What is the rate of infertility in women after IPAA for UC

What is known

- The pooled meta-analysis found an approximately threefold increased risk of infertility post-IPAA versus medical management for UC. ^1,2 - An IVF-referral case-control series reported a global infertility rate of 27% (11/15 conceived), with year-specific rates of 41%, 21%, and 10% at 1, 2, and 3 years after IPAA. ² - An earlier cohort using the standard 1-year definition reported 9% infertility after IPAA versus 2% before surgery. ³ - Laparoscopic/minimally-invasive IPAA appears to reduce adhesions and infertility relative to open surgery. ^4,5

What is unknown / caveats

- Individual-series rates span ~9% to ~40%, driven by differing infertility definitions, follow-up length, and open vs laparoscopic technique - Most primary studies are retrospective/cross-sectional with small pouch cohorts - No single retrieved study reports one definitive population rate - A precise single-point infertility rate cannot be pinned down from the retrieved evidence given heterogeneous definitions and cohorts.

## References

1. Waljee A, Waljee J, Morris AM, Higgins PD. Threefold increased risk of infertility: a meta-analysis of infertility after ileal pouch anal anastomosis in ulcerative colitis. Gut. 2006;55:1575-80. PMID: 16772310.

2. Pabby V, Oza SS, Dodge LE, Hacker MR, Moragianni VA, Correia K, Missmer SA, Fox JH, Ibrahim Y, Penzias A, Burakoff R, Cheifetz A, Friedman S. In Vitro Fertilization Is Successful in Women With Ulcerative Colitis and Ileal Pouch Anal Anastomosis. Am J Gastroenterol. 2015;110:792-7. PMID: 25512339.

3. Scott HJ, McLeod RS, Blair J, O'Connor B, Cohen Z. Ileal pouch-anal anastomosis: pregnancy, delivery and pouch function. Int J Colorectal Dis. 1996;11:84-7. PMID: 8739832.

4. PMID: 29857942. (metadata not in corpus)

5. Indar AA, Efron JE, Young-Fadok TM. Laparoscopic ileal pouch-anal anastomosis reduces abdominal and pelvic adhesions. Surg Endosc. 2009;23:174-7. PMID: 18855064.

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_Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct._