Advanced therapy has no impact on time to pregnancy in women with IBD

Exposure to advanced therapies, including biologics and small molecules, within 3 months of conception is not associated with an increase in time to pregnancy among women with inflammatory bowel disease (IBD), according to the WIsDoM* trial presented at the Crohn’s and Colitis Congress 2026.

The researchers conducted a prospective study involving 444 women (median age 32.61 years) with IBD who were planning to become pregnant within 15 months of enrolment. Among these participants, 56.5 percent had Crohn’s disease, while the remaining had ulcerative colitis. More than half (74.7 percent) of the participants were exposed to advanced therapy.

Results showed that women who were either exposed or not exposed to advanced therapy within 3 months of conception showed no significant difference in time to pregnancy, with a median duration of 2 months observed in both groups (p=0.295). [Gottlieb Z, et al, CCC 2026]

After adjusting for potential confounders, such as age, parity, pelvic surgery, and disease activity, neither advanced therapy exposure (hazard ratio [HR] 1.93, 95 percent confidence interval [CI], 0.76–1.88; p=0.446) nor active disease** within 3 months of conception (HR 1.5, 95 percent CI, 0.98–2.3; p=0.06) were independently linked to a longer time to pregnancy, although the latter was trending toward significance, said the researchers.

On the other hand, the history of any IBD-related surgery was significantly associated with an increased time to pregnancy (HR, 0.47, 95 percent CI, 0.29–0.74; p=0.002), which was primarily attributed to pelvic surgical history.

In particular, women with a history of pelvic surgery had a significantly prolonged time to pregnancy, with a median of 6 months compared with 2 months in those without (p=0.03).

This finding was consistent with that of another study indicating that women with IBD, especially those who had undergone surgery, experienced a significant increase in time to pregnancy compared with women without IBD. [Gastroenterol Hepatol 2020;18:1537-1544]

Overall, WIsDoM is the first prospective study to demonstrate that preconception exposure to advanced therapy does not affect the time to pregnancy in women with IBD, while also reaffirming that pelvic IBD surgery impairs fertility, according to the researchers.

“Continuation of advanced therapy before conception is safe and can improve fertility by maintaining remission,” they added.