Infertility risk higher after ulcerative colitis surgery

Women with severe ulcerative colitis who undergo colectomy with ileal pouch-anal anastomosis (IPAA) are about three times more likely to experience infertility than women treated with medical management, according to study findings published in the November issue of Gut.

Akbar Waljee, MD, of the University of Michigan in Ann Arbor, and colleagues performed a meta-analysis of eight studies that looked at the relative risk of infertility in ulcerative colitis patients treated medically and those who had IPAA.

In women who tried to conceive within 12 months, the relative risk for infertility was threefold higher for those treated surgically (3.17) than those treated medically. The researchers could not identify patient or procedure variables associated with risk. The weighted average infertility rate in women treated medically was 15% compared to 48% in those who had IPAA.

Waljee A, Waljee J, Morris AM, et al. Threefold increased risk of infertility: a meta-analysis of infertility after ileal pouch anal anastomosis in ulcerative colitis. Gut. 2006;55:1575-1580.