Yes, j-pouch surgery increases your infertility risk three-fold. However, that does not mean it is like being sterilized. ANY surgery that involves the pelvic cavity can lead to scar tissue that affects your reproductive organs. It is possible, but not a certainty. You also need to look at what your chances are of carrying to term if you get pregnant while suffering with uncontrolled colitis.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1860095/What some women do to preserve their fertility when surgery is necessary, is to have the colectomy (leaving the rectum) and an end ileostomy until they complete childbearing. They then opt for completion surgery later, removing the rectum and constructing the j-pouch. Most of the risk is associated with removal of the rectum and j-pouch construction, because of the proximity. Having the surgery laparoscopically is also another way to reduce the infertility risk.
Hope that makes it more clear.
Jan
