The DOI matches its Crossref record; 16 of the 16 references it cites were found in a registry or an index.
Threefold increased risk of infertility: a meta-analysis of infertility after ileal pouch anal anastomosis in ulcerative colitis
Open accessAbstract
Background: Increased infertility in women has been reported after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis but reported infertility rates vary substantially. Aims: (1) To perform a systematic review and meta-analysis of the relative risk of infertility post-IPAA compared with medical management; (2) to estimate the rate of infertility post-IPAA; and (3) to identify modifiable risk factors which contribute to infertility. Methods: Medline, EMBASE, Current Contents, meeting abstracts, and bibliographies were searched independently by two investigators. The titles and abstracts of 189 potentially relevant studies were reviewed; eight met the criteria and all data were extracted independently. Consensus was achieved on each data point, and fixed effects meta-analyses, a funnel plot, and sensitivity analyses were performed. Results: The initial meta-analysis of eight studies had significant heterogeneity (p = 0.004) due to one study with very high preoperative infertility (38%). When this study was omitted, the relative risk of infertility after IPAA was 3.17 (2.41–4.18), with non-significant heterogeneity. The weighted average infertility rate in medically treated ulcerative colitis was 15% for all seven studies, and the weighted average infertility rate was 48% after IPAA (50% if all eight studies are included). We were unable to identify any procedural factors that consistently affected the risk of infertility. Conclusions: IPAA increases the risk of infertility in women with ulcerative colitis by approximately threefold. Infertility, defined as achieving pregnancy in 12 months of attempting conception, increased from 15% to 48% in women post-IPAA for ulcerative colitis. This provides a basis for counselling patients considering colectomy with IPAA. Further studies of modifiable risk factors are needed.
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Cites
Infliximab for Induction and Maintenance Therapy for Ulcerative Colitis
Rutgeerts, P., Sandborn, W. J., Feagan, B. G., Reinisch, W., Olson, A., Johanns, J., Travers, S., Rachmilewitz, D., Hanauer, S. B., Lichtenstein, G. R., et al. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa050516 · Cited by 3,902
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Fertility and pregnancy in inflammatory bowel disease
Hudson, M., Flett, G., Sinclair, T. S., Brunt, P. W., Templeton, A., & Mowat, N. A. G. (1997) · International Journal of Gynecology & Obstetrics · doi:10.1016/s0020-7292(97)00088-x · Cited by 272
Results of national registration of familial adenomatous polyposis
Bülow, S. (2003) · Gut · doi:10.1136/gut.52.5.742 · Cited by 218
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Fertility after ileal pouch–anal anastomosis in women with ulcerative colitis
Olsen, K. Ø., Joelsson, M., Laurberg, S., & Öresland, T. (1999) · Journal of British Surgery · doi:10.1046/j.1365-2168.1999.01076.x · Cited by 187
Infliximab for Induction and Maintenance Therapy for Ulcerative Colitis
(2006) · New England Journal of Medicine · doi:10.1056/nejmx060025 · Cited by 183
Female Infertility After Ileal Pouch-Anal Anastomosis for Ulcerative Colitis
Johnson, P., Richard, C., Ravid, A., Spencer, L., Pinto, E., Hanna, M., Cohen, Z., & McLeod, R. (2004) · Diseases of the Colon & Rectum · doi:10.1007/s10350-004-0570-7 · Cited by 177
Cited by
Lamb, C. A., Kennedy, N. A., Raine, T., Hendy, P. A., Smith, P. J., Limdi, J. K., Hayee, B., Lomer, M. C. E., Parkes, G. C., Selinger, C., et al. (2019) · Gut · doi:10.1136/gutjnl-2019-318484 · Cited by 2,346
Ordás, I., Eckmann, L., Talamini, M., Baumgart, D. C., & Sandborn, W. J. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60150-0 · Cited by 2,078
Evidence-based clinical practice guidelines for inflammatory bowel disease
Matsuoka, K., Kobayashi, T., Ueno, F., Matsui, T., Hirai, F., Inoue, N., Kato, J., Kobayashi, K., Kobayashi, K., Koganei, K., et al. (2018) · Journal of Gastroenterology · doi:10.1007/s00535-018-1439-1 · Cited by 698
Colectomy Rate Comparison After Treatment of Ulcerative Colitis With Placebo or Infliximab
Sandborn, W. J., Rutgeerts, P., Feagan, B. G., Reinisch, W., Olson, A., Johanns, J., Lu, J., Horgan, K., Rachmilewitz, D., Hanauer, S. B., et al. (2009) · Gastroenterology · doi:10.1053/j.gastro.2009.06.061 · Cited by 473
Turner, D., Levine, A., Escher, J. C., Griffiths, A. M., Russell, R. K., Dignass, A., Dias, J. A., Bronsky, J., Braegger, C. P., Cucchiara, S., et al. (2012) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0b013e3182662233 · Cited by 382
Metadata
- Authors
- Waljee, A., Waljee, J., Morris, A. M., & Higgins, P. D. R.
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2006-06-13
- Volume
- 55
- Issue
- 11
- Pages
- 1575-1580
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- OpenAlex
- W2164180626
- Cited by
- 375
- References
- 16
- FWCI
- 1.19
- Type
- journal article
- Language
- en
- Open access
- bronze
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