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Concerns about sexual health, fertility, and pregnancy are common in patients with inflammatory bowel disease (IBD). Fertility is usually normal, although may be decreased in women with active Crohn's disease. Women with active IBD (especially Crohn's disease) are at risk of having small and premature babies. In some patients with IBD it may be desirable to continue drug treatment during pregnancy in order to control disease activity. Early engagement in discussion of these issues is important and it should be possible for most patients with IBD to have a normal outcome of pregnancy.