Just what Is IBD and How Does it Affect your Fertility?
IBD, inflammatory bowel disease, is the collective term used for both Ulcerative Colitis and Crohn’s disease.
Both of these conditions cause inflammation in the intestines and even though they have some factors in common, there are some differences as well that create different symptoms and risks.
For men with IBD who want to father their own child, drug treatment is less complicated than it is for women who want to get pregnant and have inflammatory bowel disease.
This is because the embryo and fetus won’t be exposed directly to the toxicity of some drugs.
There are however some medications for IBD that will affect male fertility and decrease a couple’s chances of getting pregnant.
Any drugs that can harm the fetus or that can decrease fertility in men should be discontinued for at least six months before a couple is going to try to conceive.
This also applies to men who are going to be using sperm storage to preserve their sperm for future use.
For sperm storage, it’s essential that sperm of high quality are stored rather than sperm that has been damaged by certain medications.
IBD: Differences between Ulcerative Colitis and Crohn’s Disease
There are several differences between Ulcerative Colitis and Crohn’s disease. Ulcerative Colitis is an inflammatory condition of the colon where the inner lining of the intestine is irritated and grows open sores.
This condition is most severe in the rectal area of the body and can cause chronic diarrhoea in some men.
In cases where the lining of the colon is greatly damaged, there may be mucus and blood in the stool.
Crohn’s disease usually affects the largest section of the small intestine (terminal ileum) as well as some sections of the large intestine.
Inflammation that is the result of Crohn’s disease moves deep into the lining of the walls of the intestine where it can affect the entire wall of the bowel.
Of the two disorders, Crohn’s disease is more complicated and has more risks linked to it.
IBD and Infertility in Men
While IBD does not necessarily decrease fertility in men, there are certain drugs that are used to treat and control this condition that can lead to infertility factors and problems conceiving.
Even though many of the medications that are used to treat IBD are safe to use when you’re trying to conceive, there are some immunosuppressive medications that are known to cause birth defects in the developing fetus.
If you and your partner are thinking about having a baby you’ll need to talk to your doctor first about discontinuing any harmful drugs.
Some of these drugs include mycophenolate mofetil and methotrexate.
Two new drugs that are used to treat Crohn’s disease, Infliximab, and Adalimumab, should be discontinued for at least six months prior to your trying to get pregnant.
The problem with discontinuing any medication is that if there isn’t an available alternative drug some of the more severe symptoms of IBD may flare up.
IBD Causes Reduced Male Fertility
Men who have a severe case of Crohn’s disease may not be producing enough sperm for conception to occur and the sperm that they do produce may not function normally.
Men who have IBD are often undernourished and underweight. Both of these issues can decrease fertility.
In some severe IBD cases, the colon may have to be removed. With this type of surgery, the nerves in the stomach area may be damaged and men may be unable to have an erection.
Further abscesses in the rectal and pelvic area can also cause problems with erection and ejaculation leading to impotence and erectile dysfunction.
Sulphasalazine and Infertility
A common drug that is used to treat is IBD is Sulphasalazine. This drug can lead to a decline in sperm count and so can cause decreased fertility in men.
Sulphasalazine is not used to cure Ulcerative Colitis but is taken to ease some of the symptoms associated with this disease such as stomach pain, diarrhoea, fever, and rectal bleeding.
Sulphasalazine is also be used in between flare-ups of Ulcerative Colitis to increase the amount of time from one attack to the next. The drug works by reducing the swelling and irritation in the large intestines.
There are some safe alternatives to using Sulphasalazine, such as Mesalazine and Balsalazide.
Coping with IBD
For men with IBD who want to focus on their fertility, some changes in medication may be needed. You can also increase your fertility by eating right, exercising, and drinking moderately.
Some research is being done which indicates that Zinc and Vitamin B6 may naturally be able to boost your fertility. Living with IBD can be a challenge at any time.
For men who want to have a child with their partner, IBD can cause a lot of anger and stress that will only add to a couple’s inability to get pregnant.
Even when a couple is fertile, the risks and side effects of taking a variety of different drugs can have an adverse effect on their fertility.
If you have IBD talking to your doctor can help you make choices that are best for you and your medical condition.