Ulcerative Colitis Procedure Tied to Decreased Fertility

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Ulcerative Colitis Procedure Tied to Decreased Fertility in Women

NEW YORK (Reuters Health) Dec 28 - Women with ulcerative colitis (UC)

who undergo proctocolectomy with ileal pouch-anal anastomosis are at

risk for less fertility after the procedure than before, according to

a report published in the January issue of Gastroenterology.

Dr. Kasper Olsen, from Aarhus University Hospital in Denmark, and

colleagues compared the reproductive ability of 290 female UC

patients before and after colectomy with that of 661 similar-aged

women drawn from the general population.

Prior to diagnosis and prior to surgery, UC patients were as fertile

as women in the general population. After the procedure, however, UC

patients were significantly less able to conceive than women in the

general population.

" It was previously thought that women who have undergone colectomy

might be less able to conceive after surgery, but there was no

evidence, " Dr. Olsen said in a statement.

The decision to perform surgery may be a reflection of greater

disease severity, the authors note. Thus, disease severity, and not

the procedure per se, may actually be responsible for the decreased

fertility. However, other severe disease states, such as perforated

appendicitis, do not influence fertility so it is more likely due to

the procedure itself.

Female patients of reproductive age should be made aware of the

fertility risks associated with the procedure. In addition, women who

cannot conceive following surgery should be " referred early to a

gynecologist to allow for investigations and the possibility of in

vitro fertilization, " the researchers emphasize.

Gastroenterology 2002;122:000-000.