Oluwatosin Tolulope Ajidahun explains that inflammatory bowel diseases (IBD), such as Crohn’s disease and ulcerative colitis, do not only affect the digestive system. These chronic conditions, marked by persistent inflammation, also have a significant impact on the reproductive health of both men and women. This effect occurs both directly—by altering hormones and essential biological processes for reproduction—and indirectly, by impairing nutritional status and increasing physical and emotional stress.
Understanding the Link Between IBD and Fertility
IBD are autoimmune disorders in which the immune system mistakenly attacks parts of the gastrointestinal tract, causing continuous lesions and inflammation. This inflammation is not confined to the intestines—pro-inflammatory molecules circulate throughout the body, reaching organs and tissues, including the reproductive system.
According to Oluwatosin Tolulope Ajidahun, chronic inflammation can disrupt the hypothalamic-pituitary-gonadal axis, which controls ovulation and sperm production. Additionally, poor intestinal function can impair the absorption of key nutrients such as iron, zinc, vitamin B12, vitamin D, and folic acid—all of which are vital for fertility.
Another important factor is that disease flare-ups often require the use of strong anti-inflammatory and immunosuppressive drugs, some of which may temporarily reduce fertility or affect gamete quality.
Effects on Female Fertility
In women, IBD can cause changes in the menstrual cycle, leading to delays, irregularities, or even amenorrhea (absence of menstruation), especially when the disease is active. Deficiencies in essential nutrients may impair egg maturation and hinder endometrial thickening, making embryo implantation more difficult.
Tosyn Lopes emphasizes that pelvic inflammation, caused by post-surgical adhesions or intestinal complications, may reduce the mobility of the fallopian tubes, interfering with the meeting of egg and sperm. Moreover, beginning a pregnancy during an active IBD flare increases the risk of preterm birth, low birth weight, and maternal complications.
Effects on Male Fertility
In men, the systemic inflammation caused by IBD can lower testosterone levels, affecting libido and erectile function. The excess of free radicals associated with the inflammatory process can also damage sperm motility and morphology.
According to Tosyn Lopes, certain medications used in treatment, such as methotrexate or some immunosuppressants, may reduce semen quality. Therefore, men of reproductive age should discuss the possibility of sperm preservation with their doctor before starting therapies that could impact fertility.
Strategies to Preserve Fertility
Managing IBD with a focus on fertility preservation requires a multidisciplinary approach involving gastroenterologists, gynecologists, urologists, and reproductive specialists. The first step is achieving and maintaining disease remission, which helps reduce systemic inflammation and allows reproductive function to recover.
Oluwatosin Tolulope Ajidahun suggests that pregnancy planning should occur during a period of clinical stability lasting at least six months. During this time, it is essential to correct nutritional deficiencies, adopt an anti-inflammatory diet rich in fruits, vegetables, lean proteins, and healthy fats, and ensure adequate intake of essential vitamins and minerals.
From Inflammation to a Positive Test: Overcoming Barriers
Inflammatory bowel diseases present significant challenges for those who wish to become parents, but they do not rule out motherhood or fatherhood. With proper treatment, medical guidance, and preventive strategies, it is possible to minimize the disease’s impact on reproductive capacity.
Tosyn Lopes concludes that each case must be assessed individually, taking into account the stage of IBD, current treatments, and the patient’s goals. This way, a personalized plan can be created to ensure safety and improve the chances of successful conception and a healthy pregnancy.
Author: Eura Tymal
The images shared in this post were provided by Oluwatosin Tolulope Ajidahun, who holds legal authorization for the use of the likeness of all individuals depicted.
