welcome to oneFAPvoice
- a positively charged Familial Adenomatous Polyposis community.- join today!
- login
Impact of Ileal Pouch-Anal Anastomosis on Female Fertility: Meta-analysis and Systematic Review
source: International Journal of Colorectal Disease
year: 2011
authors: Rajaratnam S G, Eglinton T W, Hider P, Fearnhead N S
summary/abstract:PURPOSE:
The aim of this review is to determine the effect of ileal pouch-anal anastomosis (IPAA) on female fertility in ulcerative colitis (UC) and familial adenomatous polyposis (FAP), the mechanisms of this effect, strategies for prevention and management of infertility post-IPAA.
METHODS:
This paper is a systematic literature review of all articles investigating IPAA and fertility from 1966 onwards that were found searching the Medline and Embase databases. Meta-analysis was performed on relevant studies.
RESULTS:
Seventeen relevant studies were identified. Six studies were excluded (duplicate data, one; predominantly not IPAA patients, one; no control group, four). The control groups of the remaining 11 studies were too varied for comparison, and so the meta-analysis was limited to six studies that provided data on infertility both pre- and post-IPAA. Five of these involved predominantly UC patients and one FAP. Average infertility rates were 20% pre-IPAA and 63% post-IPAA. The relative risk of infertility after IPAA is 3.91 ([2.06, 7.44] 95% CI). The possibility of publication bias suggests that the risk may be lower. Any increased risk is probably due to tubal dysfunction secondary to adhesions. Various methods have been proposed to reduce pelvic adhesions, but there is no evidence they have any effect in preventing infertility. Infertility treatment post-IPAA is associated with good success rates.
CONCLUSIONS:
Infertility is increased after IPAA in female patients in both UC and FAP. Both these disease processes affect patients during their reproductive years. This evidence emphasizes the need for careful consideration of fertility in the choice and timing of surgery.
DOI: 10.1007/s00384-011-1274-9
read more full text source
expertly curated content related to this topic
-
Patterns of Adenoma Recurrence in Familial Adenomatous Polyposis Patients After Ileal Pouch-Anal AnastomosisAIM : This study aims at identifying the...
-
ivette moya’s storyHi, my name is Ivette Moya. I live in Pe...
-
Pancreatic Enzyme Replacement TherapyPancreatic enzymes help digest fat, prot...
-
Discrepancies in Biopsy Results in Pre- Versus Post-Endoscopic AmpullectomiesAbstract Purpose: Endoscopic ampullec...
-
Risk of Cancer and Secondary Proctectomy After Colectomy and Ileorectal Anastomosis in Familial Adenomatous Polyposi...PURPOSE : The aim of our retrospective s...
-
A Total Laparoscopic Approach Reduces the Infertility Rate after Ileal Pouch-Anal Anastomosis: A 2-Center StudyOBJECTIVE: To assess the infertility ra...
-
Evaluation of 28 Years of Surgical Treatment of Children and Young Adults with Familial Adenomatous PolyposisBACKGROUND : In this retrospective study...