Hello Aarti,
Thanks for your query.
Because ulcerative colitis (UC) usually starts between the ages of 20 and 30, it hits during a woman’s prime childbearing years.

Some women with ulcerative colitis may feel so exhausted and uncomfortable, they have no desire to try to get pregnant. Others with IBD put off starting a family because they're worried that the disease will get worse during pregnancy or that they’ll pass on ulcerative colitis to their baby.

Having inflammatory bowel disease (IBD) shouldn't prevent you from starting a family. Despite the challenges, women with UC can have healthy pregnancies and deliveries.

The chance of a woman with ulcerative colitis getting pregnant is no different than that of other women her age.

Although UC doesn't directly affect fertility, women who have had a colectomy -- surgery to remove all or part of the large intestine -- may have a harder time getting pregnant. When the entire large intestine is removed, surgeons create an XXXXXXX pouch to hold waste. Because this surgery can produce scar tissue in the pelvic area, it can increase the risk of infertility.

You may be able to avoid having surgery by controlling the disease with medication.

If you do need to have a colectomy and know you want to have children, another option is to have a partial colectomy. Instead of making an XXXXXXX pouch, the surgeon creates an opening and the woman wears the pouch on the outside of her body. This type of surgery would not affect your chances of getting pregnant. After you have children, you can get a colectomy with the XXXXXXX pouch.

The most important thing you can do is to get active ulcerative colitis under control and into remission before trying to get pregnant.

If you get pregnant while the disease is still active, there's a good chance symptoms will continue or get worse during pregnancy.

Active flare-ups of UC can leave you underweight and without the nutrients you need to get pregnant and carry a baby to term. Being underweight may significantly increase the risk of having a miscarriage in the first trimester of pregnancy. It also increases the chances that you’ll deliver a baby who is premature or underweight.

As soon as you start thinking about getting pregnant, make an appointment to see your gastrointestinal doctor or healthy pregnancy.

You might also want to get the help of a dietitian to make sure you're eating a well-balanced diet.
For pregnant women with ulcerative colitis, the vitamin recommendation is the same as that for women without UC: Take a prenatal vitamin every day while you're trying to get pregnant and during pregnancy.

But sometimes the iron in prenatal vitamins can be rough on a gastrointestinal system that's already battered by ulcerative colitis. If the vitamin you’re taking seems to be causing you problems, try different formulations until you find one you can tolerate.

Women with UC are prone to anemia, so be sure to get your iron levels checked and take a supplement if they're low.

You may also need to take extra folic acid. Ulcerative colitis, as well as one of the medications used to treat it, sulfasalazine, can make it hard for the body to absorb folic acid. Folic acid helps prevent birth defects like spina bifida.

See your doctor to ensure that you're getting enough of all of the vitamins and minerals you need.

It's critical to talk to your gastrointestinal doctor when you're considering getting pregnant. You'll want to weigh the advantages of having the disease under control against the risks of being on ulcerative colitis medication during pregnancy.

Two drugs for ulcerative colitis are known to cause birth defects: methotrexate and thalidomide. A woman should be on a reliable form of birth control before taking either of these medications and should stop taking them at least three months before trying to get pregnant.

Steroid drugs can carry some risks during pregnancy, including a slightly higher chance that a baby will be born with a cleft palate. Your doctor may recommend that you stop taking steroids during pregnancy or take it at the smallest possible dose.

Other medications for ulcerative colitis may be OK to take while you're trying to get pregnant or while pregnant. Ask your doctor to help you develop a plan for controlling a flare during pregnancy.

Your chances of having a healthy baby are very good if you take care of yourself and keep ulcerative colitis under control during pregnancy.

Women with IBD do face a higher risk of complications such as miscarriage, preterm delivery, and delivering a low-birth-weight baby than women who don't have the condition. The risk of birth defects may also be slightly higher, probably because of certain medications for ulcerative colitis, not the disease itself.

The chance of a woman passing on ulcerative colitis to her baby is very small -- about 2%-5%. The risk goes up to about 30% if both parents have IBD.

I hope your questions have been addressed.
With proper concerted teamwork between your gastroenterologist and your obstetrician, there is no reason why you should not enjoy motherhood.
DO not put off the decision till it is late biologically.

All the best.

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