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Assisted reproductive technology less successful inulcerative colitis
Refers to Nrgrd, B. M. etal. Live birth and adverse birth outcomes in women with ulcerative colitis and Crohns disease receiving assisted reproduction: a 20year nationwide cohort study. http://dx.doi.org/10.1136/gutjnl-2015-311246
Web End =Gut 65, 767776 (2016)
undergo assisted fertility procedures; therefore, applicability of these findings could be limited and the addition of population-based data to the body of literature is critical.
In a newly published population-based study by Nrgrd etal.7, investigators used multiple Danish registries to obtain data on outcomes from ART in women with ulcerative colitis or Crohns disease compared with healthy individuals. Each woman had a history of at least one embryo transfer over a 20-year study period from January 1994 to December2013. The primary outcome of interest was the percentage of live births follow ing an ART cycle, and the secondary outcome of interest was the incidence of adverse birth outcomes defined as low birth weight, preterm birth or congenital anomaly. For each woman, covari ates included age, the Charlson Index score (a validated scoring system to assess 10-year mortality risk on
Women with ulcerative colitis or Crohns disease are often diagnosed during their most fertile years (aged 1835 years). Previous studies suggest that for ulcerative colitis, fertility rates are similar to healthy individuals1,2,
but following an ileopouch anal anastomosis procedure the ability of a woman with ulcerative colitis to get pregnant can be decreased by as much as 50%3. Evidence suggests that patients with IBD typically have low levels of knowledge in regard to their reproductive health and a deeper understanding could have a substantial impact on decision- making when considering treatment options4.
However, data are sparse for how successful ART treatments (such as invitro fertilization and transfer of frozenthawed embryos) really are in women with ulcerative colitis or Crohns disease. Interest in the past decade has turned to whether women with IBD who have undergone IBD surgery have more difficulty conceiving than women treated medically, but this outcome was not found to be the case3. Previous data on the efficacy of ART in women with IBD come from a tertiary-care setting in a limited number of patients5,6. These patients could represent a more complicated population than women...