Evaluation of the outcome of assisted reproductive techniques in patients with inflammatory bowel disease: A cross sectional study

Abstract

Objective: Women are two times more affected with inflammatory bowel disease (IBD) than men. The mean age at diagnosis is 11.8 years (median 12.6 years). More women are diagnosed with IBD during their reproductive age. Infertility in patients with IBD may be related to the autoimmune nature of the disease or the associated pelvic pathology. Assisted reproductive technologies are being offered more frequently as treatment option for IBD associated infertility. Little is known about the IVF outcome in those patients. The objective of this study is to evaluate the outcome of IVF in patients with IBD. Tabled 1VariableIBDTubal- FactorIdiopathic InfertilityMale- FactorNo. of IVF cycles14687153FSH treatment duration9.7 ± 2.49.4 ± 1.88.9 ± 1.89.2 ± 1.5No. of FSH amps used40.4 ± 1133.4 ± 12.437 ± 13.837.3 ± 15.8Total oocytes retrieved9 ± 7.814.2 ± 8.312.2 ± 714.4 ± 6.6Fertilization rate (%)58.364.757.155.4Blastocyst rate (%)9.822.91414.5Clinical pregnancy (%)1038.736.143.8Values are expressed as mean ± SD unless otherwise noted. Open table in a new tab Values are expressed as mean ± SD unless otherwise noted. Design: Cross sectional study Materials/Methods: Patients with IBD (n = 14) referred for IVF/ICSI between 1995–2002 were included. The study group was compared to 3 control groups who underwent IVF/ICSI during the same period. Control groups were patients with tubal factor infertility (n = 68), idiopathic infertility (n = 71), and male-factor infertility (n = 53). All 4 groups were comparable regarding age, body mass index, and parity. All laboratory procedures were performed by the same embryologist. Results: There were no statistically significant differences in the parameters of ovulation induction between all groups (table). The total number of oocytes retrieved was not significantly different among the groups as well. Fertilization rates and day 5/6 blastocyst development rates were also comparable among all groups. Patients with IBD showed significantly lower clinical pregnancy rates (10%) compared to patients with tubal factor infertility (38.7%), idiopathic infertility (36.1%), and male-factor infertility (43.8%) (P values were 0.01, 0.03, and 0.01, respectively). Conclusions: Patients with IBD respond adequately to controlled ovarian hyperstimulation. Pregnancy rates in patients with IBD are lower compared to other diagnoses in an IVF setting. Given the autoimmune nature of the disease, poor IVF outcome could be due to an autoimmune process affecting the endometrial receptivity. Supported by: None.