Threefold increased risk of infertility: a meta-analysis of infertility after ileal pouch anal anastomosis in ulcerative colitis

Waijee, A.; Waijee, J.; Morris, A. M.; Higgins, D. R.
November 2006
Gut;Nov2006, Vol. 55 Issue 11, p1575
Academic Journal
Background: Increased infertility in women has been reported after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis but reported infertility rates vary substantially. Aims: (1) To perform a systematic review and meta-analysis of the relative risk of infertility post-IPAA compared with medical management; (2) to estimate the rate of infertility post-IPAA; and (3) to identify modifiable risk factors which contribute to infertility. Methods: Medline, EMBASE, Current Contents, meeting abstracts, and bibliographies were searched independently by two investigators. The titles and abstracts of 189 potentially relevant studies were reviewed; eight met the criteria and all data were extracted independently. Consensus was achieved on each data point, and fixed effects meta-analyses, a funnel plot, and sensitivity analyses were performed. Results: The initial meta-analysis of eight studies had significant heterogeneity (p = 0.004) due to one study with very high preoperative infertility (38%). When this study was omitted, the relative risk of infertility after IPAA was 3.17 (2.41–4.18), with non-significant heterogeneity. The weighted average infertility rate in medically treated ulcerative colitis was 15% for all seven studies, and the weighted average infertility rate was 48% after IPAA (50% if all eight studies are included). We were unable to identify any procedural factors that consistently affected the risk of infertility. Conclusions: IPAA increases the risk of infertility in women with ulcerative colitis by approximately threefold. Infertility, defined as achieving pregnancy in 12 months of attempting conception, increased from 15% to 48% in women post-IPAA for ulcerative colitis. This provides a basis for counselling patients considering colectomy with IPAA. Further studies of modifiable risk factors are needed.


Related Articles

  • Infertility risk triples after colitis surgery.  // GP: General Practitioner;6/16/2006, p2 

    The article reports that according to U.S. researchers, a woman's risk of becoming infertile triples after surgery for ulcerative colitis (UC). Researchers re-analysed data from seven studies which looked at the risk of infertility associated with ileal pouch-anal anastomosis (IPAA), a surgical...

  • Acardiac twin with different presentations: report of two cases. Sharbaf, F. Rahimi; Mirzaie, F.; Izadi mood, N. // Tehran University Medical Journal;Jun2009, Vol. 67 Issue 3, p226 

    Background: Acardiac twin is a rare complication affecting monozygotic twins and is related to the twin reversed atrial perfusion sequence (TRAP). The TRAP sequence involves a pump twin perfusing a recipient twin through vascular anastomosis. Here, we report two cases with different...

  • Not just for men. Motluk, Alison // New Scientist;04/08/2000, Vol. 166 Issue 2233, p6 

    Reports on the findings of researchers from Sher Institute of Reproductive Medicine in Las Vegas, Nevada which reveals that the anti-impotence drug Viagra can help infertile women conceive. Effectiveness of the drug in improving dilating effects of nitric oxide on blood vessels; Role in...

  • Second TIME AROUND. SACKS, MEG // Jacksonville Magazine;Oct2015, p50 

    A personal narrative is presented which explores the author's experience of struggling with infertility after losing several pregnancies.

  • Unreviewed Reports. Cherry, John; Seymour, M.T.J.; Keith, A.O.; Mallick, U.K.; Singh, M.; Kaur, S.; Kell, R.J.A.; Ellis, M.E.; Lyn, P.C.W.; Teh, H.C. // British Medical Journal (Clinical Research Edition);11/30/1985, Vol. 291 Issue 6508, p1542 

    Reports developments in medicine in Great Britain as of November 30, 1985. Diagnosis of autophony in pregnancy; Common complication of ulcerative colitis; Side effects of cisplatin.

  • INFERTILITY: IDENTIFICATIONS AND DISRUPTIONS WITH THE MATERNAL OBJECT. Klempner, Linda G. // Clinical Social Work Journal;Summer92, Vol. 20 Issue 2, p193 

    For many women, infertility is the first major crisis of adulthood. Maternal identification provides a template for parenting and infertility disrupts the opportunity to recapitulate this relationship or make reparation for early failures. Supportive work is often useful to address the manifest...

  • Oocyte donation. Bromwich, Peter // BMJ: British Medical Journal (International Edition);6/30/90, Vol. 300 Issue 6741, p1671 

    Focuses on the oocyte donation in Great Britain. Chance of pregnancy to infertile women; Difficulties of oocyte donation; Efficacy of the technique.

  • HOW TO PROTECT YOUR FUTURE FERTILITY. Graves, Ginny // Cosmopolitan;Oct2003, Vol. 235 Issue 4, p254 

    Elaborates the causes of infertility in women, precautions to prevent it and consequently getting pregnant. INSETS: TEST YOUR FERTILITY;FERTILITY MYTHS EXPOSED;REASONS WHY HE MIGHT BE SHOOTING BLANKS.

  • Infertility risk higher after ulcerative colitis surgery.  // Contemporary OB/GYN;Dec2006, Vol. 51 Issue 12, p18 

    The article focuses on the findings of a study that women with severe ulcerative colitis who undergo colectomy with ileal pouch-anal anastomosis (IPAA) have higher infertility risk than women treated with medical management, conducted by Akbar Waljee of the University of Michigan in Ann Arbor...


Read the Article


Sign out of this library

Other Topics