Chronic inflammatory bowel diseases and the desire to have children - are they compatible?

IBD patients may hesitate to have children over pregnancy and childbirth concerns, but good planning can lessen hurdles.

Key takeaways:

Reluctance to fulfil the desire to have children

People who suffer from chronic intestinal diseases often decide against having children. This may be due to fear of passing on the disease, uncertainty about the therapy, and also the chances of success for a healthy pregnancy. However, if the treating gastroenterologists are involved in family planning at an early stage, IBD is no longer a major hurdle on the way to the desired family.

The right time is important

Especially for patients with relapsing forms of the disease, the question of when is even more crucial than for other couples. Ideally, women should become pregnant during phases of remission. According to experts, the probability of successful fertilisation is then just as high as in healthy people. However, fertility in people with IBD can be affected by sexual dysfunction or, in women, pelvic surgery.

Continuing with medication intake

Continuing treatment for IBD is especially important during pregnancy. A new episode can harm the foetus. Therefore, all medications should be continued, with the exception of methotrexate, ozanimod and the JAK inhibitors. It is also advisable to talk to the treating gastroenterologist so that treatment decisions can be made early. In this way, a disease flare-up can be recognised and treated promptly. 

Pouch and stoma are no obstacles either

Women who have a stoma or a pouch can also successfully carry a child to term and give birth. Even vaginal deliveries are often possible, depending on the individual cases. 

Conclusion for medical practice

Nowadays, fulfilling the desire to have a child is also possible for people with IBD. However, as the disease can complicate the individual situation, it makes sense to involve the treating specialists and to monitor the disease activity closely. Continuation of drug therapy is possible and also sensible, with the exception of certain drugs. Successful pregnancies are also possible with a pouch or stoma. Affected patients should be informed about their options.

Source
  1. Press release by the German Society for Gastroenterology, Digestive and Metabolic Diseases (Acronym: DGVS). November 2022. In German only: Kinderwunsch und chronisch-entz√ľndliche Darmerkrankungen