ArticleInternational journal of colorectal disease2025
Current status of fertility rates and modes of delivery after restorative proctocolectomy with ileal pouch-anal anastomosis.
Article in International journal of colorectal disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Fertility and mode of delivery after ileal pouch-anal anastomosis for ulcerative colitis: A population-based study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Article
- Suture Materials: Conventional and Stimulatory-Responsive Absorbable Polymers with Biomimetic Function.Biomimetics (Basel, Switzerland) · 2025Review
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9 authors.
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Abstract
purposeAfter restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA), fertility rates decline, and cesarean section (CS) has been the preferred mode of delivery. We aimed to assess the current trends and outcomes of pregnancy and delivery in patients who underwent RPC with IPAA.
methodsThis retrospective cohort study included 386 patients who underwent RPC with IPAA for UC between 2007 and 2023. Clinical data were collected through a chart review. Surgical techniques were mainly one- or modified two-stage RPC with stapled IPAA. The fallopian tube traction technique was applied to prevent adhesions. Fertility rates and delivery outcomes were also examined.
resultsAmong 83 females of < 40 years of age, 18 attempted pregnancy after surgery. Natural conception was achieved in 14 cases (78%), and 2 cases were conceived through in vitro fertilization, resulting in a total of 16 pregnancies (89%). Among the 15 births, 11 (73%) were vaginal deliveries (VD), and 4 (27%) were CS. The reasons for CS included breech presentation (2 cases), prior CS (1 case), and a history of rectovaginal fistula (1 case). One VD case required episiotomy and the other experienced a perineal tear. However, there were no significant differences in postpartum defecation between the VD and CS groups.
conclusionFertility after RPC with IPAA appears to have improved compared to previous reports, possibly due to the prevention of fallopian tube adhesions. After a stapled IPAA, VD is a feasible option, and CS is not universally required solely because of the history of IPAA.
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