Voluntary Childlessness for Crohn's Patients

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You’ve thrown the worst fear
That can ever be hurled
Fear to bring children
Into the world

- Bob Dylan

 

Many women with Crohn's Disease (CD) choose not to have children. 

Available studies show that the percent of women with CD who have children is 17% to 44% less than similarly-aged women without CD.  These are studies of CD patients who did not have CD-related surgery and are capable of having children. (1)

Much of this voluntary childlessness is attributed to fear, including:

  • Fear of IBD-related congenital abnormalities [birth-defects]
  • Concern about genetic risk of IBD in child [passing IBD to a baby]
  • Concern about medication teratogenicity (methotrexate and non-methotrexate) [meds causing cancer]
  • Medical advice that conception not possible/ inadvisable with IBD
  • IBD-related fatigue prohibitive (2)

Fortunately most of these fears are unfounded--especially fears of poor pregnancy outcomes. 

The choice not to have a child isn't limited to women.  For men with CD, the rate of voluntary childlessness ranges from 18% to 50% less than men without CD.(1)

 This is one of the sadder notes of IBD.  But no one needs to listen to Mr. Dylan for this one.  There are many, many healthy children of IBD dads and moms--both moms using special diets and those who do not.


Bob Dylan lyrics: http://www.bobdylan.com/us/songs/masters-war

(1) Tavernier, N., Fumery, M., Peyrin-Biroulet, L., Colombel, J.-F., & Gower-Rousseau, C. (2013). Systematic review: fertility in non-surgically treated inflammatory bowel disease. Alimentary pharmacology & therapeutics, (August), 1–7. doi:10.1111/apt.12478

(2) Mountifield, R., Bampton, P., Prosser, R., Muller, K., & Andrews, J. M. (2009). Fear and fertility in inflammatory bowel disease: a mismatch of perception and reality affects family planning decisions. Inflammatory bowel diseases, 15(5), 720–5. doi:10.1002/ibd.20839