REFILE-IVF success hampered by inflammatory bowel disease

Reuters Health Information: REFILE-IVF success hampered by inflammatory bowel disease

REFILE-IVF success hampered by inflammatory bowel disease

Last Updated: 2016-03-11

(Corrects spelling of Dr. Friedman's first name in para 2; rewrites paras 4 and 5 to add data.)

By Marilynn Larkin

NEW YORK (Reuters Health) - Women with ulcerative colitis or Crohn's disease cannot expect the same success when undergoing assisted reproduction treatments as women without inflammatory bowel disease, researchers from Denmark have reported.

"I see these young women on a day-to-day basis suffering with fertility problems. So I really wanted to know how they do with ART (assisted reproductive technology) to give them some hope if they can't have a baby in the natural way," senior author Dr. Sonia Friedman, of the University of South Denmark in Odense and the Crohn's and Colitis Center at Brigham and Women's Hospital in Boston, told Reuters Health in an interview.

Dr. Friedman's team examined the medical records of all women undergoing embryo transfer in Denmark over a 20-year period. The analysis included 1,360 ART treatments in 432 women with ulcerative colitis; 554 ART treatments in 182 women with Crohn's disease; and 148,540 ART treatments in 52,489 women without inflammatory bowel disease.

"The chance of a live birth for each embryo transfer was significantly reduced in ART treatments in women with UC (OR=0.73), but not significantly reduced in the full model of ART treatments in women with CD," the authors reported in an article online February 26 in Gut. "Surgery for CD before ART treatment significantly reduced the chance of live birth for each embryo transfer (OR=0.51)."

Also, they wrote, "In children conceived through ART treatment by women with UC, the OR of preterm birth was 5.29 in analyses including singletons and multiple births," but the risk for these women when the analysis was restricted to singletons was not statistically significant.

"Now that we know these women have a reduced chance of a live birth each time they have an embryo cycle, we might want to push them a bit to initiate IVF sooner if they want to get pregnant," Dr. Friedman said.

"And because there's an increased risk of preterm birth in women with ulcerative colitis, we're advising more careful prenatal care in this population. The same is true for Crohn's patients who have had surgery for Crohn's, because they have an especially reduced chance of a live birth after IVF," she added.

"Why do these women have a significantly reduced risk of a live birth during each embryo cycle? Is it the inability to conceive or to hold onto the pregnancy? Or other problems related to the pregnancy? We don't know," Dr. Friedman acknowledged. Her group is planning a study to learn more. "We need to find out at what stage the chance is reduced, and if there's anything that can be done during IVF, or anything we can do to better care for these patients during their pregnancy, to reduce the risks."

The Crohn's and Colitis Foundation of America supported this research. The authors made no disclosures.

SOURCE: http://bit.ly/1TI0l8p

Gut 2016.

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