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Pregnancy

Many young women are affected by IBD and will often have questions about having children. Being fertile, passing on IBD to offspring, the effect of pregnancy on IBD, the effect of IBD on the pregnancy and the safety of IBD drugs during pregnancy and breast feeding are all common concerns. Having children is generally not a problem for women with IBD. Your doctor will encourage and support you throughout pregnancy.

Passing on IBD

IBD is caused by a mixture of genes (one inherits from the parents) and some changes in the environment (not discovered so far). IBD can run in families but generally only affects a small number of children to a parent with IBD. The risk of offspring developing IBD if one parent suffers from it is 5-10% only.

Fertility in men

Men with IBD normally do not have any problem with infertility. Sulphasalazine can temporarily reduce the sperm activity, but this returns to normal after stopping the drug.

Fertility in women

Most women with IBD do not have fertility problems. It is easier to fall pregnant if your IBD is well controlled at the time. A small proportion of women with Crohn’s disease might find it a bit more difficult to get pregnant. Pouch surgery for ulcerative colitis can make it more difficult for women to get pregnant. If you experience any difficulties getting pregnant contact your doctor for specialist advice.

Safety of drugs

Active IBD (lots of inflammation and symptoms) is a risk towards your pregnancy as it can increase the risk of miscarriage and is associated with pre-term delivery. It is important to keep IBD well controlled. For most medications the benefit of staying well far outweighs the risks of the drug on the unborn child. Your specialist can advise you what to do in your situation. Generally it is a good idea to plan becoming pregnant with your specialist before hand.

Sulphasalazine, Mesalazine (Salofalk, Mezavant, Pentasa, Colazide)

These drugs are all safe during pregnancy and breast feeding. Nearly all women with IBD should continue taking them.

Azathioprine (Imuran), 6-Mercaptopurine (Purinethol)

Several studies have confirmed that in women with IBD the benefit of the drugs outweigh the small risk during pregnancy and breast feeding by far.

Methotrexate

This drug causes severe abnormalities in babies and can not be taken prior or during pregnancy. Women on Methotrexate are advised to stop the drug for 3-6 months before falling pregnant. Men on Methotrexate should also stop the drug for 3-6 months before fathering a child.

Infliximab (Remicade), Adalimumab (Humira)

These drugs are considered probably safe in pregnancy. As they are only used in women with severe disease they should be continued to avoid the disease getting worse and thereby putting a risk to the pregnancy. Most doctors decide to continue these drugs for the first 2 trimesters and stop them during the third trimester.

General advice

Active disease represents the biggest risk for offspring. Couples desiring pregnancy should be adequately evaluated and counselled before pregnancy. Generally, women should be advised preferably to conceive when their bowel disease is inactive. It is better to plan a pregnancy than to contact your doctor just after you became pregnant. Your doctor should refer you to a gynaecologist early during pregnancy.




MORE LINKS

If you are interested in other gastrointestinal-focused information and intervention websites developed and hosted at
Swinburne University of Technology,
please go to:

IBSclinic.org.au for individuals with Irritable Bowel Syndrome

Gastroparesisclinic.org for individuals with Gastroparesis

DISCLAIMER

This website and its content is not intended or recommended as a substitute for medical advice, diagnosis or treatment. Always seek advice of your own physician or other qualified health care professional regarding any medical questions or conditions.

© 2014 Swinburne University of Technology | CRICOS number 00111D