Colectomy with ileorectal anastomosis preserves female fertility in ulcerative colitis.
OBJECTIVE
Restorative proctocolectomy with ileoanal anastomosis (IPAA) is the surgical standard for patients with ulcerative colitis (UC). Significant reduction in female fertility and fecundity after IPAA has been shown in recent studies. In selected cases, colectomy with ileorectal anastomosis (IRA) is another surgical option. The aim of this study was to evaluate fertility in women with UC who underwent IRA.


METHODS
This study included all women with UC who underwent IRA between 1962 and 1999 and who were 40 years old or younger at the time of surgery, and older than 18 years of age at the time of the interview. Data were collected using a structured telephone interview concerning reproductive behavior and waiting times to pregnancy.


RESULTS
Among 40 eligible patients, 37 whose mean age at IRA was 28 years (range 11-39) answered the questionnaire. Twenty-two were unmarried, not wishful of pregnancy and/or already had children. Among 15 females wishing children after IRA, 10 (66%) became pregnant: one had therapeutic abortion, two had a miscarriage, four had 1 child, two had 2 children and one had 4 children. Five patients were sterile after IRA.


CONCLUSIONS
These preliminary results suggest that IRA for UC preserves female fertility. If confirmed in other series this information should be provided to young women with UC before deciding surgical option.
Mortier
Pierre-Eugène
PE
Clinique des Maladies de l'Appareil Digestif, CHRU, 59037 Lille Cedex.
Gambiez
Luc
L
Karoui
Medhi
M
Cortot
Antoine
A
Paris
Jean-Claude
JC
Quandalle
Pierre
P
Colombel
Jean-Frédéric
JF
D000328:Adult; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000379:methods*; D003093:Colitis, Ulcerative / Q000601:surgery*; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007247:Infertility, Female / Q000517:prevention & control; D011247:Pregnancy; D011256:Pregnancy Outcome; D012007:Rectum / Q000601:surgery*