Prevention and Treatment of Postproctectomy Infertility

Physicians who care for patients of childbearing potential of both genders who require pelvic surgery must have a clear understanding of the best-available evidence with regards to infertility as an outcome in this cohort. More specifically, colorectal surgeons must clearly understand the ramifications of altered anatomy on fertility and be able to adequately counsel patients. In this article we provide definitions associated with fertility and review the best-available literature regarding the impact of medical therapy for inflammatory bowel disease on fertility and both female and male infertility after proctectomy for chronic ulcerative colitis and rectal cancer. Finally, we review techniques for optimization of fertility as well as available options and treatments for those who have difficulty conceiving.