Crohn’s disease is a type of inflammatory bowel disease (IBD). More than half a million people in the United States have it. There’s no cure, but treatments can effectively manage it and bring relief.

People with Crohn’s disease may be concerned about how their condition might affect their fertility, or the ability to conceive children. Inflammation, nutritional deficiencies, certain medications, and surgery can all impact your fertility and sexual health when you have IBD.

People with Crohn’s have higher rates of mental health conditions, like depression and anxiety, which can decrease libido. Symptoms of IBD can also make people feel self-conscious about their bodies and intimacy.

Many people who have Crohn’s are able to safely conceive. Research to understand how Crohn’s affects fertility is still ongoing, but let’s take a look at what we know so far.

Women who have IBD (including Crohn’s and ulcerative colitis) have similar fertility rates as women who do not, according to a 2021 review of medical literature. Women with IBD do have a higher risk of complications, like preterm delivery and cesarean delivery, though findings are mixed.

Women who have Crohn’s may have slightly lower fertility rates than the general population, according to a 2015 U.K. study and a 2021 Swedish study. The latter study concluded that bowel resection surgery and perianal disease brought down fertility outcomes when Crohn’s was present.

In another 2021 review, women with Crohn’s disease were found to have infertility rates of 3 to 15 percent. This is slightly higher than infertility rates of women without Crohn’s, which ranges from 2.4 to 14 percent.

Many researchers currently believe that men who have well-managed Crohn’s disease have the same fertility rates as the general population (or people without IBD). The exception to this might be men who are taking certain types of Crohn’s medication.

The medication sulfasalazine is often used for treating Crohn’s disease. It can temporarily reduce sperm count and the viability of the sperm that’s produced. It can take several months for sperm to return to healthy levels after sulfasalazine treatment.

A note on gender and sex terminology

Most research surrounding fertility and IBD separates participants into male and female sex categories and uses gender and sex terminology interchangeably. Gender and sex are not the same, and both occur on a spectrum.

In summarizing scientific articles or studies for our readers, we have to use their language to preserve intent and accuracy. However, Healthline acknowledges that medical research often doesn’t represent everyone equally, and we should all strive toward more inclusive practices.

People of all genders and sexes can have IBD, including Crohn’s disease, and may also experience fertility and sexual health effects. Finding a doctor you trust and receiving an individualized approach to your care is essential.

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There’s no single component of IBD that damages someone’s fertility. Many people with IBD will have little to no effects on fertility or libido.

However, there are a variety of factors that, separately or together, may become issues for someone with IBD trying to conceive children.

Let’s look at some common concerns and research findings.

Crohn’s and getting pregnant

Women with Crohn’s may have difficulty getting pregnant after a colon resectioning surgery. This type of surgery can sometimes damage reproductive organs and leave scar tissue in the area.

There’s also concern that pelvic inflammation from Crohn’s that isn’t being managed well with medication could decrease your chances of conceiving.

Crohn’s and being pregnant

Some studies have suggested that people with poorly managed IBD symptoms may have higher miscarriage rates than people who don’t have IBD. It’s also not yet clear whether IBD can increase the chances of having a child with congenital disorders.

There’s a chance Crohn’s can flare during pregnancy, even if you were in remission when you got pregnant. This is why it’s essential to have active treatment for your IBD during pregnancy and work with your doctor to safely address any symptom flare-ups should they arise.

Crohn’s and sperm count

A 2019 review of 14 studies found that quality studies on how all types of IBD affect male fertility are lacking.

From what we do know, it seems most people with Crohn’s have no issue with having normal levels of healthy, viable sperm. Medications for Crohn’s, especially sulfasalazine, can cause a temporary reduction in sperm quality and sperm count. Switching to a different medication for several months typically solves this issue.

Crohn’s and choosing to be child-free

Some people with Crohn’s may view their condition as an obstacle to pregnancy. They may avoid trying to conceive children out of concern for their health.

Medical literature points to widespread misconceptions about Crohn’s and fertility as part of the reason many people with Crohn’s forego having children.

While there’s research suggesting IBD can affect fertility and reproductive health, many people with Crohn’s are able to have healthy, safe pregnancies. Managing Crohn’s symptoms effectively is key.

It’s important to remember not everyone wants children. Some people may make the personal decision to be child-free due in part to their Crohn’s disease, or completely irrespective of it.

Your sexual and reproductive health is no one’s business but your own. While everyone deserves access to the information and care surrounding fertility that they need, no one should face judgment for the decisions they make regarding their own sexual and reproductive health.

If you’re planning to start or expand your family and you have Crohn’s disease, there are steps you can take to have the best outcome possible.

Achieve remission

Getting your Crohn’s into remission (having no major symptoms) through effective treatment is the primary goal. Crohn’s that’s managed well and in remission results in the best pregnancy outcomes.

One 2021 review found that women who had active IBD at the time they conceived had twice the risk of ongoing symptoms during their pregnancy than people who started their pregnancy during a time of remission.

Delaying surgery

If you want to pursue pregnancy, you may want to delay any surgeries for IBD until you are finished having children. Of course, this isn’t always an option due to disease progression, so it’s best left to you and your doctor to discuss.

Learn more about the types of surgery used to treat Crohn’s disease and ulcerative colitis.

Changing medication

Medications used to manage IBD in women won’t generally affect fertility, but certain medications can impact sperm count and quality in men.

Regardless of your parenting goals, always talk with your doctor about long-term medication side effects.

Other reproductive options

Some people with Crohn’s may choose to adopt children rather than pursue pregnancy.

It’s also possible to freeze eggs or sperm for later use, should you have concerns over your fertility due to Crohn’s symptoms or treatments, such as surgery.

Young men who have Crohn’s are often advised to bank sperm ahead of a proctocolectomy (removal of colon and rectum) or other surgery.

Surgery for Crohn’s can affect sexual performance as well as libido in some cases. This may make pregnancy more difficult.

Addressing nutritional deficiencies

Crohn’s and other forms of IBD can impact your body’s ability to successfully absorb necessary nutrients from the food you eat, causing health concerns.

Over time, this can lead to malnutrition, which may prevent your body from successfully carrying out its functions, including reproductive systems. Malnutrition symptoms can include weight loss, anemia, and fatigue.

Iron, calcium, and vitamin B12 are just a few of the common micronutrient deficiencies in people with IBD.

Nutritional modifications can be a way to improve fertility outcomes for men, even if you don’t have IBD. Working with a nutritionist to adjust your diet or add nutrient supplements can help. It’s important to always take any vitamins and supplements exactly as directed.

If you are pregnant or trying to become pregnant, tell your doctor about every medication or supplement you take.

Crohn’s can affect your sexual health in ways that go beyond fertility. People with Crohn’s disease often report low self-esteem and anxiety surrounding sex due to their condition.

Chronic, intense gastrointestinal symptoms and unpredictable flares can make people with IBD feel self-conscious about their bodies. And recovering from surgery for Crohn’s disease can require you to avoid sex for weeks to months to fully heal.

There’s also the mental health component of Crohn’s that can further affect body image, relationships, and intimacy. Crohn’s disease and ulcerative colitis are linked to an increased chance of depression and anxiety. Depression, and some medications used to treat it, can also be responsible for lowering libido.

Having any type of IBD, including Crohn’s, is nothing to be ashamed of. No matter what your symptoms or disease progression with IBD, you deserve a partner who supports and accepts you fully.

It may be necessary to seek mental health care and treatment alongside your Crohn’s management.

A 2021 study found sexual dysfunction in people with IBD was not resolved by treating Crohn’s alone. Researchers advised incorporating mental and sexual health care approaches in addition to managing IBD symptoms.

More than one treatment approach

There’s a wide variety of options for people looking to get professional support for their mental and sexual health in relation to a chronic condition.

Learn more about talk therapy and sex therapy to decide what might be the next best steps for you.

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Research indicates that people who are effectively managing their Crohn’s disease have similar fertility rates as those without any type of IBD.

Complications from Crohn’s or another form of IBD can lead to nutritional deficiencies and inflammation, which can impact fertility. Medication and surgery can also change your body’s reproductive processes.

More research is needed to better understand Crohn’s effects on fertility and reproductive health. If you’re considering getting pregnant and have Crohn’s disease, talk with your gastroenterologist about risk factors and how best to prepare for parenthood.