According to a popular belief, pregnancy in most cases will be affected by menstruation, ovary, endocrine and other reproductive organs or systems, but the latest clinical research found that inflammatory bowel disease can also affect women’s pregnancy and reduce their fertility.
In recent years, with the change of people’s diet and life, inflammatory bowel disease has become a serious threat to human health in modern times. In medicine, inflammatory bowel disease is divided into a broad sense and a narrow sense. Inflammatory bowel disease in a broad sense includes all intestinal inflammatory reactions caused by different reasons. However, it is inflammatory bowel disease (IBD) in a narrow sense that affects the pregnancy rate of women.
IBD is an inflammatory reaction of the digestive tract caused by inflammatory factors invading the rectum, colon and ileum, including ulcerative colitis and Crohn’s disease. The prevalence of IBD has increased year by year. According to statistics, the total prevalence rate in China from 2005 to 2014 was as high as 350,000 people.
IBD is a problem that has not been solved by medicine and cannot be cured until now, mostly because its pathogenic factor is still unknown. At present, inflammatory factors can only be inhibited by symptomatic medication, mesalazine, biological preparation and the like, and cannot be completely killed. Even after operation, the inflammatory factors in the intestinal tract cannot be completely eliminated.
A Lifelong Disease Has a Great Peril
Because IBD cannot be cured completely, it becomes a lifelong disease. Although patients with IBD can take the medicine for a lifetime, they still have to suffer from physical troubles and injuries brought by IBD.
Among the subtypes of IBD, ulcerative colitis is most troubling because of the presence of blood, pus, and mucus in the stool. Patients with mild symptoms defecate 2 to 4 times a day while those with severe symptoms may even have 10 to 30 bowel movements per day, with stool like water after washing meat; The most painful symptom of Crohn’s disease is diarrhea, most patients defecate 2 ~ 6 times a day, with mushy or watery stool, generally without pus or mucus. In addition, in patients with severe IBD, the whole digestive tract, eyes, skin, liver and gallbladder, skeletal muscles, blood and respiratory system will be damaged to varying degrees, then leading to related diseases.
IBD Brings Double Hidden Troubles to Pregnancy
IBD is a typical intestinal disease. Its inflammatory factors not only destroy the body’s intestines, but also affect a woman’s pregnancy to some extent.
An article published in the journal Clinical Gastroenterology and Hepatology confirmed that women who undergo pelvic surgery to treat IBD take significantly longer time to become pregnant than healthy women. This suggests that the decline in fertility of women with IBD  is related to the changes in physical environment under the effects of surgery and inflammatory factors.
For pregnancy-ready women with active IBD, the chances of conception will also be reduced even if they don’t have the operation, which is mainly related to fever, abdominal pain, diarrhea, malnutrition, mental sexual intercourse difficulties, loss of sexual desire and other reasons. However, if the disease is in remission, the fertility of patients is not significantly different from that of normal women.
Affect the Fetus
When the disease of pregnant women is in the active stage, the antibiotics and biological agents taken by the patients will have a certain impact on the fetus, resulting in accidental abortion, and significant increase in fetal abortion. Other studies showed that mothers with IBD are more likely to pass on the disease to their daughters than to their sons, and that mothers with IBD have a higher heritability than fathers with IBD .
IBD Can Be Traced
Nowadays, many people find their diseases in the advanced stage, mainly because they fail to notice the symptoms of illness in the early days, missing the critical period of treatment. IBD patients, in fact, have a clear signal from their body before they are diagnosed.
Intermittent diarrhea often occurs after inflammatory factors appear in the gut, especially when the diet and life are irregular, but this cannot be diagnosed as IBD at this period. IBD can only be diagnosed with increased inflammation leading to bloody or mushy stools and with the symptoms of more than 2 bowel movements per day. The period from intermittent diarrhea to the diagnosis of IBD is the "golden period of self-help", which needs to be paid great attention to.
In addition to this obvious physical change, blood tests can also reveal signs of inflammatory factors. When inflammatory factors are active in human body, patients’ platelet count and C-reactive protein are significantly increased, while their hemoglobin concentration, erythrocyte hemoglobin concentration and mean hematocrit are significantly decreased .
Therefore, when finding these abnormalities in blood routine during the annual physical examination, we should pay special attention to them. For women with intermittent diarrhea in preparation for pregnancy, it is advisable to have another routine blood test to see if there are any abnormalities in these indicators so as to offer assistance in the early diagnosis of IBD.
If a woman of childbearing age is diagnosed with IBD before conception, there is no need to worry too much. As long as the disease is treated early and kept in remission (with normal defecation, 1-2 times a day and with normal stool texture and shape), the chances of a successful pregnancy are basically the same as those of healthy women. In addition, pregnancy-ready women and expectant mothers can also take probiotics under the guidance of doctor, which will be beneficial to conceive and maintain the balance of intestinal flora. An intestinal disease is not a minor problem and should be taken seriously. Once abnormal conditions are found, patients should seek medical advice in a timely manner.
 Olsen K, Juul S, Berndtsson I, et al.Ulcerative colitis:female fecundity before diagnosis, during disease, and after surgery compared with a population sample[J].Gastroenterology, 2002, 122 (1) :15-19
 Zelinkova Z, Stokkers P C, van der Linde K, et al.Maternal imprinting and female predominance in familial Crohn’s disease[J]. J Crohns Colitis, 2012, 6 (7): 771-776
 Sun Xiuju. The Value of Blood Routine Examination in the Diagnosis of Inflammatory Bowel Disease[J]. Electronic Journal of Clinical Medical Literature, 2019, 6 (14): 136