Issue 03

Clinical Question

What are the chances of successful in vitro fertilization (IVF) in women with ulcerative colitis (UC) who have had ileal pouch anal anastomosis (IPAA)?

Editor’s Bottom Line

IVF success rates in UC patients with an IPAA are similar to those UC patients without an IPAA and to women without IBD.

Reference

Pabby V, Oza SS, Dodge LE, et al. In vitro fertilization is successful in women with ulcerative colitis and ileal pouch anal anastomosis. Am J Gastroenterol. 2015 Jun;110(6):792–7. https://www.ncbi.nlm.nih.gov/pubmed/25512339

Synopsis

Women presenting for IVF between 1998 and 2011 were identified. Those with UC were further categorized into those who had undergone IPAA versus those who had not. Each individual was followed until they discontinued IVF, delivered a live infant or completed 6 IVF cycles. The primary outcome, cumulative live birth rate (e.g., the proportion who delivered a live infant), was determined for each UC group and compared to the non-IBD group.

A total of 541 women undergoing IVF treatment were included in the study. The IPAA cohort had a significantly higher incidence of infertility (54.5%) compared to the 49 women with UC but no IPAA (8.2%; P<0.001) or the 470 women without IBD (14.0%; P=0.001). After the first IVF cycle, there was no significant difference between the 3 cohorts regarding the proportion who underwent oocyte retrieval, embryo transfer, became pregnant, or had live births. After 6 cycles of IVF, the cumulative live birth rates in the IPAA cohort was 64% and did not differ significantly compared to the UC without IPAA (71%; P=0.63) or the non-IBD (53%; P=0.57) cohorts.

Details

Study Design: Retrospective cohort study
Funding: None
Allocation: n/a
Setting: 2 hospitals in Boston, MA
Level of Evidence: 2b (Oxford Levels of Evidence)

The summary and conclusion in this issue of E-mentoring in IBD pertains to the manuscript(s) being reviewed, and should be considered in the context of what is already known surrounding the topic and incorporated into practice as deemed appropriate by the individual learner.