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Two recurring questions arise for gastroenterologists treating patients with inflammatory bowel disease (IBD): Does treatment of IBD with immunosuppressants or biotherapies have an impact on male fertility and on subsequent pregnancy outcomes for couples? In pregnant women, when is the best time to stop anti-TNF treatment during pregnancy, and when should the newborn be administered a live-attenuated vaccine? A review of the literature and a meta-analysis collated studies describing the consequences of IBD treatment with biotherapy or immunosuppressants on spermatogenesis and the development of a possible pregnancy in couples. Sperm analysis, including sperm count, morphology, and motility, did not differ with or without treatment. Rates of adverse pregnancy events (miscarriage, prematurity, and congenital malformation) were not significantly different according to whether or not the male parents had received treatment for IBD. Recommendations concerning the use of biotherapies have recently been drawn up by the European group ECCO (European Crohn’s and ­Colitis Organization). A physiologically-based pharmacokinetic modelling study of biotherapies in both pregnant women and exposed children sought to predict the ideal timing for the final biotherapy injection, taking into account the mother’s dose and the intervals between injections or infusions.