Struggling With Infertility as a Man With IBD
Last updated: April 2023
We all remember those days in high school when they tell you, "You must use protection or your partner will automatically get pregnant." What they failed to mention was that it isn't always that easy to get pregnant.
Struggling to conceive with Crohn's
My wife and I had a year-long struggle with conceiving, and I wanted to share with you all the things I (an IBD patient) wished I knew before heading into this. My wife knew that conceiving would be a struggle because of our ages (mid 30s), so we wanted to give ourselves at least 6 months.
After 6 months of trying, I did an "online semen test," where I mailed in a sample to a lab. Let's just say I got an "F." They test volume, mobility, morphology, and a few other traits. I bombed it. Being a man, I really struggled with this "grade," because it made me feel "less than a man."
It caused a boatload of anger, frustration, anxiety, and let's just say a lot of sleepless nights. I was determined to figure out what was the reason behind the "failing sperm tests." I knew it couldn't be my Crohn's, as my colorectal surgeon stated many times before how careful he was not to disrupt the essential blood vessels needed for reproduction.
More sperm tests
I did meet with my regular doctor and we stopped all my "non-essential medications," such as my hair-loss medication. My wife and I continued trying but we wanted to wait until 3 months. The medication was fully out of my system because by then my sperm should be able to "regenerate."
We did another sperm test and I got the results back. They were better this time, but not where we wanted them. Let's just say that I got a "C."
Is my Crohn's connected to my fertility?
We started looking at articles online, and we could not find much correlation between IBD and male infertility. My wife and I were determined to figure out why my sperm was not the best for conception. After about a year of trying and testing, we decided to go to a fertility specialist group.
They did all kinds of blood work and testing for my wife and me. The great news was that my wife's fertility tests came back great. There was nothing from her end that would lead to problems getting pregnant.
Once again I was sad, depressed, and angry. Not a great combination when trying to conceive. And what happens when those occur with Crohn's? Yup, a flare-up.
Flare-up from the stress
This was my first flare-up in about 6 years. I really had to get a handle on myself but now I was dealing with trying to control my emotions and the flare. I did what I usually do in a flare. I ate very bland food and stayed hydrated.
I didn't want to call my gastroenterologist because I was afraid he would put me on a quick-acting steroid to calm my Crohn's. The steroid could be another factor in my infertility saga. After a few weeks, the flare subsided.
We had taken a break from trying, and just started to enjoy each other's company. I still needed answers... I decided to go to a reproductive urologist.
Finally some answers...
The reproductive urologist had such great details surrounding why we could not get pregnant. He said that a few of my medicines, such as my injectable for Crohn's, can cause low sperm count and some issues with sperm morphology. He said the same thing about azathioprine. He was happy to hear I was off the hair replacement medications but didn't feel that was going to make a huge difference.
The risk of going off the biologic and azathioprine was too big, because it would cause a major flare. He stated that when in a flare, my sperm counts are even lower. This seemed true based on the sperms tests in the past. He suggested that we try intrauterine insemination (IUI).
So what choice did we have? We decided to give IUI a try, knowing that it was only a 17% chance of working. Hey, it seemed better than the 3% chance the doctor gave us if we didn't try IUI. I had no hope, thinking, "Yep I'm going to be bankrupt when we have to start IVF."
But then my wife went in for 1 treatment of IUI... and the results were exactly what we had hoped for. My wife is now 16 weeks pregnant and very healthy! Luck is finally on our side!
What has been the most helpful for managing IBD symptoms?