Trying to conceive with a husband who has Crohn's

[Philippa09]

Hi everyone,

I'm new here and recently joined hoping to get some advice.

My husband was diagnosed with Crohn's in September 2012 and was put on prednisone and pentasa. His consultant assures him that whilst so far this seems to have it 'under control with only a few flare ups, that its not treating the condition or improving it and wants to put him on the azathiroprine (sp).

We have been trying to conceive since October 2012 and have been reluctant to start any new medication until I've fallen.

To complicate things further, I have endometriosis and had a laparoscopy in May 13 to increase chances of conceiving for 6 months after. Husband also had a sperm test which showed very high sperm levels. I was also prescribed 6 months of clomid as I wasn't ovulating every month. My blood tests show a great response to the clomid, but I'm at the end of cycle 5 and still not pregnant after 15 months of trying!

Husband has a consultant appointment on thurs next week and I know the first thing he's going to ask my husband is, is your wife pregnant yet?!?

He's not been very well over Christmas, no doubt down to over indulging and drinking too much and I'm sure he'll want to start the azathiroprine. I'm just concerned what impact this will have on his sperm and in turn on this long journey of ours!

Any advice would be greatly received!

P x

 

[nogutsnoglory]

Crohn's generally is not thought to affect the sperm count in men. Azathioprine may increase risk for miscarriage but doesn't lower sperm count, there have been conflicting studies on the potential problems for the child and doctors do try to keep their patients on the drug.

http://www.nacc.org.uk/downloads/factsheets/Fertility.pdf

 

[Jmrogers4]

My husband crohn's and we conceived our youngest child while he was on Imuran. He is an extremely healthy 12 year old today. Our oldest was conceived while he was on Pentasa and he still had so many issues and flares while on Pentasa, it was a complete turn around once he was put on Imuran and was finally very healthy

 

[Philippa09]

Hi J,

Thank you so much for your reply.

Hubby has an appointment this week coming and I know the consultants first question will be 'is your wife pregnant yet'....and sadly I'm not despite 15 months of trying.

So would your suggestion be for him to start the azothrioprine and just get healthy? Hopefully conceiving will then just happen naturally!

P x

 

[Jmrogers4]

Found this study and it basically comes down to they don't know if it makes any difference in men taking Imuran. The abnormalities did not necessarily come from Imuran use. Personal opinion is that he needs to be healthy to support you. Taking care of your pregnant self or a newborn and a husband who is flaring would be a lot of stress. It's one of those does the benefit outweigh the risk which I believe is the same standard with pregnant women and Imuran. There have been women on here who have had successful pregnancy on Imuran as the benefits of the treatment outweigh the risks. If you decide starting the Imuran is the best option let your ob-gyn know so that they can monitor. Good luck, We had no issues even though our youngest was born 2 weeks prior to due date he was 8.14lbs and extremely healthy baby
From:
http://www.ncbi.nlm.nih.gov/pubmed/15023170

Abstract
BACKGROUND:
Immunosuppressive therapy with azathioprine and mercaptopurine is commonly used in patients with various chronic diseases. The few existing data on the reproductive safety of these drugs after paternal use before conception are inconclusive.
AIM:
To examine the risk of congenital abnormalities in children fathered by men exposed to azathioprine or mercaptopurine before conception.
METHODS:
This was a Danish population-based cohort study, based on data from the Prescription Database, the Medical Birth Registry and the Hospital Discharge Registry of North Jutland County, Denmark. Fifty-four exposed pregnancies, in which the father filed a prescription for azathioprine or mercaptopurine (between 1 January 1991 and 31 December 2001) before conception, were included. The controls comprised 57 195 pregnancies with no paternal azathioprine or mercaptopurine use.
RESULTS:
Four children with congenital abnormalities (underlying paternal diseases: glomerulonephritis and severe skin disease) were found in 54 exposed pregnancies (7.4%), compared with 2334 (4.1%) in controls. The adjusted odds ratio for congenital abnormalities in children fathered by men treated with azathioprine or mercaptopurine was 1.8 (95% confidence interval, 0.7-5.0).
CONCLUSIONS:
Our data may indicate that paternal use of azathioprine or mercaptopurine before conception is associated with an increased risk of congenital abnormalities. However, more data are needed to determine whether the association is causal.