Contraception After Kidney Transplantation, From Myth to Reality: A Comprehensive Review of the Current Evidence

Exp Clin Transplant. 2016 Jun;14(3):252-8. doi: 10.6002/ect.2015.0278. Epub 2016 Apr 4.

Abstract

There is a misconception among transplant clinicians that contraception after a successful renal transplant is challenging. This is partly due to the complex nature of transplant patients, where immunosuppression and graft dysfunction create major concerns. In addition, good evidence regarding contraception and transplant is scarce, with most of the evidence extrapolated from observational and case-controlled studies, thus adding to the dilemma of treating these patients. In this review, we closely analyzed the different methods of contraception and critically evaluated the efficacy of the different options for contraception after kidney transplant. We conclude that contraception after renal transplant is successful with acceptable risk. A multidisciplinary team approach involving obstetricians and transplant clinicians to decide the appropriate timing for conception is recommended. Early counseling on contraception is important to reduce the risk of unplanned pregnancies, improve pregnancy outcomes, and reduce maternal complications in patients after kidney transplant. To ascertain appropriate advice on the method of contraception, individualizing the method of contraception according to a patient's individual risks and expectations is essential.

Publication types

  • Review

MeSH terms

  • Contraception / methods*
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Kidney Transplantation / adverse effects*
  • Live Birth
  • Male
  • Pregnancy
  • Pregnancy Complications / etiology
  • Pregnancy Complications / prevention & control
  • Pregnancy, Unplanned*
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Time-to-Pregnancy
  • Treatment Outcome

Substances

  • Immunosuppressive Agents