Evidence map›Paper›PMID 34056529›Full record

ArticleJournal of the Canadian Association of Gastroenterology2021

Surgery for Inflammatory Bowel Disease Has Unclear Impact on Female Fertility: A Cochrane Collaboration Systematic Review.

Sangmin Lee, Megan Crowe, Cynthia H Seow, Paulo G Kotze, Gilaad G Kaplan, Amy Metcalfe, Amanda Ricciuto, Eric I Benchimol, M Ellen Kuenzig

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the Canadian Association of Gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Conception, pregnancy and inflammatory bowel disease-Current concepts for the practising clinician.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026
    Review
  2. Influence of biological sex in inflammatory bowel diseases.Nature reviews. Gastroenterology & hepatology · 2025
    Review
  3. Review
  4. Review
  5. Review
  6. Article
  7. Review
  8. Review
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sangmin LeeDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Megan CroweSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Cynthia H SeowDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.ORCID https://orcid.org/0000-0002-1551-9054
Paulo G KotzeIBD Outpatients Clinic, Colorectal Surgery Unit, Catholic University of Paraná (PUCPR), Curitiba, Brazil.ORCID https://orcid.org/0000-0002-9632-6691
Gilaad G KaplanDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.ORCID https://orcid.org/0000-0003-2719-0556
Amy MetcalfeDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Amanda RicciutoDivision of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada.
Eric I BenchimolSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.ORCID https://orcid.org/0000-0001-8855-3598
M Ellen KuenzigChildren's Hospital of Eastern Ontario (CHEO) Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario and CHEO Research Institute, Ottawa, Ontario, Canada.ORCID https://orcid.org/0000-0002-3984-8426

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsSurgical treatment of inflammatory bowel disease (IBD) may impair female fertility. We conducted a systematic review to determine the risk of infertility and pregnancy outcomes in women with IBD who underwent surgery.

methodsWe identified studies evaluating the impact of IBD surgery on infertility and pregnancy outcomes. Risk ratios (RR) and 95% confidence intervals (CIs) were pooled when data were presented using contingency tables. Odds ratios (OR) were pooled when raw numbers were not provided. GRADE was used to evaluate the certainty of evidence.

resultsSixteen observational studies were included, comparing women with and without surgery, open and laparoscopic surgery and before and after surgery. All studies were of low quality. The effect of surgery on infertility at 12 months (RR 5.45, 95% CI 0.41 to 72.57) was uncertain. Similarly, the fertility effects of laparoscopic versus open surgery method were unclear (RR 0.70, 95% CI 0.38 to 1.27). The impact of IBD surgery on pregnancy outcomes should be interpreted with caution. Surgery was associated with miscarriage (OR 2.03, 95% CI 1.14 to 3.60), use of assisted reproductive technologies (RR 25.09, 95% CI 1.56 to 403.76) and caesarean section (RR 2.23, 95% CI 1.00 to 4.95), but not with stillbirth (RR 1.96, 95% CI 0.42 to 9.18), preterm birth (RR 1.91, 95% CI 0.67 to 5.48), low birth weight (RR 0.61, 95% CI 0.08 to 4.83) or small for gestational age (RR 2.54, 95% CI 0.80 to 8.01).

conclusionThe effect of surgical therapy for IBD on rates of female infertility and pregnancy-related outcomes was uncertain due to poor quality of existing literature.

Indexed as

Crohn’s diseaseFertilityInfertilityInflammatory bowel diseaseSurgeryUlcerative colitis

Identifiers

PMID34056529
PMCPMC8158647

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.