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Pregnancy in primary sclerosing cholangitis (PSC) is not well studied. There is little known regarding how pregnancy might affect PSC, and how the disease might affect the fetus. In general, advice regarding conception for a woman with PSC reflects knowledge gleaned from a few small studies and case reports 1–5 A common question for a newly diagnosed patient with PSC pertains to future fertility and childbearing. The case series published in this issue of Gut by Wellge and colleagues6 (see page 1117) provides an important look at pregnancy in PSC. In the review by Wellge et al, 229 patients with PSC were evaluated as were 569 healthy controls. The authors found that the number of children was not different between the two groups. This would imply that fertility was not affected by the diagnosis of PSC. A total of 17 patients with known PSC and …