Babies don’t grow in their mother’s stomachs, but what happens in the digestive tract can have a powerful impact on reproduction. Fertility problems are a little-discussed but increasingly recognized result of several serious gastrointestinal (GI) diseases affecting millions of American women. Women with two of these diseases—Crohn’s disease and ulcerative colitis, known collectively as inflammatory bowel disease (IBD)—need to be particularly careful about how their disease is treated if they want to become pregnant. When the disease is controlled with medication alone, and not surgery, women stand a very good chance of achieving pregnancy. But surgery in the pelvic area seems to have a negative effect on fertility. So if you suffer from these illnesses and want to be pregnant some day, make sure your physician knows your intention before recommending treatment. The decision about what medication to take may be affected by your reproductive plans, too.