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Fertility & pregnancy with inflammatory bowel disease
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Fertility & pregnancy with inflammatory bowel disease

Fertility & pregnancy with inflammatory bowel disease

Inflammatory bowel disease (IBD) can affect reproductive health in some people, for a range of distinct reasons.1,2

Can inflammatory bowel disease affect my fertility?

Around two thirds of patients with IBD in a recent UK survey believed that their condition would make it harder to have children.3*

– IBDrelief IBD Quality of Life Survey

If you haven’t had surgery for Crohn’s disease or ulcerative colitis, you are likely to be as fertile as someone who does not.4

However, some people with inflammatory bowel disease choose not to have children because of worries about:1,2

  • the impact of inflammatory bowel disease on their fertility
  • passing on their condition to their children
  • their condition getting worse in pregnancy
  • getting too unwell to care for a child
  • the effects of their medication on their fertility.

Generally, IBD patients are likely to be able to become pregnant. However, some factors can impact your fertility. For instance, in Crohn’s disease (CD), having a flare-up does slightly reduce your fertility.4

Additionally, some types of surgery can affect fertility in women due to increased risk of adhesions (bands of scar-like tissue that cause internal organs to stick together).5 Rarely, in men, pelvic surgery can cause problems with ejaculation and reduce fertility in this way.5

What if I want to have children?

If you are thinking about starting a family, tell your healthcare team so you can discuss your condition, treatments, and any questions or concerns.

Pregnancy is best planned for a period when disease is under control or in remission, for the best chance of conception and a healthy baby and also to ensure you are as healthy as possible and feeling well for this important time in your life.2,4,5

If you become pregnant while in remission with Crohn’s, you have the same risk of relapse as someone who is not in remission; pregnancy doesn’t increase this chance.4

Will specific treatments affect my fertility or chance of conception?

It is important to get specific advice about your situation from your IBD team before starting or stopping any medicines or treatments. However, some general information is provided below.

For more information about using these and other medicines prior to or during pregnancy you can visit the Crohn's and Colitis UK (CCUK) information on specific treatments – find it here.

Will my pregnancy be affected by IBD?

It is normal to worry about how your IBD will affect your pregnancy.

Our short video provides you with some advice on planning for a family, managing pregnancy and caring for children, while living with IBD or supporting someone with IBD.

Most people who have IBD have normal pregnancies and healthy babies.2

Your IBD team will work together with your antenatal team to look after you in pregnancy – you can ask your consultant or nurse to give your antenatal team details about your disease and care. They can help you decide on what type of birth is right for you, and give you advice about nutrition, effects on your stoma if you have one, and any change to your medication which may be necessary.4

You can learn more about stomas and how they can affect you here.

Will my children have IBD?

The causes of IBD are numerous and dependent on complex interactions between both genetic and environmental factors.7 IBD is thought to have a strong genetic component, since family history of IBD is the greatest risk factor for disease at all ages.8 Overall however, the heritability of IBD is still unknown and having a relative with IBD is an important risk factor for developing the condition.9

How likely parents with IBD are to have a child who develops the condition seems to vary and is also higher in some groups of people than others. Estimates tend to vary but studies have shown that if one parent has ulcerative colitis, the risk of the child developing Crohn's disease or ulcerative colitis is approximately 2%. If both parents have Crohn's disease or ulcerative colitis the risk rises to above 30%.4,10

Despite genetic predisposition, other additional factors are needed to trigger the development of IBD.10 Genetics are just one risk factor, and most women can expect to have a normal pregnancy and a healthy baby.10

Read more about managing your symptoms and how you can manage your condition with regards to Sex & relationships

Visit the Crohn’s & Colitis UK pages on Reproductive health and Pregnancy and breastfeeding

Explore more in Living well

Abbreviations

CD = Crohn’s disease; IBD = inflammatory bowel disease.
*IBDrelief patient survey data from 167 respondents with IBD in the UK. Of respondents aged 18-34, 67% felt their condition would make it harder to have children.3

  1. Tavernier N, et al. Systematic review: fertility in non‐surgically treated inflammatory bowel disease. Aliment Pharmacol Ther. 2013;38(8):847–53. 
  2. CCUK. Reproductive health. https://crohnsandcolitis.org.uk/info-support/information-about-crohns-and-colitis/all-information-about-crohns-and-colitis/living-with-crohns-or-colitis/reproductive-health. Accessed October 2023.
  3. IBDrelief. Impact of IBD on physical and emotional health: Findings from an IBDrelief survey. Available at www.ibdrelief.com/impact-of-ibd-on-physical-and-emotional-health. Accessed October 2023.
  4. Ban L, et al. Decreased fertility rates in 9639 women diagnosed with inflammatory bowel disease: a United Kingdom population‐based cohort study. Aliment Pharmacol Ther. 2015;42(7):855–66. 
  5. Magro F, et al. Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders. J Crohns Colitis. 2017;11(6):649–70. 
  6. van der Woude CJ, et al. The second European evidenced-based consensus on reproduction and pregnancy in inflammatory bowel disease. J Crohns Colitis. 2015;9(2):107–24. 
  7. Okou DT and Kugathasan S. Role of genetics in pediatric inflammatory bowel disease. Inflamm Bowel Dis. 2014;20(10):1878–84.
  8. Shaw KA, et al. Genetic variants and pathways implicated in a pediatric inflammatory bowel disease cohort. Genes Immun. 2019;20(2):131–42.
  9. Loddo I and Romano C. Inflammatory Bowel Disease: Genetics, Epigenetics, and Pathogenesis. Front Immunol. 2015;6:551.
  10. CCUK. Pregnancy & breastfeeding. https://crohnsandcolitis.org.uk/info-support/information-about-crohns-and-colitis/all-information-about-crohns-and-colitis/living-with-crohns-or-colitis/pregnancy-and-breastfeeding. Accessed October 2023.