Inflammatory bowel disease has a negative impact on patients reproductive behaviour: the first multicentre survey in the Czech Republic

Abstract

Background: Several previous studies reported the negative impact of inflammatory bowel disease (IBD) on reproductive plans and fertility rate. The aim of our study was to investigate, for the first time, reproductive attitudes and fertility rate among Czech patients with IBD. Methods: Between March and August 2019, consecutive patients with IBD from 22 centres across the Czech Republic responded anonymously to a predefined questionnaire focused on the patients’ demographics, details of IBD and treatment, gynaecological/urological history, reproductive issues and patients’ knowledge on this topic. Results: The questionnaire was filled in by 798 patients (526 women; median age 34 years, 66% with Crohn’s disease). Of these, 58% of the females and 47.1% of the males already had ≥ 1 child (median 2 children). Women with IBD were significantly more worried about infertility (55.5% versus 22.4%), had more limitations in their sexual life (53.2% vs. 26.8%) and more frequently changed their earlier reproductive plans (27.6% versus 11.0%) than the males (p < 0.0001). The total fertility rate in female IBD patients was lower compared to the general population with 1.004 live births/IBD woman versus 1.69 live births/woman in the Czech population. The pattern of decreased fertility was observed in all age-specific categories. Of the childless patients, 14% of the women and 18.1% of the men were voluntarily childless. Approximately one-half of them indicated their IBD to be the primary cause. Conclusions: IBD seems to have a negative impact on patients’ reproductive plans and attitudes. The fertility rate in Czech IBD female patients was decreased compared to the general population in this study.