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Factors Associated with the Success of In Vitro Fertilization in Women with Inflammatory Bowel Disease

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Abstract

Background

It is unknown whether certain factors are associated with the success of in vitro fertilization (IVF) in women with inflammatory bowel disease (IBD).

Aim

This study assessed whether certain characteristics are associated with greater success of live birth following IVF.

Methods

In a cohort study of 8684 women with IBD seen at two tertiary care centers, we identified 121 women with IBD who underwent IVF. We assessed the effect of numerous factors on likelihood of achieving live birth after IVF.

Results

Seventy-one patients with ulcerative colitis (UC) and 49 patients with Crohn’s disease (CD) were analyzed. Patients with UC who achieved a live birth were younger (p = 0.03), had a shorter duration of disease (p = 0.01), and were more likely to be in remission (p = 0.03) versus those who did not achieve live birth. Patients with CD who achieved live birth were younger (p < 0.001), had lower body mass index (BMI) (p = 0.02), and had lower cycle day 3 follicle-stimulating hormone levels (p = 0.02). There was no difference in likelihood of achieving live birth among patients in remission and those with mild or unknown disease status (p = 0.69), though most CD patients (79.5 %) were in remission. Prior surgery was not associated with live birth in patients with UC (p = 0.31) or CD (p = 0.62).

Conclusions

As in the general infertility population, younger patients and those with lower BMI were more likely to achieve live birth. History of surgery was not associated with live birth among IBD patients. This is important information for practitioners counseling IBD patients.

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Abbreviations

BMI:

Body mass index

CD:

Crohn’s disease

IVF:

In vitro fertilization

IBD:

Inflammatory bowel disease

IQR:

Interquartile range

UC:

Ulcerative colitis

CD3 FSH:

Cycle day three follicle-stimulating hormone

BIDMC:

Beth Israel Deaconess Medical Center

BWH:

Brigham and Women’s Hospital

HBI:

Harvey–Bradshaw Index

IPAA:

Ileal pouch anal anastomosis

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Author contributions

Sveta Shah Oza, MD, contributed to the study concept and design, acquisition of data, analysis and interpretation of data, and drafting of the manuscript; Vikas Pabby, MD, contributed to study concept and design, acquisition of data, and analysis and interpretation of data; Laura E. Dodge, MPH, and Michele R. Hacker, ScD, analyzed and interpreted the data and drafted the manuscript; Janis H. Fox, MD, designed the study and analyzed and interpreted the data; Vasiliki A. Moragianni, MD, MS, was involved in study design, acquisition of data, and analysis and interpretation of data; Katharine Correia, MPH, and Stacey A. Missmer, ScD, contributed to study design and analysis and interpretation of data; Yetunde Ibrahim, MD, was involved in acquisition of data; Alan Penzias, MD, and Robert Burakoff, MD, contributed to study concept and design and analysis and interpretation of data; Sonia Friedman, MD, and Adam S. Cheifetz, MD, was involved in study concept and design, acquisition of data, analysis and interpretation of data, and drafting of the manuscript.

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Author notes

    Authors and Affiliations

    1. Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, MA, USA

      Sveta Shah Oza

    2. Harvard Medical School, Boston, MA, USA

      Sveta Shah Oza, Laura E. Dodge, Janis H. Fox, Vasiliki A. Moragianni, Katharine Correia, Stacey A. Missmer, Yetunde Ibrahim, Robert Burakoff, Sonia Friedman & Adam S. Cheifetz

    3. Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

      Vikas Pabby

    4. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA

      Laura E. Dodge, Michele R. Hacker, Vasiliki A. Moragianni & Yetunde Ibrahim

    5. Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA

      Michele R. Hacker & Alan S. Penzias

    6. Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Boston, MA, USA

      Janis H. Fox, Katharine Correia & Stacey A. Missmer

    7. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

      Katharine Correia & Stacey A. Missmer

    8. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

      Stacey A. Missmer

    9. Division of Reproductive Endocrinology and Infertility, Beth Israel Deaconess Medical Center and Boston IVF, Boston, MA, USA

      Alan S. Penzias

    10. Gastroenterology Division, Brigham and Women’s Hospital, Boston, AM, USA

      Robert Burakoff & Sonia Friedman

    11. Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center, Boston, MA, USA

      Adam S. Cheifetz

    Authors
    1. Sveta Shah Oza
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    2. Vikas Pabby
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    6. Vasiliki A. Moragianni
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    13. Adam S. Cheifetz
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    Corresponding author

    Correspondence to Adam S. Cheifetz.

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    Conflict of interest

    Adam S. Cheifetz: Consulting/research: Janssen, Abbvie, Takeda, Pfizer, UCB, Prometheus; Alan Penzias: Advisory Board (with compensation): OvaScience; Nora Therapeutics; Consultant: ReproSource, Inc; Speakers Bureau: Ferring Pharmaceuticals; Michele R. Hacker: Support from Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102) and financial contributions from Harvard University and its affiliated academic healthcare centers; Sveta Shah Oza, Vikas Pabby, Laura E. Dodge, Vasiliki A. Moragianni, Janis H. Fox, Katherine Correia, Stacey A. Missmer, Yetunde Ibrahim, Robert Burakoff, and Sonia Friedman have no disclosures or conflicts of interests.

    Additional information

    Sonia Friedman and Adam S. Cheifetz: Shared senior authorship also contributed equally to this work.

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    Cite this article

    Oza, S.S., Pabby, V., Dodge, L.E. et al. Factors Associated with the Success of In Vitro Fertilization in Women with Inflammatory Bowel Disease. Dig Dis Sci 61, 2381–2388 (2016). https://doi.org/10.1007/s10620-016-4076-7

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