Sexual and Reproductive Health Assessment in a Group of Female Renal Transplant Recipients

Abstract

Fertility and sexual health are impaired in individuals with chronic kidney disease and can be restored after a successful renal transplant. This is a single-center prospective study about the sexual and reproductive health (including contraceptive methods and gynecologic cancer screening) in renal transplant recipients. Female renal transplant recipients, aged 18 to 49 years at transplant, were interviewed about their gynecologic history, sexual health, and use of contraceptive methods. Ninety-one patients fulfilled the inclusion criteria. The majority of women maintained menstrual cycles during dialysis therapy, being almost 60% of the women in an irregular rhythm. Pregnancies were reported for 51 women, 20% after transplant, and associated with low-weight newborns. The incidence of spontaneous abortion was 12.5%. Thirty-one patients were denied contraceptive methods due to the vasectomy of the partner (n=16) or the belief that they would not become pregnant (n=15). The most common contraceptive method was a condom, and the use of an intrauterine device was rare. Gynecologic assessment and cancer screening were out-of-date in almost one-third of patients. In this study, the majority of women were from low-income areas and had low levels of education. Despite access to public universal health care, adherence to yearly screening tests and use of contraceptive methods were lower than expected.