Abstract
Sexual life and fertility are compromised in end stage kidney disease both in men and in women. Successful renal transplantation may rapidly recover fertility in the vast majority of patients. Pregnancy modifies anatomical and functional aspects in the kidney and represents a risk of sensitization that may cause acute rejection. Independently from the risks for the graft, pregnancy in kidney transplant may cause preeclampsia, gestational diabetes, preterm delivery, and low birth weight. The nephrologist has a fundamental role in correct counseling, in a correct evaluation of the mother conditions, and in establishing a correct time lapse between transplantation and conception. Additionally, careful attention must be given to the antirejection therapy, avoiding drugs that could be dangerous to the newborn. Due to the possibility of medical complications during pregnancy, a correct follow-up should be exerted. Even if pregnancy in transplant is considered a high risk one, several data and studies document that in the majority of patients, the long-term follow-up and outcomes for the graft may be similar to that of non-pregnant women.
Highlights
The aim of this review is to clarify the nature of the infertility, how it is possible to become pregnant in end stage kidney disease (ESKD), and how this condition changes after successful kidney transplantation
Erectile dysfunction is a common manifestation of sexual dysfunction and the disorder is reported in approximately 80% of patients in hemodialytic treatment (HD) [2,3,4]
In ESKD, there is a loss of the normal pulsatile release of gonadotropin-releasing hormone (GnRH) from the hypothalamus with loss of the cycle luteinizing hormone (LH)-follicle stimulating hormone (FSH) [27]
Summary
Most men and women with end stage kidney disease (ESKD) are infertile [1]. The aim of this review is to clarify the nature of the infertility, how it is possible to become pregnant in ESKD, and how this condition changes after successful kidney transplantation. The new problems that arise in pregnancy after kidney transplantation will be examined and discussed
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