Crohn’s disease is an inflammatory bowel disorder (IBD) that causes inflammation in the digestive tract, typically focusing on the small intestine. This inflammation can lead to chronic diarrhea and, more severely, scarring in the intestines that can affect digestion and movement of wastes through the body. Crohn’s disease can be a life-changing diagnosis and typically affects those approaching or in their childbearing years, ranging from 13-30, according to the National Digestive Diseases Information Clearinghouse.

While Crohn’s disease affects men and women equally, it can bring added concern for women who wonder if the condition can affect a person’s ability to become pregnant or carry a pregnancy to term. Typically, women with Crohn’s disease have similar fertility rates to women who do not, with some exceptions. For example, women who are currently experiencing an active Crohn’s disease flare-up may have a more difficult time becoming pregnant. Also, women who have undergone bowel surgery to correct Crohn’s-related inflammation and scarring may also have a more difficult time. Examples of these surgeries could include a resection of a portion of severely diseased bowel.

Another concern about becoming pregnant with Crohn’s disease is the medications a patient may be taking. For example, physicians commonly prescribe the drug methotrexate to treat Crohn’s-related symptoms. This drug is absolutely not safe in pregnancy; in fact, it is the drug used to treat ectopic pregnancies and as such, women hoping to become pregnant are usually advised to discontinue this medication approximately 3-6 months before starting to try to conceive.

If you are pregnant or thinking of becoming pregnant and have Crohn’s disease, talk to your doctor. There are numerous treatments for IBD that do not adversely affect a growing baby’s health. Women should not discontinue medications on their own because this could cause the disease to flare up, which can make regaining control of the disease difficult during pregnancy. Women with active IBD are more likely to experience a miscarriage than those whose IBD is in remission, so waiting until you have been flare-free before trying to conceive is often prudent advice.

Reviewed by Dr. Jen Lincoln, April 2020

Takeaways

  • Crohn’s disease can cause inflammation and scarring in the digestive tract.
  • The disease is characterized by periods of active, damaging inflammation and remission when symptoms and inflammation do not occur.
  • Women with Crohn’s disease typically have similar conception rates than those who do not. An exception can be women who have undergone past bowel surgeries.
  • Always speak with a physician about medications you are on—especially methotrexate— as these medications are not safe in pregnancy.

References

  1. Beth Israel Deaconess Medical Center. Pregnancy and Crohn’s Disease.
  2. Crohn’s & Colitis Foundation of America. Pregnancy and IBD.
  3. Crohn’s & Colitis Foundation of Canada. Fertility.
  4. National Digestive Diseases Information Clearinghouse. Crohn’s Disease.
  5. UpToDate. Inflammatory Bowel Disease and Pregnancy.

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