Fertility Treatment Often Works Well in Women With IBD

TOPLINE In a prospective study of women with inflammatory bowel disease (IBD), 73% of those who underwent intrauterine insemination (IUI) and/or embryo transfer (ET) achieved pregnancy. Success was far higher with ET than with IUI alone, and neither active disease nor prior IBD-related surgery showed a significant association with outcomes.

METHODOLOGY Women with IBD, especially those who have had pelvic surgery, often have reduced fertility. Guidance suggests that assisted reproduction may work about as well in women with and without IBD, but prospective data on how these treatments are used and what predicts success in this group are sparse.

Researchers analyzed data from the WIsDoM registry, launched in 2021 across more than 30 US and Canadian sites. It enrolled 421 women with IBD aged 18-45 years who planned to conceive within 15 months; 67 of them underwent at least one type of fertility treatment. Of these 67 women, 52 tried conceiving using IUI alone (13 women) or ET with or without IUI (39 women).

Together, they made 97 attempts, 49 using IUI and 48 using ET. The remaining 15 women had eggs retrieved but did not undergo ET during the study. Women completed a baseline survey and then monthly online questionnaires about their fertility treatment and pregnancy outcomes, and the responses were adjudicated with medical records.

The main goal was to see how often fertility treatment led to pregnancy. Researchers also compared women who underwent treatment to those who did not and looked at whether factors such as demographics, disease characteristics, prior surgery, and reproductive factors were associated with success.

TAKEAWAY Women who did vs did not undergo fertility treatment were older (median age, 34 vs 32 years), had tried to conceive longer (11 vs 2 months), and were more likely to have had prior fertility treatment (31.3% vs 8.8%) and pelvic IBD surgery (16.4% vs 5.4%). Active disease was more common in the treated group (56.7% vs 43.5%), but the difference was not statistically significant.

Pregnancy occurred in 38 of 52 women (73%) who underwent IUI and/or ET. Success was 85% (33 of 39) with ET, with or without IUI, vs 38% (5 of 13) with IUI alone. Per attempt, 40 of 97 (41%) attempts resulted in pregnancy, with ET succeeding in 35 of 48 attempts (73%) compared with 5 of 49 (10%) for IUI; after adjustment, the odds of pregnancy were 44 times higher with ET (95% CI, 8.9-221), and the advantage was seen regardless of whether a woman had previously tried IUI.

Active disease and prior IBD surgery were not associated with treatment success. Among the nine women who had pelvic IBD surgery, all seven who underwent ET became pregnant compared with none of the two who tried IUI alone. IN PRACTICE "These findings support ART [assisted reproductive technology] as a viable reproductive option for women with IBD, including those with prior IBD surgery," the authors wrote.

SOURCE The study was led by Eugenia Shmidt, MD, University of Minnesota, Minneapolis, and Zoë S. Gottlieb, MD, Icahn School of Medicine, Mount Sinai Medical Center, New York City. It was presented at the American College of Gastroenterology (ACG) 2026 Annual Scientific Meeting in Nashville, Tennessee.

LIMITATIONS The study did not mention any limitations explicitly. DISCLOSURES Multiple authors disclosed receiving consulting fees, having advisory board roles, participating in speakers bureau, or receiving research support from several pharmaceutical companies. This article was created using several editorial tools, including AI, as part of the process.

Human editors reviewed this content before publication.