Crohn’s disease: can it affect your fertility?

by | Nov 14, 2018 | Blog


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If you have Crohn’s disease, then you’ll know all about living with this painful inflammatory disease of the intestines. But does having Crohn’s disease mean that it will be harder for you to fall pregnant? In today’s blog, I talk about what Crohn’s disease is and let you know the answer….

What is Crohn’s disease?

If you’ve only recently been diagnosed with Crohn’s disease, you might still be trying to get your head around what it is, so let me give you a quick summary. Crohn’s disease is an inflammatory disease that can occur right along the length of the digestive tract. Unfortunately, symptoms are unpleasant and include intestinal ulcers, abdominal discomfort, pain, reduced appetite and weight loss. It can also impact your body’s ability to absorb some nutrients.  Crohn’s disease and another similar condition called ulcerative colitis belong to a group of diseases known as inflammatory bowel disease.

Crohn’s and fertility

If you have Crohn’s disease, or are being investigated by your doctor for it, could it affect your fertility? Well, I’ll start with the good news first and say that your chances of falling pregnant are very similar to women who don’t have it if your Crohn’s is well treated and in remission. But there can be a few additional challenges…..

Firstly, if you are in the midst of an acute flare up episode of Crohn’s, you might have more trouble conceiving during that period of time. Also, if you have had abdominal or pelvic surgery like a partial or total colectomy, then this CAN affect fertility rates, most likely due to internal scarring around the fallopian tubes.  There are instances where the medications used to treat Crohn’s disease can cause a temporary, but usually reversible reduction in fertility too.

Secondly, if you’ve experienced a significant loss of body weight, or have developed nutritional deficiencies as a result of your Crohn’s, these can also impact your ability to conceive.  But, don’t worry, as these are treatable with the right care.   We’ll discuss these in a minute….

I should also state that there is an increased risk of pregnancy complications like miscarriage and preterm delivery if your Crohn’s disease flares up during pregnancy, so just make sure that you work closely with your treating doctor during pregnancy.  Also, corticosteroid medications have been associated with an increased risk of gestational diabetes, so if you’re taking them, you’ll need to be extra vigilant.  I’d highly recommend that you watch my videos on gestational diabetes, so that you know what to do to avoid this.

Taking this all together, what it means is that the best time to get pregnant is when your Crohn’s is in remission. While you may not be able to control a flare up happening during your pregnancy, it makes sense to go into pregnancy in as stable a state as possible. That’s because a flare up at the time you conceive means there is a good chance that it will remain active throughout your pregnancy.

One bit of good news for women with Crohn’s disease who are planning to conceive, is that, pregnancy is actually beneficial!   Studies show that women who have had children have lower rates of needing surgical intervention for their Crohn’s later in life. They also have fewer relapses. Good news, hey?!

Nutrients to watch out for

As I said earlier, if you have Crohn’s you are at high risk for nutritional deficiencies, so it’s important to check your nutritional status before trying to conceive.  The inflammation that occurs along the length of your digestive tract can affect the absorption of certain nutrients. During a flare up, symptoms like diarrhoea and vomiting can cause you to lose fluids, nutrients, and weight. You may also eat less because of nausea, cramps, and changes in how food tastes.  So, there’s a few key nutrients that I’d like you to focus on…..

  1. Folic acid: Corticosteroid medications used to control a Crohn’s flare up have been associated with a small, but increased risk of your baby being born with a cleft palate, and while your Crohn’s is active, you may not absorb very much.  So, if you have Crohn’s, it’s usually recommended that you take extra folic acid supplements before conceiving and during your first trimester of pregnancy.
  2. Low levels of iron and vitamin B12 in Crohn’s disease are a major cause of anaemia, and this can be particularly problematic during pregnancy. Iron supplements may actually aggravate your Crohn’s so I’d recommend trying to get your iron from food, or getting intravenous iron if you need it.
  3. Vitamin D deficiency is also common and some studies suggest that low vitamin D levels may also be associated with infertility.
  4. Other micronutrients such as selenium, magnesium and zinc may also be low, so before trying to become pregnant, it is certainly worthwhile getting your doctor to do blood tests to check you’re in good health.

It may also be helpful to note that preliminary studies on turmeric, prebiotics and probiotics suggest that these compounds may be helpful in reducing flare ups, so it can be beneficial to discuss these with your dietitian.

If you’re not in the best of health nutritionally and are suffering any symptoms related to anaemia or weight loss, it is even more important to pay attention to your diet at this time. This is where getting the expert advice of a dietitian will definitely be of help.

I’m sure that you’ve got loads of questions, so feel free to comment in the chat box below, or make an appointment to see a dietitian for more information.

So, to summarise, women with Crohn’s disease are just as likely to fall pregnant as women who do not have Crohn’s, but:

  1. If you are experiencing a flare up, then it is best to consider delaying your pregnancy for a short time until it is under control
  2. Make sure that you have a check up for key nutrients like vitamin D, folate, iron and vitamin B12
  3. Ensure that you are taking extra folate before conceiving and during your first trimester, and
  4. Finally, if you’re struggling to conceive, make sure that you see a dietitian.

I’d recommend that you download my free fertility meal plan to help you prepare your diet for conceiving. You can download it from www.melaniemcgrice.com/fertility.  And, if there’s anything else that I can do to help, please let me know.

 

2 Comments

  1. Nicole

    Would be interested to find out more about males with Crohn’s and how medication (eg methotrexate & infliximab infusions) can affect fertility too. Future info for my son. Thank you

    I understand methotrexate needs to cease at least 3-6 months before conception. Not sure about infliximab

    Reply
    • Melanie McGrice

      Thanks for your enquiry Nicole. Your son will need to speak to his treating doctor about his medications. However, if his Crohn’s has impacted his nutritional status, that can impact the health of his sperm. It’s wise for men with Crohn’s to check their nutritional status before trying to conceive, and it’s best to try to conceive when not experiencing an acute flare up. If he needs any assistance, he can make an appointment to see myself or one of our fertility dietitians.

      Reply

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