Female fertility & childbirth after ileal pouch-anal anastomosis for UC

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Female

fertility and childbirth after ileal pouch-anal anastomosis for ulcerative colitis

Authors:

Lepistö, A.; Sarna, S.; Tiitinen,

A.; Järvinen, H. J.

Source: British Journal of Surgery,

Volume 94, Number 4, April 2007 Publisher:

Wiley & Sons, Ltd.

The aim

of this study was to calculate the probability of becoming pregnant after ileal pouch-anal anastomosis

(IPAA) for ulcerative colitis, and to evaluate complications during pregnancy

and childbirth.

Methods:

A

questionnaire was posted to 160 women with an IPAA and to 160 controls. The probability of becoming pregnant after IPAA was

calculated by the Kaplan-Meier method.

Results:

Of 54

women who had undergone IPAA surgery, 36 (67 per cent) succeeded in becoming

pregnant naturally, compared with 49 (82 per cent) of 60 controls. The probability of pregnancy after 2 years of trying was

56 per cent in the IPAA group and 91 per cent in the control group (P < 0·001). Women

in the IPAA group needed infertility investigations more often (24 versus 10 per cent; P = 0·044). In

all, 39 (72 per cent) women in the IPAA group and 53 (88 per cent) in the

control group bore a child. Twenty-one of 39 women in

the IPAA group and 13 of 53 in the control group had a caesarean section (P = 0·005). Anal

incontinence after delivery occurred more often in the control group.

Conclusion:

Women

with an IPAA mostly suffer a reduction in the probability of conception rather

than complete infertility. Because complications

during pregnancy and delivery were rare, caesarean section should be based

mainly on obstetric indications. Copyright © 2007 British

Journal of Surgery Society Ltd. Published by Wiley & Sons, Ltd.

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