - 2

ER -