Part 2: Has Crohn’s Disease Robbed Us From Starting a Family Naturally?

Quick Recap

Welcome back! The last time we were here, I began to unravel the story of turning 39, my geriatric womb, and opening a Pandora’s Box. I also discussed some pretty nifty data points that should help put IBD patients’ minds at ease when it comes to family planning. And lastly, “Part 1 of Has Crohn’s disease Robbed Us…” ended with my Reproductive Endocrinologist dropping a bomb, “I don’t think it’s cancer.”

For Housekeeping

• There’s about a 3% risk of a child from a parent with Crohn’s developing an IBD, as well.¹
• That is a 97% chance that a child will not develop an IBD.¹
• The risk does increase if both parents have an IBD, or multiple family members have an IBD.²
• Being in remission is the best time for someone to fall pregnant.²

Back to the cancer bomb drop...

An obstruction in my uterus

As my doctor said there was an obstruction in my uterus, followed by, “I don’t think it’s cancer,” my brain raced. I’m so used to talking with fellow IBD patients about intestinal obstructions that other formats of obstruction just did not compute.

I prodded my doctor for more clarity. “What kind of obstruction?”

She informed me that she wasn’t planning on doing procedures on Friday because it’s her paperwork day. However, she was booking me for an early morning procedure to get a better view. "Time is of the essence," she said. Followed by, “I don’t think it is cancer. This stuff happens.”

I wanted to find comfort in that, but my mom’s rare cancer diagnosis the year prior left me wary.

I got dressed quickly to make that appointment.

After the procedures

One day and one more procedure later, my doctor got the images she wanted and said I could sit up.

She said, typically these obstructions are polyps in the uterus. There is also sometimes polypoid tissue (beginning of polyps / bumpy tissue) but she will take care of that in the next procedure. The polyps and bumpy tissue make it near impossible for a pregnancy to stick. They can also cause miscarriage. She ordered a D&C (dilation and curettage) procedure. In my case, the procedure would scrape away the inflamed bumpy tissue to allow healthy smooth tissue to grow.

Two weeks later, the D&C was completed and I was awake, the doctor came out to speak to me. She said everything went as expected. Two sizable polyps and a lot of polyp-like tissue (polypoid) were found. She saw no other physical reason for not being able to maintain a pregnancy.

Things I learned from this experience

While going through the emotions from feeling forced into having the D&C, I came to a few conclusions.

• I was mad that when this Crohn’s flare began in 2012, I couldn’t financially or physically justify the toll of hormone cycles and egg freezing.
• Once you freeze your eggs, you have to pay a pricey annual fee to keep them frozen.
• Hormone therapy is part of egg freezing and later it is part of the implantation process.
• Lastly, fertility treatment is a privilege. Only a few states require fertility treatment to come as part of an insurance plan’s offerings. Not all plans cover fertility help at all. For those with chronic conditions who need fertility assistance, it doesn’t matter. Some insurance plans allow for a small portion of financial assistance, but there is usually a lifetime cap on expense.

Two weeks later, I went in for my post-op follow-up appointment. The pathology report was back and everything was standard for polyps. I peppered my doctor with a slew of questions.

Questions for my doctor

"Can women without Crohn’s disease or ulcerative colitis get these polyps?" Yes, absolutely.

"Are women with inflammatory conditions like in my case with Crohn’s, psoriasis, and psoriatic arthritis prone to this form of inflammation?" Yes.

I asked if this would reset the 6-month trying clock. At first, she said yes. Then paused, smiled, and then said, “Wait, how old are you, again?”

“Turned 39, last week,” I replied.

“Oh, you look so young, I keep forgetting! Your parts look great for your age, but it would be 3 months, not 6 months, to start making some decisions."

Y’all I would like that to go on my tombstone, “Parts looked great for her age."

This is all an additional complication of my Crohn's

While IBD doesn’t necessarily impact fertility rates for women, chronic inflammation can create a negative effect. I had 20-plus years of untreated inflammation. It’s just one more “unfair” thing I have to come to terms with due to improper treatment of my Crohn’s for so many years.

I may not be able to answer the question, “Has Crohn’s robbed us from starting a family naturally?” But I can say that Crohn’s disease hasn’t stopped us from wanting- or-trying-to start a family.