Abstract
Background and aims
Inflammatory bowel disease (IBD) can affect patients during their childbearing years.
Literature evidence is scarce regarding the level of knowledge among health care professionals
(HCPs) and patients about the impact of IBD on fertility. The aim of this survey was
to investigate HCPs' and patients' knowledge on fertility, pregnancy, and sexual function,
to evaluate how HCPs approach this topic and to report patients’ reproductive outcomes.
Methods
Subjects were invited to anonymously complete an online questionnaire collecting data
on demographics, patients' disease characteristics, Crohn's and colitis pregnancy-specific
disease-related knowledge (CCPKnow), family planning, reason of childlessness, pregnancy
outcomes, need for assisted reproductive technology, impact on sexual function, and
availability of patients’ information regarding IBD and pregnancy.
Results
A total of 257 HCPs from 40 countries and 793 patients (615 females, 176 males and
2 who preferred not to disclose their gender; 396 (50%) with ulcerative colitis, 381
(48%) with Crohn's disease, 14 (1.8%) with undetermined IBD) from 4 countries completed
the survey. In total, 98.4% of HCPs had good or very good pregnancy-specific knowledge
according to CCPKnow score, compared to only 29.3% of patients. Of the women surveyed,
56.3% had no children (14.1% due to a voluntary choice). A total of 427 pregnancies
and 401 live births were reported in 266 women. Twenty-four pregnancies (5.6%) in
22 women required assisted reproductive technologies (ART). There were no more complications
in pregnancies resulting from ART compared with spontaneous conception (5/24; 20.8%
vs 81/401; 20.2%). Three quarters of IBD patients (75.6%) had breastfed. An impaired
sexual function was found in one-fifth (21.9%) of men with IBD, while two-thirds (66.1%)
of the women reported sexual function impairment. Surprisingly, 63% of patients reported
not having received any information about IBD and pregnancy, and only 10% of patients
had received information from their IBD specialist. In addition, 42.1% and 36% of
HCPs had already referred a patients to a medically assisted reproduction center to
receive general information about their reproductive health and about options of fertility
preservation (e.g., cryopreservation), respectively.
Conclusion
IBD patients have a poor knowledge about the impact of IBD on fertility and pregnancy
and HCPs do not sufficiently inform their patients. More information on these topics
is needed for IBD patients.
Keywords
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Article info
Publication history
Published online: January 23, 2023
Accepted:
January 4,
2023
Received:
November 22,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
