Section 7: Fertility
ECCO statement 7A [adapted from statement 2A in van der Woude et al.16]There is no evidence that ulcerative colitis affects fertility [EL3]. High levels of voluntary childlessness in women with ulcerative colitis indicate the need for better education [EL4]
ECCO statement 7B [statement 3A in van der Woude et al.16]If conception occurs at a time of quiescent disease, the risk of relapse is the same as in non-pregnant women [EL3]. Conception occurring at a time of active disease increases the risk of persistent activity during pregnancy [EL3]. Pregnancy may influence the course of ulcerative colitis [EL3]
ECCO statement 7C [adapted from statement 4B, 4C and 4D in van der Woude et al.16]Disease activity at conception or during pregnancy is associated with preterm birth and low birthweight [EL3]. The risk of congenital abnormalities in offspring from women with ulcerative colitis does not seem to be increased [EL2]. Fetal exposure to most ulcerative colitis medications is considered of low risk to the child, except for methotrexate and thalidomide [EL2]
ECCO statement 7D [statement 5A in van der Woude et al.16]Appropriate treatment of ulcerative colitis should be maintained in those patients who wish to conceive, in order to reduce the risk of flares during pregnancy [EL5]. Acute flares during pregnancy carry a high risk of adverse maternal and fetal outcome, and are best treated appropriately and without delay to prevent these complications [EL3]
