Inflammatory bowel disease meets fertility: A physician and patient survey

Background and aims: Inflammatory bowel disease (IBD) can affect patients during their childbearing years. Literature evidence is scarce regarding the level of knowledge among health care professionals (HCPs) and patients about the impact of IBD on fertility. The aim of this survey was to investigate HCPs' and patients' knowledge on fertility, pregnancy, and sexual function, to evaluate how HCPs approach this topic and to report patients' reproductive outcomes. Methods: Subjects were invited to anonymously complete an online questionnaire collecting data on de-mographics, patients' disease characteristics, Crohn's and colitis pregnancy-specific disease-related knowl-edge (CCPKnow), family planning, reason of childlessness, pregnancy outcomes, need for assisted repro-ductive technology, impact on sexual function, and availability of patients' information regarding IBD and pregnancy.Results: A total of 257 HCPs from 40 countries and 793 patients (615 females, 176 males and 2 who preferred not to disclose their gender; 396 (50%) with ulcerative colitis, 381 (48%) with Crohn's disease, 14 (1.8%) with undetermined IBD) from 4 countries completed the survey. In total, 98.4% of HCPs had good or very good pregnancy-specific knowledge according to CCPKnow score, compared to only 29.3% of patients. Of the women surveyed, 56.3% had no children (14.1% due to a voluntary choice). A total of 427 pregnancies and 401 live births were reported in 266 women. Twenty-four pregnancies (5.6%) in 22 women required assisted reproductive technologies (ART). There were no more complications in pregnancies resulting from ART compared with spontaneous conception (5/24; 20.8% vs 81/401; 20.2%). Three quarters of IBD patients (75.6%) had breastfed. An impaired sexual function was found in one-fifth (21.9%) of men with IBD, while two-thirds (66.1%) of the women reported sexual function impairment. Surprisingly, 63% of patients reported not having received any information about IBD and pregnancy, and only 10% of patients had received information from their IBD specialist. In addition, 42.1% and 36% of HCPs had already referred a patients to a medically assisted reproduction center to receive general infor-mation about their reproductive health and about options of fertility preservation (e.g., cryopreservation), respectively.Conclusion: IBD patients have a poor knowledge about the impact of IBD on fertility and pregnancy and HCPs do not sufficiently inform their patients. More information on these topics is needed for IBD patients.& COPY; 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Automated summary

This study investigated the level of knowledge among health care professionals and patients about the impact of inflammatory bowel disease (IBD) on fertility. The results showed that health care professionals had good knowledge, while patients had poor knowledge. The study also revealed a lack of understanding among patients regarding the impact on sexual function and reproductive outcomes. The findings highlight the importance of improving education for both health care professionals and patients regarding fertility and sexual function in IBD.