{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T18:39:41Z","timestamp":1782931181669,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Fertility and mode of delivery are major concerns for women with ulcerative colitis (UC) undergoing ileal pouch\u2010anal anastomosis (IPAA). Although infertility after IPAA has been attributed to pelvic adhesions, the impact of minimally invasive approaches remains uncertain. Similarly, evidence guiding Caesarean section (CS) versus vaginal delivery is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective, population\u2010based study using Ontario health administrative databases (1994\u20132022). Female UC patients aged 18\u201345\u2009years undergoing IPAA were matched by birth year, parity and rural residence to UC controls (without surgery) and non\u2010UC controls. Primary outcome was live birth after IPAA. Subgroup analyses included nulliparous patients and laparoscopic versus open IPAA. Among patients with live births, delivery modes were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 1,094 eligible women with IPAA (median age 32). After IPAA, 13.8% had \u22651 live birth, significantly lower than UC controls (27.2%; RR 0.53, 95% CI 0.46\u20130.60) and non\u2010UC controls (22.5%; RR 0.53, 95% CI 0.47\u20130.59). Among nulliparous women, live birth rates remained significantly reduced (18.5% vs. 32.7% in UC controls; RR 0.66, 95% CI 0.57\u20130.77). Laparoscopic IPAA did not significantly increase live birth rates (13% vs. 10%, RR 1.41, 95% CI 0.75\u20132.65), though the number of births per patient was higher. CS rates were substantially elevated in women who delivered after IPAA versus controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this population\u2010based study, IPAA for UC was associated with significantly reduced live birth rates compared with both controls. Laparoscopic IPAA did not eliminate fertility disadvantage, though higher birth numbers suggest possible benefit. CS rates were markedly higher after IPAA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70437","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T10:10:55Z","timestamp":1775124655000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Fertility and mode of delivery after ileal pouch\u2010anal anastomosis for ulcerative colitis: A population\u2010based study"],"prefix":"10.1111","volume":"28","author":[{"given":"Mantaj S.","family":"Brar","sequence":"first","affiliation":[{"name":"Department of Surgery, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane Jungyoon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Surgery, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"de Buck van Overstraeten","sequence":"additional","affiliation":[{"name":"Department of Surgery, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03397.x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.30345"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2004.06.018"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-015-2497-y"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5509"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-011-1274-9"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.090316"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00300204"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2013.02.031"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318250caa9"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182813741"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0570-7"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjad079"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-014-3043-4"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.08.018"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-007-0240-7"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2014.02.019"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjaa191"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000001037"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20082"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2009.10.001"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjw078"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/715354"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005569"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-008-0139-y"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znaf136"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-005-0124-7"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-025-04938-2"}],"container-title":["Colorectal 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