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* = Presenting author

P668 Fertility in IBD women is comparable to fertility in non-IBD controls

A. de Lima*1, M. van Amelsfort1, E. Steegers2, C.J. van der Woude1

1Erasmus Medical Center, Gastroenterology and Hepatology, Rotterdam, Netherlands, 2Erasmus Medical Center, Obstetrics and Gynecology, Rotterdam, Netherlands

Background

As inflammatory bowel diseases (IBD) often arises in young people, questions about fertility and reproduction are common. Prior studies on infertility in IBD women are scarce and conflicting. The aim of this study was to compare subfertility between IBD women and non-IBD controls. Furthermore, we investigated the effect of several IBD associated factors on fertility.

Methods

All consecutive IBD women with a pregnancy wish from 2008-2014 were prospectively followed at the preconception outpatient clinic in the Erasmus University Medical Center Rotterdam. Data on patient characteristics, disease and obstetric/gynecologic history, paternal health, time to conception and pregnancy outcomes were recorded. The control group consisted of a random age-, and ethnicity-, matched sample from a large non-diseased birth cohort (Generation R) from the same geographical region. Primary aim was to compare subfertility rates between IBD women and non-diseased controls. Subfertility was defined as the inability to conceive within 12 months of unprotected intercourse and/or the need for fertility treatment to conceive. Secondary aim was to identify risk factors for subfertility in IBD women.

Results

A total of 333 cases in 227 IBD women (236 CD (70.9%), 87 UC (26.1%), 10 IBDU (3.0%)) and 804 non-diseased controls were included. Mean maternal age was 30.5 yrs (SD=4.4 yrs). There were no differences between the IBD and the control group in maternal and paternal BMI (p=0.55 and p=0.53, respectively) and smoking status (p=0.14 and p=0.06, respectively). Median time to conception was 2.4 months (IQR: 0.9-7.2) in the IBD group versus 3.0 months (IQR: 2.0-7.0) (p=0.001) in the control group. IBD was not significantly associated with subfertility when compared to controls (aOR: 1.39 (95% CI: 0.99-1.94, adjusted for maternal age, BMI, education and paternal smoking). IBD women more often underwent fertility treatment than controls (21 (10.1%) vs 30 (3.7%), p=0.001). Reasons for fertility treatment in the IBD group were of gynecologic or andrologic cause in 18 cases (85.7%). Diagnosis, previous bowel surgery, perianal disease activity, IBD medication type and the number of disease flares in the past year were not associated with subfertility in IBD women.

Conclusion

This study shows IBD is not associated with increased time to conception or subfertility. Fertility treatment was more common in IBD women, but this was not associated with IBD. Type of IBD, previous bowel surgery, perianal disease, IBD medication and disease activity were not associated with subfertility in IBD women.