Medical advice regarding the desire to have children and pregnancy in patients with inflammatory bowel disease (IBD) is often requested. The influence of IBD on pregnancy and--vice versa--of pregnancy on the activity of IBD is discussed. Based on three clinical cases the chances and limitations of medical treatment of CED during pregnancy are reviewed. Generally it is important to balance the therapy between the patients desire to be treated most effectively and to deliver a healthy child after an uncomplicated pregnancy. An interdisciplinary treatment is always advisable in patients with IBD and a desire to have children.