Fertility and IBD Part 3

Can I improve my fertility?

For women, it helps if you can get your IBD under control for at least 3 months before trying to conceive. As your fertility may be being affected by factors other than your IBD, you may also find it helpful to follow some of the suggestions and tips usually given to couples wishing to conceive a child. For example: 

Try to eat a healthy and balanced diet. If this is difficult because of your IBD, you could discuss with your doctor taking some supplements to ensure you get all the nutrients needed. Zinc and vitamin B6 are particularly important for fertility in both men and women. (See our booklet Food and IBD for more information on healthy eating for people with UC or Crohn’s)


For any woman, it is important to take folic acid supplements prior to conception and for the first twelve weeks of pregnancy, to reduce the risk of birth defects. The usual recommendation is 400 micrograms a day. This can be particularly important for women with Crohn’s of the small intestine as their condition can affect folic acid absorption. Sulphasalazine also reduces absorption. If you are on sulphasalazine or if you have had surgery to remove part of the small intestine, you may need to increase your folic acid supplement up to 2 mg (2000 micrograms) a day. Check with your doctor what level of folic acid would suit you.

Women can improve fertility by not smoking and by avoiding alcohol. Regular moderate exercise of around 30 minutes a day can help by maximising your fitness and keeping your weight in check.

Men can increase their likelihood of producing plenty of healthy sperm by not smoking, keeping alcohol drinking within guideline limits (not more than 3-4 units a day), exercising moderately and avoiding stress.

Men can also help their sperm develop properly by keeping their testicles cooler than the rest of the body, for example, by wearing boxer shorts and looser trousers rather than tight underpants and trousers. Ensure that you do not spend all day sitting down. If you sit on your way to work and all day at work, try to find time when you can walk, or take up some exercise or sport.

Sex
When nothing is physically wrong with your fertility, one of the biggest preventers of pregnancy may be the feeling of pressure to have sex at the ‘right’ times every month. It is difficult to be sure exactly when the right time of the month is, despite all modern aids. The stress of feeling you have to make love even if you don’t really feel like it – whether because you are not in the mood or your IBD is playing up – can take a toll on both partners’ ability to conceive. It is probably best, if you can, to try to stay relaxed and keep sex as a pleasure you share when you both want to, rather than testing and temperature-taking daily to work out when ovulation should occur. 

What if I still can’t get pregnant? 

If you have been trying to have a baby without success for some time (for more than 18 months if you are under 35 or more than 6 months if you are over 35) you can ask to be referred to a fertility clinic. It may be nothing to do with your IBD. A great many couples without IBD have problems with fertility. One in seven of all couples trying to have a child cannot conceive without help. So, if you wish to have a child but there is a problem, you should not necessarily assume that your IBD is the cause. 


Occasionally, women with Crohn’s may find it harder to be accepted for fertility investigations and treatment, and it may be helpful if your gastroenterologist can liaise with the gynaecologist about the likely effects of Crohn’s on your fertility.

If you feel worried that the two specialist departments are not fully aware of each other’s views, then it may be worth deciding which of your doctors you find most approachable and arranging an appointment to discuss your concerns.

For a list of other helpful organisations and their contact details, visit our information leaflet Fertility and IBD.