In a prospective cohort study presented at the American College of Gastroenterology annual meeting, assisted reproductive technology helped most women with inflammatory bowel disease become pregnant, but the type of procedure mattered greatly. Among 52 women who underwent fertility treatment, 73% achieved pregnancy. However, success was concentrated in embryo transfer: 73% of embryo transfer attempts led to pregnancy, versus just 10% of intrauterine insemination attempts.
The analysis included 97 fertility treatment attempts from the WIsDoM study, which enrolled women ages 18-45 with IBD planning pregnancy. After adjustment for confounders, the odds of pregnancy with embryo transfer were 44 times higher than with IUI. Once the procedure type was accounted for, factors such as disease activity, prior IBD surgery, and disease duration were not significantly associated with failure, suggesting embryo transfer can overcome mechanical barriers from pelvic adhesions.
The authors highlighted a striking subgroup: among nine women with prior IBD-related pelvic surgery, all seven who underwent embryo transfer conceived, while neither of the two who used IUI alone did. They concluded that clinicians should consider early referral to IVF and embryo transfer rather than prolonged IUI trials, especially for women with prior pelvic surgery. The findings are from a single observational study presented at a meeting and have not yet been peer-reviewed.