Fertility and IBD

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One frequently asked question by young patients suffering from IBD concerns its possible impact on fertility [5, 6]. Generally, the infertility rate is similar to that in the healthy population, which is more or less 8-10%. However, epidemiologic studies show that these patients deliver fewer children than the general population. This fact might be ascribable to reduced fertility due to physical damage caused by the disease and by a decision not to have children because of difficulty developing interpersonal relationships due to poor self-image of their body and their sexuality and fears regarding pregnancy.

Prospective studies revealed that in patients suffering from UC, fertility is not affected except in cases in which the patient has undergone surgery [7]. This topic will be discussed later in the chapter. For women suffering from CD, fertility is reduced exclusively during the stages of the disease activity, probably due to inflammation and accretions involving tubes and ovaries. Control of disease recrudescences usually restores reproductive ability.

As for male patients, there is no certain evidence [8] that CD may cause infertility even if malnutrition and stages of disease activity are negative influences. As for the influence of the drugs prescribed for patients with IBD, there is considerable proof of the negative but temporary impact caused by the phar-macologic therapy [9], by sulfasalazine, in particular, which causes dose-related anomalies of seminal fluid and fertility in about 60% of men. The effect may be potentially reversible 2 months following interruption of therapy [10]. When sulfasalazine is replaced with another drug belonging to the 5-aminosalicy-lates group, fertility improves.

In both men and women, psychological attitude towards the disease is important as, even more so than the physical condition, it affects the sex life and, consequently, the ability to conceive.

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100 Pregnancy Tips

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