Fertility and pregnancy with inflammatory bowel disease (IBD)

Starting a family with IBD

Many people with inflammatory bowel diseases (IBD) such as Crohn's disesae and ulcerative colitis - including those who are living with a stoma or have had other surgery - go on to successfully have a family. But, you may find that your IBD - or the treatments you are having for it - present you with some challenges along the way.

It’s a good idea to learn about how IBD might affect your family plans - for both men and women with IBD in advance of getting pregnant.

Fertility and IBD

Before attempting to conceive it is advised for women to try to get their IBD under control and, ideally, in remission. If your IBD is active you may find it more difficult to get pregnant (more so in Crohn's disease¹ than ulcerative colitis). Many doctors advise not to try to conceive during a flare as, if you fall pregnant, your IBD is likely to remain active throughout your pregnancy and this can cause problems such as premature birth, lower birth weight and, occasionally, miscarriage.

There are a few circumstances which may affect the fertility of both men and women with IBD. These include:

• Active inflammation in women with IBD (as mentioned above)
• Medications which can decrease fertility
• Some types of surgery in both men and women

In general, these issues can be overcome with medical support. 

It’s important to remember that if you are having fertility issues these may be due to reasons outside of your IBD. If you have any concerns speak to your doctor.

Pregnancy and IBD

For most women with IBD the course of their pregnancy and birth is no different to the rest of the non-IBD population. Women who conceive when their IBD is under control and can keep their IBD under control during their pregnancy generally have a pregnancy similar to women who don’t have IBD. Many medications used by people with IBD are safe to use during pregnancy, but discuss with your doctor before getting pregnant.

However, some women experience some difficulties and complications as a result of their IBD. These can include:

• More flares of their IBD
• Delivering the baby preterm (early)¹
• Lower birth weight¹
• Stomas changing size and/or shape as your belly expands
• Stoma blockages as your belly expands
• Increase in stoma output during 3rd trimester
• A small risk of miscarriage¹

Again, it’s important to remember there are reasons outside of your IBD why you may have complications during pregnancy. If you are concerned speak to your doctor.

Pregnancy and IBD - Dr Mel Gunn

Can I deliver my baby naturally?

Yes, most people with IBD can go on to have a vaginal delivery. In some cases a cesarean may be recommended. This will be discussed with you during your pregnancy.

Will my baby be healthy?

The majority of women with IBD who give birth go on to have healthy babies. Research suggests there is a slight risk that parents with IBD will have a child with IBD, but it is not inevitable.

Some medications - taken by either the mother or father (at conception) - can cause birth defects. Before getting pregnant you should discuss with your doctor about the medication you or the father are taking and the possible effects they may have on your baby.

It’s important to remember that there are many reasons outside of IBD which may affect the health of a newborn baby.