eP407 - Impact of Ileal Pouch Anal Anastomosis on Fertility in Female Patients with Ulcerative Colitis: A Systematic Review

Sunday, June 2, 2024

2:15 PM – 2:20 PM ET, USA

Location: Baltimore Convention Center, Room 318-320

ePoster Presenter(s)

Rehab Alsayari, MD

Resident
McMaster University
McMaster University
Hamilton, ON, Canada

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

CE

Cagla Eskicioglu, MD, Msc, FRCSC

Associate Professor, Colon & Rectal Surgeon
Faculty of Health Sciences, McMaster University
Hamilton, Ontario, Canada

Disclosure information not submitted.

Author(s)

Tyler McKechnie, MD, MSc (he/him/his)

Resident Physician
McMaster University
McMaster University
Hamilton, ON, Canada

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
SI

Simarpreet Ichhpuniani, MD

Resident
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Calgary, Alberta, Canada

Disclosure information not submitted.
YL

Yung Lee, MD MPH

Resident
McMaster University
Hamilton, Ontario, Canada

Disclosure information not submitted.

Purpose/Background: Ulcerative colitis remains a common disorder that affects females during their reproductive years. Younger individuals with strong baseline continence who understand and accept the concomitant changes in bowel function following the procedure are typically advised to undergo Ileal-Pouch Anal Anastomosis (IPAA). For certain patient populations, IPAA can significantly improve quality of life (QoL). This systemic review was conducted to ascertain the likelihood of infertility and the success of pregnancy in these patients, particularly after there has been an increase in the use of minimally invasive methods for these operations, which may be linked to a decreased risk of infertility and a shorter time to childbirth. The aim of this review is to study the impact of IPAA on fertility in females with Ulcerative colitis.Methods/Interventions: OVID Medline, Embase, and CENTRAL were systematically searched for studies investigating females with ulcerative colitis undergoing IPAA. The primary outcome was infertility. The secondary outcome was pregnancy. Meta-analyses were performed with inverse variance random effects.Results/Outcomes: From 124 citations, nine studies were included. According to this study's results, which are in line with prior reviews, females' infertility risk is 29% (95%CI 19-40%, I2=82.2%), while chances of becoming pregnant following IPAA are 32% (95%CI 22-42%, I2=83%). These numbers are lower than previously reported, although studies have high levels of heterogeneity.Conclusion/

Discussion: Infertility continues to be an issue for females with ulcerative colitis who undergo IPAA. It is necessary to conduct larger, prospective comparative studies to assess the true effect of the procedure and the role of minimally invasive methods in reducing the effect.