Hepato-Gastroenterology and Digestive Oncology, University Hospital CHU of Liège, Liège, Belgium.
Centre for Reproductive Medicine, UZ Brussel, Brussels, Belgium.
Dig Liver Dis. 2023 Jul;55(7):888-898. doi: 10.1016/j.dld.2023.01.149. Epub 2023 Jan 23.
Inflammatory bowel disease (IBD) can affect patients during their childbearing years. Literature evidence is scarce regarding the level of knowledge among health care professionals (HCPs) and patients about the impact of IBD on fertility. The aim of this survey was to investigate HCPs' and patients' knowledge on fertility, pregnancy, and sexual function, to evaluate how HCPs approach this topic and to report patients' reproductive outcomes.
Subjects were invited to anonymously complete an online questionnaire collecting data on demographics, patients' disease characteristics, Crohn's and colitis pregnancy-specific disease-related knowledge (CCPKnow), family planning, reason of childlessness, pregnancy outcomes, need for assisted reproductive technology, impact on sexual function, and availability of patients' information regarding IBD and pregnancy.
A total of 257 HCPs from 40 countries and 793 patients (615 females, 176 males and 2 who preferred not to disclose their gender; 396 (50%) with ulcerative colitis, 381 (48%) with Crohn's disease, 14 (1.8%) with undetermined IBD) from 4 countries completed the survey. In total, 98.4% of HCPs had good or very good pregnancy-specific knowledge according to CCPKnow score, compared to only 29.3% of patients. Of the women surveyed, 56.3% had no children (14.1% due to a voluntary choice). A total of 427 pregnancies and 401 live births were reported in 266 women. Twenty-four pregnancies (5.6%) in 22 women required assisted reproductive technologies (ART). There were no more complications in pregnancies resulting from ART compared with spontaneous conception (5/24; 20.8% vs 81/401; 20.2%). Three quarters of IBD patients (75.6%) had breastfed. An impaired sexual function was found in one-fifth (21.9%) of men with IBD, while two-thirds (66.1%) of the women reported sexual function impairment. Surprisingly, 63% of patients reported not having received any information about IBD and pregnancy, and only 10% of patients had received information from their IBD specialist. In addition, 42.1% and 36% of HCPs had already referred a patients to a medically assisted reproduction center to receive general information about their reproductive health and about options of fertility preservation (e.g., cryopreservation), respectively.
IBD patients have a poor knowledge about the impact of IBD on fertility and pregnancy and HCPs do not sufficiently inform their patients. More information on these topics is needed for IBD patients.
炎症性肠病（IBD）可影响育龄患者。有关医护人员（HCPs）和患者对 IBD 对生育力影响的认知水平的文献证据有限。本调查旨在调查 HCPs 和患者对生育力、妊娠和性功能的认知程度，评估 HCPs 如何处理这一问题，并报告患者的生育结局。
邀请受试者匿名填写在线问卷，收集人口统计学、患者疾病特征、克罗恩病和结肠炎特定妊娠相关知识（CCPKnow）、计划生育、不孕原因、妊娠结局、辅助生殖技术需求、对性功能的影响以及患者关于 IBD 和妊娠的信息可用性等数据。
共有来自 40 个国家的 257 名 HCPs 和来自 4 个国家的 793 名患者（615 名女性，176 名男性，2 名性别不详；396 名溃疡性结肠炎患者，381 名克罗恩病患者，14 名未确定 IBD 患者）完成了调查。根据 CCPKnow 评分，98.4%的 HCPs 具有良好或非常好的妊娠特异性知识，而仅有 29.3%的患者具有良好或非常好的妊娠特异性知识。在接受调查的女性中，56.3%没有孩子（14.1%是出于自愿选择）。在 266 名女性中，共报告了 427 次妊娠和 401 次活产。22 名女性中的 24 次妊娠（5.6%）需要辅助生殖技术（ART）。与自然受孕相比，ART 妊娠并发症并无增加（5/24；20.8% vs 401/401；20.2%）。四分之三的 IBD 患者（75.6%）进行了母乳喂养。1/5 的男性 IBD 患者（21.9%）存在性功能障碍，而 2/3 的女性（66.1%）报告存在性功能障碍。令人惊讶的是，63%的患者表示未收到任何关于 IBD 和妊娠的信息，只有 10%的患者从 IBD 专家那里获得了信息。此外，42.1%和 36%的 HCPs 已经将患者转介到医学辅助生殖中心，以获得有关其生殖健康和生育力保存（如冷冻保存）选择的一般信息。
IBD 患者对 IBD 对生育力和妊娠的影响知之甚少，HCPs 也未能充分告知患者。IBD 患者需要更多关于这些主题的信息。
