fathering children while on chrons medications

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New Member

Date Joined Feb 2009
Total Posts : 2
   Posted 2/8/2009 3:12 PM (GMT -7)   

Sorry if this has been asked before (searched site and did not find anything specific).

wondering if anyone has had any experiance, or knows any information, good resource regarding the risks of fathering children while on medication for chrons?
My main current drugs are:
entocort (2 x 3mg)
pentasa (4 x 500mg)
mercaptopurine (2 x 50mg)

I have only recently swapped to entocort from prednisone which (along with others listed) I have been on for years.

I have looked at the individual drugs side effects claims and while some say ok / some not ok, most say further study needed.

Looking to start a family but want to provide bet possible start as some medications indicate 'possible' complications to the child.

Any information would be greatly appreciated.


Elite Member

Date Joined Apr 2005
Total Posts : 14995
   Posted 2/8/2009 3:37 PM (GMT -7)   
Many women on this board have had children while on Imuran, 6mp, Remicade and Humira. All have had healthy pregnancies and babies. I do not believe this will cause any problems for you. Some have even been on steroids too. Good luck and happy baby making:)
Gail*Nanners* Co-Moderator for Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia and Osteoarthritis and Anxiety. Currently my Crohns is in remission.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

Forum Moderator

Date Joined Nov 2003
Total Posts : 7121
   Posted 2/8/2009 6:14 PM (GMT -7)   
Actually, I am not sure if it is known if there is an effect on men in terms of fathering a child while on 6MP. Entocort and pentasa are considered okay. Doing a quick google search produced several pages of links to studies regarding 6MP and sperm production and damage potential. [I searched using the words - 6MP effect sperm] If your GI doctor is up on his latest reading, I'm sure he can give you the latest info regarding 6MP and fathering a child so you can make an informed decision.
Moderator Crohn's Disease Forum
CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, and a host of other medical problems.

Rider Fan
Veteran Member

Date Joined May 2008
Total Posts : 1445
   Posted 2/8/2009 7:36 PM (GMT -7)   

Dx'ed in 1999. No surgeries.

Current meds: 25mg Methotrexate. 8mg prednisone. Udo's Choice Probiotics (30 billion).

Tried SCD, didn't work, now avoiding gluten and dairy.

Rider Fan
Veteran Member

Date Joined May 2008
Total Posts : 1445
   Posted 2/8/2009 9:00 PM (GMT -7)   

http://www3.interscience.wiley.com/cgi-bin/fulltext/113522432/PDFSTART {Text posted below in case the link doesn't work. How I wish I followed her advice and stayed on the 6MP. I went off and am in the middle of a 10 month flare.}

Outcome of pregnancies when fathers are treated with
6-mercaptopurine for inflammatory bowel disease. Rajapakse
RO, Korelitz BI, Zlatanic J, Baiocco PJ, Gleim GW. Am
J Gastroenterol2000;95:684-8.
The immunomodulators are important drugs in Crohn’s disease
and ulcerative colitis and allow patients to enter remission
and be weaned from steroids about two-thirds of the time. The
safety of these drugs during pregnancy has been studied retrospectively,
and most of the data pertain to their use in women.
Data on fetal outcome when the father has used 6-mercaptopurine
(6-MPjlazathioprine is scanty and has been reported
only in the renal transplant literature. The article by Rajapakse
et al. is the first study of the outcome of pregnancies when
fathers are treated with 6-MP for inflammatory bowel disease
(TBD). The authors did a retrospective study of male patients
with IBD seen at a single center over a 27-year period of time.
Patients were divided into two groups. Group 1 comprised
pregnancies fathered by men who had taken 6-MP at some
point prior to conception. Group 2 comprised pregnancies fathered
by men who had never taken 6-MP or who had taken it
after the conception of their children (90 pregnancies). Group 1
was subdivided into A and B. The pregnancies in 1A were
conceived within 3 months of 6-MP use by the fathers (13
pregnancies), and the pregnancies in 1 B were conceived at least
3 months after 6-MP was discontinued by their fathers (37
pregnancies). All paternal characteristics were equivalent between
the groups, and there were no maternal risk factors such
as illnesses, exposure to medications or toxins, infections, or
Remarkably, in group lA, 4 of the 13 pregnancies were
associated with a compIication: 2 with a spontaneous abortion
(15%) and 2 with a congenital abnormality (1.5%). The congenital
abnormalities consisted of a missing thumb in a male
child and acrania combined with digital and limb abnormalities
in one fetus. This perhaps mirrors reports of limb abnormalities
found in the offspring of female rabbits exposed to 6-MP during
pregnancy. In groups 18 and 2, there were two spontaneous
abortions in each (2.7% and 2.2%, respectively) and no congenital
abnormalities. Although the incidence of complications
between groups 1 and 2 did not reach statistical significance
(p < 0.097), the incidence of complications between groups 1A
and 1B as well as groups 1A and 2 was significant (p < 0.013,
odds ratio [OR] 16.0, 95% confidence intervals [CI] 1.6161;
and p < 0.002, OR 19.6, 9.5% CI 3.1-122, respectively). The
authors conclude that 6-MP should be discontinued, when feasible,
at least 3 months before a planned conception.
The results of this study stand in contrast to the other retrospective
studies of the toxicity of immunomodulators during
pregnancy. The two studies of immunomodulators in pregnant
women with IBD show no adverse fetal outcomes. Alstead et
al. (Gastroenterology 1990;99:443-6) report on the outcome of
16 pregnancies in 14 women, 7 who continued taking azathioprine
throughout pregnancy, and 5 who stopped the drug before
16 weeks’ gestation. The only complication was a maternal
hepatitis B infection. There were no congenital abnormalities,
no spontaneous abortions, no delays in growth and develop-
Infimmatory Bowel Diseases? Vol. 6, No. 4, November 2WO
ment, and no ncoplasia. The results are similar in the casecontrolled
study by Francella et al. (Gastroenterology 1996;
I10:909). Here, the authors reported on 347 conceptions in 155
womcn. Thc control group (180 conceptions) was never exposed
to 6-MP. The 167 conceptions where women used 6-MP
were divided into three groups: 6-MP used before conception,
6-MP used during conception but stopped during pregnancy,
and 6-MP used during conception and pregnancy. There were
no spontaneous abortions or congenital abnormalities in the
eight women who used 6-MP throughout their pregnancy.
Among the 64 women who were on 6-MP at conception, there
was no increased rate of spontaneous abortions or congenital
abnormalities compared with the control group.
The two studies of immunomodulator use in fathers in the
renal transplant literature have similar results. Penn et al. report
on 23 pregnancies fathered by renal transplant recipients while
taking azathioprine. There were 21 normal births, 1 spontaneous
abortion, and 1 child with myelomeningocele-a risk the
authors deem “not exorbitant” (JAMA 1971;216:1758-61). In a
multicenter transplant registry, Golby reports 38 normal births
and 2 first trimester abortions (5%), an incidence not above that
in the general population (Transplantation 1970;10:2014). In
retrospective studies of women with transplants andlor autoimmune
disease taking immunomodulators, there has been no
increased incidence of congenital abnormalities or spontaneous
Should we follow the recommendations of the authors and
take potential fathers off 6-MP? Aside from the known effccts
of sulphasalazine on male fertility, traditional teaching has always
been that the active disease itself rather than the medications
used to Ireat it is the real impediment to a normal conception
and pregnancy. 6-MPhzathioprine effectively maintains
remission in IBD, and one should think twice before
igniting the fire once again. We should gain some confidence in
our decision to continue the medication after we examine the
statistics in this article. The confidence intervals are wide and
the rate of spontaneous abortions in the control group is low
(3%), compared with the 10-12% rate in the general population.
This may inflate the differences between the groups. As
the authors suggest, larger studies and registries will help sort
out the issue of 6-MPlazathioprine toxicity; but until these are
complete. we should not remove the damper from the flame.
Sonia Friedman, M.D.
Gastroenterology Division
Brigham and Women’s Hospital
Boston, Massachusetts, U.S.A.

My GI thinks the below study is a poor one since there were only 13 subjects.

Dx'ed in 1999. No surgeries.

Current meds: 25mg Methotrexate. 8mg prednisone. Udo's Choice Probiotics (30 billion).

Tried SCD, didn't work, now avoiding gluten and dairy.

Post Edited (Rider Fan) : 2/8/2009 9:03:51 PM (GMT-7)

Veteran Member

Date Joined Feb 2003
Total Posts : 1811
   Posted 2/8/2009 9:15 PM (GMT -7)   
From my understanding entocort and pentasa have a localized effect and not a systemic effect based on the fact they don't break-down until way far along in the digestion process (large intestine). Therefore, it would seem likely that they would have the least effect, if any, on sperm. As for the 6mp, that is a more serious med, and I'm sorry that I don't have any info on it for you, but ... many women have had healthy 6mp babies. Good luck!!!

New Member

Date Joined Feb 2009
Total Posts : 2
   Posted 2/8/2009 9:27 PM (GMT -7)   

Thanks heaps for all your replies - the previous thread referenced by rider fan seemed to hit it on the head.

It is concerning that the official literature is still unsure wether the instance's of birth defects etc increase while on these meds so it is essential for me to hear it from real people, with real world exposure to this issue, as its an important consideration to any decision on bringing a child into the world.

Thanks again.
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