After 14 years of living with Crohn's disease, Kristina Whiton, a social worker from Boston, Massachusetts, recently underwent her fifth abdominal surgery. This time, scar tissue from previous operations had caused a cyst—the size of two footballs—to develop.
Whiton first started experiencing symptoms of Crohn's, an inflammatory bowel disease that can affect the digestive tract from the mouth to the anus, at age 21. Common symptoms included pain, diarrhea, and rectal bleeding. By the time Whiton was 31, surgeons had removed her colon and rectum and left her with a permanent ileostomy (external bag for drainage).
Last September, Whiton began thinking about preconception care in relation to the disease. Her primary care physician sent her to a reproductive endocrinologist who recommended that her current surgeon document his findings during the fifth surgery.
"The issue is really the adhesions," says Whiton about the scar tissue the surgeon will be examining. "They can wrap around the ovaries or fallopian tubes and block the eggs."
If her doctor determines that the adhesions will cause blockage, Whiton will be eligible for in vitro fertilization (IVF) aid. Her reproductive endocrinologist had recommended IVF as a quicker method of conception for her because of her age and illness.
Six years ago, Whiton had tried a variety of medications for her disease, such as prednisone, 5-ASA, 6-mercaptopurine (6-MP), antibiotics, and interleukin 11, but she is no longer taking them. Her concern now is not how medications affect pregnancy, but whether she is able to conceive.
"It's strictly the biology," she says. "Can I get pregnant with all the surgery I've had on my belly?"