Crohn's Disease Forum » General IBD Discussion » Imuran and pregnancy?


09-12-2006, 03:00 AM   #1
andilynn09
 
Imuran and pregnancy?

Was just wondering if any of you, or your significant others, who have been on Imuran have had any dealings with pregnancy and Imuran. GI told me when I started it that if I am able to stay on the Imuran, it could potentially be a problem when it comes to starting a family. My hubby and I had been planning to start trying for a baby this summer before I was DX'd with Crohns this Spring...obviously those plans are on hold right now being as I have yet to even find remission yet.

Guess I was just wondering if any of you had any experience with the risks the Imuran can pose for the baby if the mother has to stay on the drug during pregnancy, or any experience with being able to lower or get off the drug long enought to try for a baby. I know my GI told me up until recently, all studies showed Imuran has very high risks for birth defects....but some of the new studies show there may possibly be some more optimistic scenarios out there. Was just curious to know if any of you had dealt with this personally.
09-12-2006, 10:04 AM   #2
Valentina
 
if your doing some digging on this subjuect, you might want to use the term azathioprine (I found when I was on Imuran there wasnt as much info as there was for aza)

http://www2.netdoctor.co.uk/medicines/100000216.html

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

Women should use effective contraception to avoid getting pregnant and men should use effective contraception to avoid fathering a child during treatment with this medicine. Women who do get pregnant while they or their partner is receiving treatment should consult their doctor immediately. Azathioprine may increase the risk of premature birth, low birth weight and miscarriage. Seek medical advice from your doctor.

This medicine passes into breast milk. Seek medical advice from your doctor before using this medicine during breastfeeding.
and another article I found:
http://homepage.mac.com/sholland/Pap...thioprine.html

hope this helps.. and good luck!!!
09-12-2006, 12:35 PM   #3
theatherly
 
My GI and Peri took me off the Imuran while I was pregnant. I continued with Remicade treatments with no trouble. You just have to weigh the risk and what your comfortable with.

If you do take it while pregnant I'd request to have a Peri so that you can be closely monitored for any problems.

Good Luck!
09-12-2006, 10:51 PM   #4
Skinsfan1229
 
Well I havent been on Imuran and I'm not a female but I am on methotrexate and I do a lot of reading up on medicines. And I know with methotrexate they say to even wear a condom even if the women is on birth control, because of the semen fluid might be affected by the methotrexate, which in turn might affect the female....this of course is coming from my perspective...the male.
09-13-2006, 01:01 AM   #5
theatherly
 
Skinsfan1229 said:
Well I havent been on Imuran and I'm not a female but I am on methotrexate and I do a lot of reading up on medicines. And I know with methotrexate they say to even wear a condom even if the women is on birth control, because of the semen fluid might be affected by the methotrexate, which in turn might affect the female....this of course is coming from my perspective...the male.

Methotrexate is often used to induce early abortions when combined with another medication.

Imuran is totally different from that though. Imuran can cause birth defects in some cases.
09-29-2006, 10:52 AM   #6
Micheladelfina
 
I am currently on purinethol, a very close relative of Imuran. About 2 years ago, despite using protection, I became pregnant while on the medication. After consults with numerous doctors and weighing the risks, not only of the good chance of birth defects, but the fact that my body may not have been healthy enough to withstand a pregnancy, I made the difficult decision to end the pregnancy and undergo a tubal ligation. It was a very personal choice, and may not be right for everyone, but I figured that if I was meant to have children one day, it would be via adoption instead. To me, it just wasn't worth the risk, and I've never regretted the decision.
10-04-2006, 11:09 AM   #7
Valentina
 
Micheladelfina said:
I made the difficult decision to end the pregnancy and undergo a tubal ligation. It was a very personal choice, and may not be right for everyone, but I figured that if I was meant to have children one day, it would be via adoption instead. To me, it just wasn't worth the risk, and I've never regretted the decision.
wow, Im really sorry you had to go through that at all. It must have been very difficult, and a very hard decision to make.
this is one of my biggest fears.. having to make a choice like that.
10-04-2006, 02:33 PM   #8
Micheladelfina
 
It was a difficult decision, and I feel bad for others that may be put in that same position. If you are on immunosuppressants like Imuran, Purinethol, etc. hormonal birth control methods can have reduced effectiveness, and three different doctors refused to do an IUD or implant for me because of the risk of infection. I understand their concern, of course, but it doesn't leave people in that position with a whole lot of choices.
10-07-2006, 09:14 AM   #9
Cara Fusinato
Sarcastic Forum Comedian
 
Join Date: Sep 2006
Wow! I never really thought about the whole pregnancy question. My husband and I decided not to have children and he got the big V about 7 years ago. Now, looking at how hard it would be or how rough it would be to be sick and raise children, it was the right decision for us. The dogs, cats, and sheep can all manage without me on a down day -- esp. my special dog that just lays with me all day no matter what. I do remember that my GI doc mentioned that if I am on the immune suppressant I should NOT get pregnant. I just kind of waved him off, but he did make a point of it.
08-04-2007, 09:10 PM   #10
Martin
New Member
 
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Join Date: Apr 2006
I see a lot written about women taking Imuran and getting pregnant. but what about men taking it? what are the effects on pregnancy if the man takes Imuran and the woman doesn't have crohn's?

does anybody know or have any knowledge about this?

my wife and I would like to have another kid but I'm currently taking 150mg Imuran/day. should we go for it? my specialist isn't convinced that the risk is all that great or much to be concerned about. but then, his office is full of pharmaceutical company paraphernalia!

thanks for any input.
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08-04-2007, 09:35 PM   #11
D Bergy
Senior Member
 
Join Date: Apr 2007
I doubt that any large studies have been done concerning these drugs and pregnency. I can imagine a scenario that someone gives birth and if the child has some kind of issue such as a birth defect then you will always wonder if it would have happened if no medication was involved. It really would not matter if the medication did anything or not because you would never know for sure.

Sorry I could not be more help, but it is a real tough choice you have to make.

D Bergy
08-04-2007, 11:00 PM   #12
old hat
 
This is the largest and most recent study I could find.
http://cat.inist.fr/?aModele=afficheN&cpsidt=14623809
The safety of 6-mercaptopurine for childbearing patients with inflammatory bowel disease: A retrospective cohort study
Auteur(s) / Author(s)
FRANCELLA Andrew (1) ; DYAN Alan (1) ; BODIAN Carol (1) ; RUBIN Peter (1) ; CHAPMAN Mark (1) ; PRESENT Daniel H. (1) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Department of Medicine and Biostatistics, Mount Sinai Hospital Medical Center, New York, New York, ETATS-UNIS

Résumé / Abstract
Background & Aims: 6-mercaptopurine/azathioprine Is effective in IBD patients. However, data regarding toxicity associated with pregnancy are lacking, raising both patients' and physicians' concerns and sometimes resulting in elective abortion. Methods: To evaluate potential toxicity of 6-mercaptopurine (6-MP), we reviewed the records of 485 patients who had received the drug. We contacted 462, of whom 155 had conceived at least 1 pregnancy after developing IBD. Pregnancies were analyzed as to whether the patient had taken 6-MP before, or at the time of, conception. These were compared with IBD patients who had their pregnancies before taking 6-MP. We collected data on live births, spontaneous abortions, prematurity, abortions secondary to birth defects, major and minor congenital birth defects, infections, and neoplasia. Outcomes were analyzed comparing pregnancies from men and women who had taken or were currently taking 6-MP to controls. Results: There was no statistical difference in conception failures (defined as a spontaneous abortion), abortion secondary to a birth defect, major congenital malformations, neoplasia, or increased infections among male or female patients taking 6-MP compared with controls (RR = 0.85 [0.47-1.55], P = 0.59). Conclusions: 6-MP use before or at conception or during pregnancy appears to be safe. Discontinuation of the drug before and during pregnancy is not indicated.
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