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Does Crohn's Disease Affect Fertility?
More studies are needed to better understand Crohn's effects on fertility and reproductive health. Here's what we know so far.
People with Crohn's disease may be concerned about how their condition might affect their fertility or their ability to conceive children.
Many people who have Crohn's are able to safely conceive. Research to understand how Crohn's affects fertility is still ongoing.
What the research says
Inflammation, nutritional deficiencies, certain medications, and surgery can all impact your fertility and sexual health when you have inflammatory bowel disease (IBD).
Women who have IBD (including Crohn's and ulcerative colitis) have similar fertility rates as women who do not, according to a 2021 review of medical literature. Women with IBD do have a higher risk of complications, such as preterm delivery and cesarean delivery.
Women who have Crohn's may have slightly lower fertility rates than the general population, according to a 2021 Swedish study.
In another 2021 review, women with Crohn's disease were found to have infertility rates of 3% to 14%. This is around the same as the infertility rates of women without Crohn's, which range from 2.4% to 14%.
Many researchers currently believe that men who have well-managed Crohn's disease have the same fertility rates as the general population (or people without IBD). The exception to this might be those taking certain types of Crohn's medication.
The medication sulfasalazine is often used for treating Crohn's disease. It can temporarily reduce sperm count and the viability of the sperm that's produced. It can take several months for sperm to return to healthy levels after sulfasalazine treatment.
A note on gender and sex terminology
Most research surrounding fertility and IBD separates participants into male and female sex categories and uses gender and sex terminology interchangeably. Gender and sex are not the same, and both occur on a spectrum.
In summarizing scientific articles or studies for our readers, we use their language to preserve intent and accuracy. However, Healthline acknowledges that medical research often doesn't represent everyone equally, and we should all strive toward more inclusive practices.
People of all sexes can have IBD, including Crohn's disease, and may also experience fertility and sexual health effects. Finding a doctor you trust and receiving an individualized approach to your care is essential.
Potential causes of fertility issues in IBD
There's no single component of IBD that definitively impacts fertility. Many people with IBD will have little to no effects on fertility or libido.
However, there are a variety of factors that, separately or together, may become issues for someone with IBD trying to conceive children.
Let's look at some common concerns and research findings.
Crohn's and getting pregnant
Women with Crohn's may have difficulty getting pregnant after colon resection surgery. This type of surgery may sometimes impact reproductive organs and leave scar tissue in the area.
There's also concern that pelvic inflammation from unmanaged Crohn's could decrease the chances of conceiving.
Crohn's and being pregnant
There's a chance Crohn's may flare during pregnancy, even if you were in remission when you got pregnant.
This is why it's essential to have active treatment for your IBD during pregnancy and work with your doctor to safely address any symptom flare-ups should they arise.
Crohn's and sperm count
A 2019 review of 14 studies found that quality studies on how all types of IBD affect male fertility are lacking.
From what we do know, it seems most people with Crohn's have no issue with having levels of healthy, viable sperm. Medications for Crohn's, especially sulfasalazine, can cause a temporary reduction in sperm quality and sperm count. Switching to a different medication for several months typically solves this issue.
Crohn's and choosing to be child-free
Some people with Crohn's may view their condition as an obstacle to pregnancy. They may avoid trying to conceive children out of concern for their health.
Medical literature points to widespread misconceptions about Crohn's and fertility as part of the reason many people with Crohn's forego having children.
While there's research suggesting IBD can affect fertility and reproductive health, many people with Crohn's are able to have healthy, safe pregnancies. Managing Crohn's symptoms effectively is key.
It's important to keep in mind that not everyone wants children. Some people may make the personal decision to be child-free due in part to their Crohn's disease, or completely irrespective of it.
Your sexual and reproductive health is no one's business but your own. While everyone deserves access to the information and care surrounding fertility that they need, no one should face judgment for the decisions they make regarding their sexual and reproductive health.
