UC and Fertility
As the peak incidence of IBD is among young men and women between the ages of 20 and 40, questions regarding family planning often arise. One of the greatest concerns often voiced by patients is whether having UC will affect their reproductive capability. Several studies have looked at this topic and have determined that the diagnosis of UC unto itself does not alter fertility for men or women. There are, however, disease related issues that may affect reproduction:
1) Active disease - The presence of active disease has been shown to diminish fertility among women with Crohn's disease, likely due to inflammation and scarring of the ovaries and fallopian tubes from adjacent bowel. While studies have not borne out the same results in UC, it seems reasonable to recommend family planning during a period of quiescent disease.
2) Medications - Among the wide array of medications used to treat UC, none have been shown to affect female fertility. For men with UC, however, there is well documented evidence of diminished sperm counts and motility while taking sulfasalazine. This effect is reversible; sperm counts and motility usually return to normal within 3 months of stopping the medication. As such, it recommended that men attempting to conceive stop sulfasalazine or replace it with a 5-ASA medication.
3) Surgery - Women who undergo colectomy with an ileal-pouch anal anastomosis for UC prior to reproduction, may experience difficulty becoming pregnant. It is believed that manipulation in the pelvis required for creation of a pouch can disrupt the ovaries and fallopian tubes, making conception more challenging.