I am considering having a tubal ligation at the same time my gyno wants me to have a D&C. Is there anything I should be informed about with this sugery? And other than informing my gyno about my Jpouch anything else I should tell him? Any opinions on the tubal ligation?

Thanks

Laurie,

I realize it has been a while since your original post, but I thought I would add my two cents, for what it's worth.
I developed UC at 21 years old (I just turned 27). It was uncontrollable from the beginning, despite numerous medications. I was on 6MP and Remicade for quite some time, during which time I used double methods of birth control, because the doctors warned me about the severe risk of birth defects. Of course, I got pregnant anyway. My boyfriend and family were very supportive, and we consulted several doctors, all of whom felt the risk to the baby was high, and the risk to my own health (something I hadn't considered) was high as well. It was a difficult decision, but we decided to terminate the pregnancy. After that, I was scared that I would get pregnant again, and I didn't want to put myself or anyone else through that again. I consulted several GYN's, originally thinking I would have an IUD put in. None of them would do it due to the risk of infection (being immunosuppressed from the meds). I decided on a tubal ligation, as I'm pretty open minded about kids and adoption. I had the tubal done in 2005 and have not regretted it. In the end, who knew I'd end up having my colon removed and a pouch, which often creates fertility problems of its own.
It's a very personal decision, but I'm glad that I made the choice I did.

Michelle,

If at some point you wanted to get pregnant, couldn't you try invitro?

Mila,

If I used a donor egg and a surrogate, that would be possible. The doctors believe being on the 6MP for so long affected my eggs, and they do not advise carrying a pregnancy myself. If I ever do decide to have children, I'd be more likely to adopt...why go through the whole invitro/surrogacy process when there are so many kids who need homes? =)

My understanding is that the more current research does not support the notion that 6MP is a serious risk during or before pregnancy. The early fears were based on small mammal studies using very high doses and human data has not supported it. However, the combination with Remicade may change things. In any event, my understanding is that 6MP is not associated with a higher rate of birth defects as compared to control groups. Basically, we have to deal with things based on the information available at the time. There is more available information now.

However, each case needs to be evaluated on an individual basis.

http://gastroenterology.jwatch.org/cgi/content/full/2003/325/1

http://www.medscape.com/viewarticle/490027_29

Jan