Many factors influence the sexual health of people with Crohn’s disease, but active disease and depression play key roles. The fertility rate in nonoperated patients with inflammatory bowel disease with quiescent disease is similar to that in the general population. Crohn’s disease can increase the risk for adverse pregnancy outcomes, but being in remission on a stable, steroid-free medication regimen for at least 3 months before conception and adhering to the treatment throughout pregnancy can improve outcomes. Infants with intrauterine exposure to anti–tumor necrosis factor medications should avoid live vaccines for the first 9 months or until drug concentrations are undetectable.
Key points
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Fertility in men with inflammatory bowel disease (IBD) can be decreased by certain medications and by having active disease. In women with IBD, fertility is decreased in the setting of active disease and following surgery within the pelvis.
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Many factors influence sexuality in patients with Crohn’s disease, including symptoms of active disease, extraintestinal manifestations of disease, medication side effects, and evidence of prior surgery.
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Having Crohn’s disease has been associated with a higher risk for preterm delivery, small for gestational age infants, low birth weight babies, and stillbirth, but no increased risk for congenital anomalies. Being in a state of disease remission before conception is associated with the best pregnancy and neonatal outcomes.
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Other than methotrexate, most medications used to treat Crohn’s disease are safe to continue throughout pregnancy.
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Infants with gestational exposure to anti–tumor necrosis factor medications should avoid live vaccines for the first 9 months of life or until the serum drug concentrations are undetectable.
Related posts:
Crohn’s Disease
Intestinal and Nonintestinal Cancer Risks for Patients with Crohn’s Disease
Targeting Specific Immunologic Pathways in Crohn’s Disease
Use of Anti–Tumor Necrosis Factors and Anti-Integrins in the Treatment of Crohn’s Disease
Interdisciplinary Management of Perianal Crohn’s Disease
Management of Crohn’s Disease After Surgical Resection
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