Proctocolectomy and ileal pouch anal anastomosis (IPAA) significantly impairs fertility andpregnancy outcomes in ulcerative colitis (UC) patients: F17


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Abstract

Aim:The study aimed to evaluate the effects of IPAA on fertility andpregnancy in UC-IPAA patients.Method:Female UC patients undergoing IPAA before the age of 44 years who were either married, cohabiting or attempting to becomepregnant filled out a questionnaire regarding fertility andpregnancy. Demographic and pouch status data were collected from aprospective database.Results:Twenty-one patients (46.3 ± 11 years, 47% Ashkenazi, 12% smokers) before IPAA had 29pregnancies, 23 deliveries (1.9 ± 1.1 offspring/patient) and after there were 13pregnancies, 10 deliveries (0.6 ± 1.1. offspring/patient), P = 0.003. More spontaneouspregnancies occurred before (24.8%) compared with after (6.5%) IPAA, P = 0.046. The time to conception was longer after IPAA (8.6 ± 16.5 vs 32.2 ± 54.2 months) and more in vitro fertilization (2 vs 6) was used (P = NS). The number of spontaneous abortions decreased by half (6 vs 3, P = NS). Pregnancy duration significantly decreased (40.0 ± 1.5 vs 38.1 ± 1.8 weeks, P = 0.01) and delivery by Cesarean section increased (22-40%, P = 0.5). Offspring weight significantly decreased after IPAA: 3.5 ± 0.5 vs 2.8 ± 0.7 kg (P = 0.008) and breastfeeding increased (50% vs 70%, P = 0.05).Conclusions:IPAA is associated with an increased risk of infertility, decreased length ofpregnancy and decreased offspring weight. Females considering IPAA should be counseled accordingly. Alternative surgical/medical approaches should be investigated.

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