Crohn’s disease: how does it affect fertility?

The prevalence of Crohn’s disease is increasing among the European population, although incidence rates vary by country, ranging from 0.5 to 10.6 cases per 100,000 people annually.

Many individuals affected by Crohn’s are of reproductive age, so today we will discuss how Crohn’s disease can impact the chances of becoming pregnant or maintaining good semen quality.

Effects of Crohn’s disease on female fertility

Crohn’s disease in itself does not prevent pregnancy. The issue lies in the symptoms, which can create conditions that make conception more challenging. Low body weight, irregular menstrual cycles, or adhesions in tissues altered during surgeries can create an unfavorable environment for pregnancy.

This chronic condition causes inflammation in parts of the digestive tract, with symptoms that can be intermittent. Typically, Crohn’s patients experience periods of active flare-ups and phases of remission. In severe cases, surgery may be necessary to control the effects of this illness.

Pregnancy and Crohn’s disease

Generally, the recommendation is for patients to wait until the disease has been in remission for at least 3 to 6 months before trying to conceive. In the most severe cases, patients need to consider delaying the indicated surgery until after childbirth.

The main issue arises in patients who have required surgery, which can lead to scar tissue in the pelvis or fallopian tubes, subsequently making fertilization difficult. This occurs because adhesions may block the fallopian tubes. Fortunately, assisted reproductive technologies provide alternatives that are compatible with this situation, as tubal patency is not required to achieve pregnancy.

How does Crohn’s affect male fertility?

In men with Crohn’s disease, semen quality can be reduced. This is often due to malnutrition resulting from a deficiency in nutrients and micronutrients. Furthermore, some medications used to manage the disease can temporarily reduce male fertility. Sulfasalazine, specifically, can cause lower sperm production and poorer sperm motility, while methotrexate can affect proper sperm formation. This effect is generally reversible, and fertility levels usually recover two to three months after stopping the medication, even if temporarily.

Functionally, in more severe cases, abscesses and fistulas in the pelvic or anal regions can also cause issues with erection and ejaculation.

Psychological consequences of Crohn’s disease

It’s important to take the psychological aspect of the disease into consideration. Crohn’s disease often presents with symptoms such as severe fatigue, abdominal pain, internal lesions, or digestive problems, which can significantly decrease libido in both sexes, further complicating the ability to conceive. A comprehensive control of this illness, aided by a specialist, is fundamental to provide the best possible basis for becoming parents.

IVI’s expertise in this kind of disorders

At IVI, we are also experts in conditions like Crohn’s disease that may cause infertility. We offer comprehensive and personalized diagnostics and have specialists in all areas of infertility. This enables us to propose individualized protocols tailored to our patients’ needs. If you would like to discuss your case with one of our experts during an initial consultation, call us or fill out our online form with your details.