Objective. To investigate changes in serum pituitary-gonadal hormones and restoration of sexual and reproductive functions after successful kidney transplantation. Patients and Methods. Serum pituitary-gonadal hormones before and after kidney transplantation were measured in 78 patients with end-stage renal disease (ESRD) and in 30 healthy adults. Pre- and postoperative semen specimens of 46 male recipients and 15 male controls were collected and compared. Additional 100 married kidney transplant recipients without children were followed up for 3 years to observe their sexual function and fertility. Results. Serum PRL, LH, and T or E2 levels gradually restored to the normal ranges in all kidney transplant recipients, and sperm density, motility, viability, and morphology significantly improved in the male recipients 4 months after successful kidney transplantation (P < .05). Thirty-three male recipients (55.93%) reobtained normal erectile function, and 49 kidney transplant recipients (61.25%) had children within the 3-year follow-up period. Conclusion. Successful kidney transplantation could effectively improve pituitary-gonadal hormone disturbance and sexual and reproductive dysfunctions of ESRD patients.

We investigated factors such as time span between transplantation and having offspring, the dosage of immunosuppressive agents during fertilisation and the effects of fertilisation on recipient's renal allograft function in 212 male recipients registered at eight Chinese organ transplantation centres. Our results are as follows: the 212 male renal allograft recipients conceived with their wives between 15 and 204 months after transplantation. The wives who became pregnant at 15-24 months after the renal transplantation gave birth to a total of 20 babies with an average weight of 3115 ± 517 g, of which 3 (15.0%) were premature. The wives who became pregnant at 25-204 months after the renal transplantation gave birth to a total of 196 babies with an average weight of 3384 ± 438 g, of which 6 (3.1%) were premature. All recipients had normal renal function during the fertile period. In conclusion, the fertility capacity of male renal allograft recipients was associated with the time after transplantation and the dose of immunosuppressive agents used during fertilisation. It might be helpful to have a fertility capacity evaluation before fertilisation. There were no effects of fertility on renal allograft function.

To examine the semen quality of patients with uraemia and renal transplant recipients, 40 patients with uraemia and 40 renal transplant recipients were included. According to their interval of post-transplantation, renal transplant recipients were subdivided into group A (22) < or =2 years and group B (18) >2 years. A total of 40 healthy men with normal fertility were included as the controls. Semen samples from all subjects were collected and analysed. The fertility index (FI) value was calculated. The FI value of the normal fertility men was 13.02 (14.26), that of the renal transplant recipient groups A and B were 5.53 (8.30) and 9.27 (22.49) respectively, while the FI of the patients with uraemia was 0.23 (0.76). Compared with the uraemia group, the FI values of renal transplant recipient group either group A or group B were significantly better (P < 0.01). However, compared with the normal control group, the FI values of renal transplant recipient group A were lower (P < 0.01), while there was no significant difference between group B and the control group (P > 0.05). In conclusion, the FI of renal transplant recipients was recovered close to the level of healthy men with normal fertility 2 years after transplantation.

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Of the 647 eligible patients, 98 (15%) reported 133 unwanted pregnancies post-transplantation. In this group (n = 98), despite an awareness of the available contraceptive measures, 56% had not applied any method of contraception, while 20% had relied on the rhythm method, and in only 12% of the cases male condoms had been used. The most common reason for not using contraception was a failure to realise that their reproductive function had been restored to normal soon after transplantation (19%). CONCLUSION In female renal transplant recipients, unprotected sex combined with incorrect judgment about their own reproductive potential post-transplantation were the major causes of unwanted pregnancies. The latter could be avoided through counselling about the risk pregnancy entails and the implementation of appropriate contraceptive measures.