Abstract
Background
Several previous studies reported negative impact of inflammatory bowel disease (IBD) on reproductive plans and fertility rate. The aim of our study was to investigate for the first time reproductive plans and fertility rate among Czech women with IBD.
Methods
Between March and August 2019 consecutive women with IBD (age 18–55 years) from 22 centres across the whole Czech Republic were anonymously surveyed during their visit of gastroenterology centre using predefined questionnaire. The questionnaire was created by physicians of participating centres and commented by members of Patient organisation. The questionnaire was divided into 5 domains focused on patient’s demographics, details on IBD and treatment, gynaecologic history, reproductive issue and patients’ knowledge on this topic. The fertility rate was calculated as mean number of children per woman with known number of children and compared with data from the general Czech population.
Results
The questionnaire was filled-in by 501 women (median age 33 years; 67% with Crohn’s disease) of whom 287 (57%) already had ≥ 1 child (median 2 children; 40% born before IBD diagnosis). Up to 56% women (281) confessed having ever fear of infertility due to IBD and 27% (137) reported that the disease influenced (mainly negatively) their earlier reproductive plans with regard to decision not to have children, to have fewer children, or another timing of the pregnancy then previously wished. The total fertility rate in our study group was lower compared with the general population with 0.99 live births/IBD women vs. 1.69 live births/woman in Czech population. The pattern of decreased fertility among IBD females was observed in all age-specific categories (Table 1). No significant difference in fertility rate between women with Crohn’s disease and ulcerative colitis was found (0.97 vs. 1.08, p = 0.51). Of the childless women, 67% planned to have offsprings in future, 16% were yet to decide and 16% did not want any children. Of those not planning infants, 58% reported IBD to be the primary cause, with the most frequent reason being fear of IBD heritability (29%) and worsening of IBD during pregnancy (26%).
Conclusion
Fertility rate in women with IBD in our survey was decreased compared with the general population of women in the Czech Republic. The negative impact of IBD seemed to contribute most to this finding.
Why We Want Children: The Value of Children and the Preferred Number of Children in the Czech Republic
