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TTC on Azathioprine

Hi, Ive been on Azathioprine nearly 2 years and am in full remission and have been for nearly 2 years (after a course of infliximab).
My husband has fertility issues so we have had to undergo years of IVF. We have a 13 month old daughter conceived when I was on infliximab only and she was an IVF pregnancy. I started Aza when I was 13 weeks pregnant and have been on it ever since. I stopped the infliximab when I was 18 weeks pregnant.

I am trying to get pregnant again. I have just turned 40. Ive done 2 goes at IVF this year and they haven't worked. The clinic can find nothing wrong with me except im 40! We have started working with a private sperm donor using AI and I have tried 2 months now. I have an ovulation predictor kit and my donor is very reliable and available. We have tried 3 times last month and twice the month before that. Neither time has worked.

I know at 40 it could take some time to get pregnant. However my consultant said 'a theoretical risk with Aza and getting pregnant but as im in remission best to carry on. However she will take me off Aza and put me back on infliximab if I get desperate.

Although ive only tried AI 2 months im getting desperate. I have 6 years of my husband infertility and endless tests and procedures as the backdrop. Together with being diagnosed with crohns in the middle of it.

So my question is can anyone tell me what the risks are with trying to get pregnant and being on aza and could aza be affecting my egg quality and therefore my chance of getting pregnant?
 
I doubt that anyone knows the answer for sure.

There are so many parts to the question - are the eggs damaged? is there a problem with the maturation process? is there damage to the delivery system (fallopian tubes) from the CD (despite your remission there could be some mild inflammation)? is there something about the immune system changes from the AZA that are affecting implantation and growth?

Why don't you draw up a plan and decide what you are comfortable with in terms of how many months you will try AI, etc. Go over it with the doctors and then do it. Maybe you would do 1 more month AI on AZA and then switch to IFX and try for 3 months on IFX.

Remember that the AZA will continue to have effects for several weeks so you may want to consider waiting for those to go away before starting IFX.

All the best
 
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