Also see entry for Celiac Disease and Crohn's Disease, and Ulcerative Colitis
What They Are
Crohn’s, ulcerative colitis, and celiac disease are all serious gastrointestinal (GI) disorders. What all three have in common is a tendency to greatly reduce the amount of nutrients that the body absorbs; doctors suspect that the extreme weight loss and malnutrition that can result is what eventually causes problems with getting pregnant.
How They Affect Fertility (And Pregnancy)
Celiac sufferers are unable to absorb food. This malabsorption of nutrients and vitamins causes suppression of the hormones that stimulate the ovaries to ovulate. If you are diagnosed with celiac and adhere to a gluten-free diet, you’ll reverse everything, including your inability to get pregnant. Once celiac disease is treated, patients are usually able to get pregnant on their own.
In Crohn’s disease, the inflammation of the bowel may affect other organs in the pelvic area, too, such as the right fallopian tube or ureter. If the fallopian tube is involved, infertility could be the result. Surgery to treat Crohn’s disease can also lead to fertility problems by causing misaligned ovaries due to scar tissue that buids up after the surgery; the misalignment makes it harder for the egg to reach the fallopian tubes. In that case, in vitro fertilization (IVF) might be recommended to achieve pregnancy.
With ulcerative colitis it’s the treatment more than the condition itself that may cause fertility problems. Many different drugs are used to treat the condition, and the risks for women who hope to get pregnant now—or in the future—vary. Some, such as thalidomide/methotrexate, are absolutely contraindicated during pregnancy, while others are viewed on an individual risk/benefit basis. It’s important to discuss plans to conceive with your physician.
Severe cases may require surgery, which carries a higher risk for infertility. Researchers estimate that women who undergo a procedure called ileal pouch anal anastomosis (in which the lower large intestine is removed and replaced with a small, artificial pouch built from the small intestine) may have as much as a 50 percent chance of infertility afterwards, versus a 15 percent risk of fertility problems after drug treatment alone.
The bottom line is that if you do have a digestive disorder, you can get pregnant, even if your disease is severe. Celiac disease can be completely controlled with diet, and then should not affect pregnancy plans. Crohn’s disease and ulcerative colitis—together called inflammatory bowel disease—need to be treated by a physician. The goal is to get you as well as possible before you begin trying to conceive. Talk to your gastroenterologist and ob/gyn about the best time to try to get pregnant, especially since this means you’ll likely have to go off your medications or change them.
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