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Female infertility following restorative proctocolectomy
1Department of Biosurgery and Surgical Technology, St Mary's Hospital, Imperial College, London, UK.
Summary
Restorative proctocolectomy (RPC) increases infertility risk. While IVF success rates are similar to the general population, few patients seek fertility management post-RPC, and Caesarean sections are more common.
Area of Science:
- Gastroenterology
- Reproductive Medicine
- Surgical Outcomes
Background:
- Restorative proctocolectomy (RPC) is a surgical procedure for ulcerative colitis.
- Females of childbearing age may experience a 2-3 fold increase in infertility post-RPC.
Purpose of the Study:
- To assess infertility and pregnancy outcomes in females after RPC.
- To evaluate the utilization of fertility treatments and delivery methods post-RPC.
Main Methods:
- A postal questionnaire was distributed to 790 females who underwent primary RPC.
- Data collected included infertility status, pregnancy details, delivery methods, and fertility treatment use.
Main Results:
- 306 females responded (38.5%); 82% had ulcerative colitis.
- 44.1% never conceived, while 5.5% conceived only after RPC.
- 57 attempted conception post-RPC, with 25 successful (45.5%); 16 underwent IVF with 4 conceptions (30.7%).
- Vaginal deliveries were more common before RPC than after (69.6% vs 35.3%).
Conclusions:
- Despite known infertility risks, few RPC patients are referred for fertility management.
- In vitro fertilization (IVF) success rates post-RPC mirror the general population.
- Caesarean section rates are higher for pregnancies conceived after RPC.
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