JLE

Médecine de la Reproduction

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Fertility and inflammatory bowel disease Volume 19, issue 2, Avril-Mai-Juin 2017

Author
Département de pathologies digestives,
service de gastro-entérologie,
Institut mutualiste Montsouris
42 boulevard Jourdan
75014 Paris
* Tirés à part

Patients with inflammatory bowel disease (IBD) are often young and of reproductive age. The rate of infertility is the same as the general population for patient with inactive disease and without surgery history. Impaired sexual function should be detected by the gastroenterologist and child desire should be discussed early after IBD diagnosis. Conception should be planned after 3 to 6 months of remission. Medications used in IBD do not affect fertility except for salazopyrine and methotrexate which have to be stopped 3 to 6 months before conception. Surgery, especially the Ileal Pouch-Anal Anastomosis (IPAA), has a negative impact on fertility. Laparoscopic IPAA improves fertility and should be widely performed. Before IPAA, multidisciplinary discussion is necessary. The use of In Vitro Fertilization in IBD women is possible with similar success than in general population