Ulcerative colitis: female fecundity before diagnosis, during disease, and after surgery compared with a population sample

Gastroenterology. 2002 Jan;122(1):15-9. doi: 10.1053/gast.2002.30345.


Background & aims: Women with ulcerative colitis generally have normal fertility. The aim of this study was to compare patients' fecundability before and after restorative proctocolectomy with ileal pouch-anal anastomosis with the fecundability of the general population.

Methods: Historical follow-up was performed on 343 consecutive female patients aged 10.6-40.5 years at surgery and a reference population of 1200 women aged 25-40 years. A total of 290 (85%) patients and 661 (55%) women in the reference population agreed to participate in a structured telephone interview concerning reproductive behavior and waiting times to pregnancy. Cox regression and Kaplan-Meier plots were used for analysis.

Results: Surgery significantly reduced the ratio of patient to reference population fecundability, which decreased to 0.20 (P < 0.0001). Before diagnosis and from diagnosis until colectomy, the fecundability of the patients was similar to that of the reference population.

Conclusions: Female patients with ulcerative colitis have normal fecundity before surgical treatment. Surgery severely reduces female fecundity. Information about this reduction in fecundity should be given before surgery, and if a woman has an unfulfilled wish for pregnancy after surgery, early referral to a gynecologist is recommended.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / epidemiology*
  • Colitis, Ulcerative / surgery*
  • Denmark / epidemiology
  • Female
  • Fertility*
  • Follow-Up Studies
  • Humans
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Rate
  • Proctocolectomy, Restorative*
  • Proportional Hazards Models
  • Sweden / epidemiology