Crohn’s disease is a type of inflammatory bowel disease (IBD). More than half a million people in the United States have it. There’s no cure, but treatments can effectively manage it and bring relief.

People with Crohn’s disease may be concerned about how their condition might affect their fertility, or the ability to conceive children. Inflammation, nutritional deficiencies, certain medications, and surgery can all impact your fertility and sexual health when you have IBD.

People with Crohn’s have higher rates of mental health conditions, like depression and anxiety, which can decrease libido. Symptoms of IBD can also make people feel self-conscious about their bodies and intimacy.

“Many people with the disease are able to have babies. We know a lot about how Crohn’s affects fertility, but we still have a long way to go.”

Women who have IBD (including Crohn’s and ulcerative colitis) have similar fertility rates as women who do not, according to a 2021 review of medical literature. Women with IBD do have a higher risk of complications, like preterm delivery and cesarean delivery, though findings are mixed.

Women who have Crohn’s may have slightly lower fertility rates than the general population, according to a 2015 U.K. study and a 2021 Swedish study. The latter study concluded that bowel resection surgery and perianal disease brought down fertility outcomes when Crohn’s was present.

In another 2021 review, women with Crohn’s disease were found to have infertility rates of 3 to 15 percent. This is slightly higher than infertility rates of women without Crohn’s, which ranges from 2.4 to 14 percent.

“Many researchers believe that men with Crohn’s disease have the same fertility rates as the general population. Men who are taking certain types of medication might be the exception.”

The medication sulfasalazine is often used for treating Crohn’s disease. It can temporarily reduce sperm count and the viability of the sperm that’s produced. It can take several months for sperm to return to healthy levels after sulfasalazine treatment.

A note on gender and sex terminology

Most research surrounding fertility and IBD separates participants into male and female sex categories and uses gender and sex terminology interchangeably. Gender and sex are not the same, and both occur on a spectrum.

“We have to use the language of the authors in our summaries. Healthline acknowledges that medical research often doesn’t represent everyone equally and we should all strive for more inclusive practices.”

People of all genders and sexes can have IBD, and may experience fertility and sexual health effects. It is important to find a doctor that you trust and can give you an individualized approach to your care.

“There is no single component that damages someone’s fertility. Many people with IBD have no effect on fertility or libido.”

There are a variety of factors that may become issues for someone with IBD trying to conceive children.

Some common concerns and research findings are discussed.

Crohn’s and getting pregnant

Women with Crohn’s may have difficulty getting pregnant after a colon resectioning surgery. This type of surgery can sometimes damage reproductive organs and leave scar tissue in the area.

“There is concern that inflammation from Crohn’s that isn’t being managed well could decrease your chances of having a baby.”

Crohn’s and being pregnant

Some studies have suggested that people with poorly managed IBD symptoms may have higher miscarriage rates than people who don’t have IBD. It’s also not yet clear whether IBD can increase the chances of having a child with congenital disorders.

If you were in good health when you got pregnant, you can still have a flare up of the disease. If you have an IBD, you should have active treatment during your pregnancies and work with your doctor to address any symptoms that arise.

Crohn’s and sperm count

A 2019 review of 14 studies found that quality studies on how all types of IBD affect male fertility are lacking.

“Most people with Crohn’s have no problem with normal levels of healthy sperm. Sperm quality can be reduced by taking medication for Crohn’s. Changing to a different medication for a while is usually the solution to this issue.”

Crohn’s and choosing to be child-free

Some people with crosius may view their condition as an obstacle to pregnant women. They may not try to have children because of their health concerns.

Medical literature points to widespread misconceptions about Crohn’s and fertility as part of the reason many people with Crohn’s forego having children.

While there’s research suggesting IBD can affect fertility and reproductive health, many people with Crohn’s are able to have healthy, safe pregnancies. Managing Crohn’s symptoms effectively is key.

It is important to remember that not everyone wants children. Some people with crosius disease may decide to be child-free solely because of it.

Your sexual and reproductive health is yours to control. Everyone deserves access to the information and care surrounding fertility that they need, but no one should be judged for their own sexual and reproductive health decisions.

If you have a disease that makes it hard to start or expand a family, there are steps you can take to have the best outcome.

Achieve remission

“The primary goal is to get your Crohn’s into remission through effective treatment. The best pregnancy outcomes are achieved by people who have managed crosiles well.”

One 2021 review found that women who had active IBD at the time they conceived had twice the risk of ongoing symptoms during their pregnancy than people who started their pregnancy during a time of remission.

Delaying surgery

If you want to have children, you may want to delay any surgeries until you are done. It is best to discuss this with your doctor, as it is not always an option due to disease progression.

Learn more about the types of surgery used to treat Crohn’s disease and ulcerative colitis.

Changing medication

“Certain medications can affect sperm count and quality in men, but they won’t affect fertility.”

Talk to your doctor about long-term medication side effects regardless of your parenting goals.

Other reproductive options

Some people with the disease may choose to adopt rather than have a baby.

It’s also possible to freeze eggs or sperm for later use, should you have concerns over your fertility due to Crohn’s symptoms or treatments, such as surgery.

Young men who have Crohn’s are often advised to bank sperm ahead of a proctocolectomy (removal of colon and rectum) or other surgery.

“Sexual performance can be affected by surgery for Crohn’s. This may make it more difficult to have a baby.”

Addressing nutritional deficiencies

“The impact of IBD can affect your body’s ability to absorb necessary vitamins and minerals from food.”

Over time, this can lead to malnutrition, which may prevent your body from successfully carrying out its functions, including reproductive systems. Malnutrition symptoms can include weight loss, anemia, and fatigue.

Iron, calcium, and vitamins B12 and B6 are some of the vitamins that people with IBD have.

Nutritional modifications can be a way to improve fertility outcomes for men, even if you don’t have IBD. Working with a nutritionist to adjust your diet or add nutrient supplements can help. It’s important to always take any vitamins and supplements exactly as directed.

If you are pregnant or trying to become pregnant, you should tell your doctor about all your medication.

Crohn’s can affect your sexual health in ways that go beyond fertility. People with Crohn’s disease often report low self-esteem and anxiety surrounding sex due to their condition.

“People with IBD feel self-conscious about their bodies because of their chronic gastrointestinal symptoms. Recovering from surgery for Crohn’s disease can cause you to avoid sex for weeks to months.”

There’s also the mental health component of Crohn’s that can further affect body image, relationships, and intimacy. Crohn’s disease and ulcerative colitis are linked to an increased chance of depression and anxiety. Depression, and some medications used to treat it, can also be responsible for lowering libido.

Being a person with any type of IBD is nothing to be ashamed of. You deserve a partner who will accept you and support you no matter what.

“It is possible to seek mental health care and treatment with your Crohn’s management.”

A 2021 study found sexual dysfunction in people with IBD was not resolved by treating Crohn’s alone. Researchers advised incorporating mental and sexual health care approaches in addition to managing IBD symptoms.

More than one treatment approach

There’s a wide variety of options for people looking to get professional support for their mental and sexual health in relation to a chronic condition.

Learn more about talk therapy and sex therapy to decide what might be the next best steps for you.

“People with a disease like Crohn’s have similar fertility rates as people without it.”

Inflammation and Complications from IBD can lead to deficiencies in nutrition and can impact fertility. Your body can change with medication and surgery.

“More research is needed to understand the effects of Crohn’s on fertility and reproductive health. If you are considering getting pregnant and have a disease, you should talk to your gastroenterologist about risk factors and how to prepare for parenthood.”