Original article
Alimentary tract
In Vitro Fertilization in Women With Inflammatory Bowel Disease Is as Successful as in Women From the General Infertility Population

https://doi.org/10.1016/j.cgh.2015.03.016Get rights and content

Background & Aims

Inflammatory bowel disease (IBD) affects women of reproductive age, so there are concerns about its effects on fertility. We investigated the success of in vitro fertilization (IVF) in patients with IBD compared with the general (non-IBD) IVF population.

Methods

We conducted a matched retrospective cohort study of female patients with IBD who underwent IVF from 1998 through 2011 at 2 tertiary care centers. Patients were matched 4:1 to those without IBD (controls). The primary outcome was the cumulative rate of live births after up to 6 cycles of IVF. Secondary outcomes included the proportion of patients who became pregnant and the rate of live births for each cycle.

Results

Forty-nine patients with Crohn’s disease (CD), 71 patients with ulcerative colitis (UC), 1 patient with IBD-unclassified, and 470 controls underwent IVF during the study period. The cumulative rate of live births was 53% for controls, 69% for patients with UC (P = .08 compared with controls), and 57% for patients with CD (P = .87 compared with controls). The incidence of pregnancy after the first cycle of IVF was similar among controls (40.9%), patients with UC (49.3%; P = .18), and patients with CD (42.9%; P = .79). Similarly, the incidence of live births after the first cycle of IVF was similar among controls (30.2%), patients with UC (33.8%; P = .54), and patients with CD (30.6%; P = .95).

Conclusions

Based on a matched cohort study, infertile women with IBD achieve a rate of live births after IVF that is comparable with those of infertile women without IBD.

Section snippets

Study Population

We identified 8684 female patients with IBD who were seen between 1998 and 2011 for possible inclusion in this matched retrospective cohort study from medical records of the gastrointestinal divisions of Beth Israel Deaconess Medical Center (Boston, MA; n = 4028) and Brigham and Women’s Hospital (Boston, MA; n = 4656). We also identified all women who underwent their first fresh, nondonor, nongestational carrier IVF cycle at Boston IVF (an affiliate of Beth Israel Deaconess Medical Center;

Results

We identified 132 patients with IBD who underwent IVF and 470 women without IBD who fulfilled matching criteria. Eleven of the women with IBD were excluded because the diagnosis of IBD could not be confirmed as having preceded the first IVF cycle. Seventy-one patients had UC, and 49 patients had CD; 1 patient had IBD-unclassified. The disease characteristics of the CD and UC patients are described in Tables 1 and 2, respectively.

Patients with CD received a diagnosis at a median of 10.3 years

Discussion

We evaluated the success of IVF in both medically and surgically treated IBD patients. Our results suggest that women with IBD have similar rates of pregnancy and live births after IVF compared with women without IBD. The cumulative live birth rates were similar to previously reported rates of 51% to 74% after 6 cycles of IVF.13, 24, 25 The cumulative live birth rates in the UC cohort were somewhat higher than in the CD and non-IBD populations, although this difference did not reach statistical

References (25)

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  • N. Tavernier et al.

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    Conflicts of interest These authors disclose the following: Adam Cheifetz has performed consulting and/or research for Janssen, AbbVie, Takeda, and Pfizer; and Alan Penzias has served on the advisory board (with compensation) for OvaScience and Nora Therapeutics, has served as a consultant for ReproSource, Inc, and has served on the speakers bureau for Ferring Pharmaceuticals. The remaining authors disclose no conflicts.

    Funding Supported by Harvard Catalyst, The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health award UL1 TR001102) and financial contributions from Harvard University and its affiliated academic health care centers (M.H.).

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    Authors share co-senior authorship.

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