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I read with interest the meta-analysis of infertility post ileal pouch-anal anastomosis (IPAA) published by Waljee and colleagues in the November issue.1 The article consolidates the increasing evidence that this procedure is associated with a significant decrease in female fertility.
Having recently reviewed the studies in their analysis, however, I was surprised the authors had included data from the following two trials; the first by Wikland et al2 assessed 41 patients treated exclusively with conventional proctocolectomy with ileostomy rather than IPAA; the other, by Hudson et al,3 included 20 patients treated with surgery of which only two had IPAA, while the remainder were treated with …
Competing interest: None.
Competing interests: None declared.
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