Fertility, pregnancy and IBD - a conversation with Dr Aarthi Mohan
Episode 47, Feb 12, 2020, 12:15 PM
Does Inflammatory Bowel Disease (IBD) affect fertility? Do people with IBD have more adverse outcomes in pregnancy? Are biologics, for example, Infliximab and Adalimumab, safe to use in pregnancy? How do you treat a flare in pregnancy? If you work in primary care and you want to know the answer to these questions and lots more, this is the podcast for you.
In this episode, GP, Dr Charles Andrews, discusses contraception, pregnancy and breastfeeding in people with IBD with Dr Aarthi Mohan, an experienced Obstetrician at St Michael's hospital in Bristol, who runs a quaternary level service for pregnant women with concurrent medical conditions. She shares a wealth of experience with Dr Andrews about all aspects of fertility and pregnancy in patients with IBD.
According to a study by Tavernier et al., infertility rates in people with IBD is mainly due to voluntary childlessness rather than infertility contributed to by the disease itself (Tavernier et al. Systematic review: fertility in non-surgically treated inflammatory bowel disease, Alimentary pharmacology and therapeutics, Oct. 2013). This voluntary childlessness is significantly higher than those not affected by IBD (14-18% vs. 6%) and this is mainly due to incorrect beliefs about how their disease may affect their fertility and outcomes in pregnancy. Therefore having a good knowledge of these issues is important for both primary care and secondary care clinicians looking after patients with IBD so that these patients can have accurate advice when planning their family.
On this podcast, they discuss:
In this episode, GP, Dr Charles Andrews, discusses contraception, pregnancy and breastfeeding in people with IBD with Dr Aarthi Mohan, an experienced Obstetrician at St Michael's hospital in Bristol, who runs a quaternary level service for pregnant women with concurrent medical conditions. She shares a wealth of experience with Dr Andrews about all aspects of fertility and pregnancy in patients with IBD.
According to a study by Tavernier et al., infertility rates in people with IBD is mainly due to voluntary childlessness rather than infertility contributed to by the disease itself (Tavernier et al. Systematic review: fertility in non-surgically treated inflammatory bowel disease, Alimentary pharmacology and therapeutics, Oct. 2013). This voluntary childlessness is significantly higher than those not affected by IBD (14-18% vs. 6%) and this is mainly due to incorrect beliefs about how their disease may affect their fertility and outcomes in pregnancy. Therefore having a good knowledge of these issues is important for both primary care and secondary care clinicians looking after patients with IBD so that these patients can have accurate advice when planning their family.
On this podcast, they discuss:
- Contraception
- The effects of IBD on fertility
- What to do with various medications in pregnancy
- How should we approach flare management in these patients
- IBD and venous thromboembolism risk in pregnancy
- Folic acid use
- Mode of delivery in those with IBD
- The pregnancy pathway for those with IBD
- IBD and breastfeeding
- Post-natal depression in patients with IBD.
You can access the IBD toolkit on the RCGP website.
The Crohns and Colitis UK website has an excellent patients' guide to IBD and pregnancy,
NB. This episode was recorded in a busy maternity hospital, so there is some background noises because of this.
The Crohns and Colitis UK website has an excellent patients' guide to IBD and pregnancy,
NB. This episode was recorded in a busy maternity hospital, so there is some background noises because of this.