Resumption of Female Reproductive Function Following Renal Transplantation

Merkatz, Irwin R.; Schwartz, Gabriel H.; David, David S.; Stenzel, Kurt H.; Riggio, Robert R.; Whitsell, John C.

doi:10.1001/jama.1971.03180370025005

Cited by 59 publications

(5 citation statements)

References 13 publications

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“…This study suggests that there is no difference in ovarian function between women using the two immunosuppressive regimens. These conclusions are consistent with previous studies which show that loss of normal menstrual function in uraemic women is most closely related to the decline in glomerular filtration rate (Goodwin et al 1967) and that the resumption of menses after renal transplantation depends on graft function (Merkatz et al 1971). Since the women were not selected for normal graft function, mean creatinine and urea levels were elevated above the reference range.…”

Section: Discussionsupporting

confidence: 93%

Ovarian function after renal transplantation: comparison of cyclosporin A with azathioprine and prednisone combination regimens

Handelsman

McDowell

Caterson

et al. 1984

BJOG

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Summary. Ovarian function was assessed in 24 women after renal transplantation who were treated either with cyclosporin A (10 patients) or with a combination of azathioprine and prednisone (14 patients) as immunosuppressive therapy. The different regimens were not associated with any differences in clinical or endocrine indices of ovarian function (LH, FSH, prolactin, testosterone, oestradiol, dehydroepiandrosterone sulphate). Excessive hair growth was common in both treatment groups. Levels of testosterone and dehydroepiandrosterone were higher in cyclosporintreated women but this was due to prednisone‐induced suppression of adrenal androgen output in the azathioprine‐ and prednisonetreated women. Excessive hair growth was present in postmenopausal women on both treatments suggesting that hypertrichosis is a consequence of renal transplantation and is not a specific side‐effect of cyclosporin A therapy.

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Section: Discussionsupporting

confidence: 93%

Ovarian function after renal transplantation: comparison of cyclosporin A with azathioprine and prednisone combination regimens

Handelsman

McDowell

Caterson

et al. 1984

BJOG

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“…However, the data are only available for seven LT patients in our study. Slightly more than half of our KT recipients (53.3%) exhibited this disorder, which was higher than the PE rate previously described for this population (5% to 45% [ 9 , 10 , 12 , 14 , 43 , 44 ]). The high overall incidence of PE in our patients may have resulted from immunosuppressive therapy as tacrolimus and corticosteroids have known nephrotoxicity [ 45 ], but can also induce hypertension [ 4 ].…”

Section: Discussioncontrasting

confidence: 62%

Pregnancies and Gynecological Follow-Up after Solid Organ Transplantation: Experience of a Decade

Bedin

Carbonnel

Snanoudj

et al. 2022

JCM

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In recent years, solid organ transplantations, such as kidney or lung grafts, have been performed worldwide with an improvement of quality of life under immunosuppressive therapy and an increase in life expectancy, allowing young women to consider childbearing. In the current study, we conduct a retrospective study in two French centers for kidney and lung transplantations to evaluate the rate and outcomes of pregnancies, contraception and gynecological monitoring for women under 40 years old who underwent solid organ transplantation. Among 210 women, progestin was the most widely used contraceptive method. Of the 210 women, 24 (11.4%) conceived 33 pregnancies of which 25 (75.8%) were planned with an immunosuppressant therapy switch. Of the 33 pregnancies, 7 miscarried (21.2%) and 21 (63.7%) resulted in a live birth with a high rate of pre-eclampsia (50%). No graft rejections were observed during pregnancies. Among the deliveries, 19 were premature (90.5%, mostly due to induced delivery) and the C-section rate was high (52.4%). No particular pathology was identified among newborns. We conclude that pregnancies following solid organ transplantation are feasible, and while they are at an increased risk of pre-eclampsia and prematurity, they should still be permitted with close surveillance by a multidisciplinary care team.

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“…This seems most likely to occur both towards the end of the pregnancy and also post partum (Legrain, 1976). Previous reports have described a reduction in glomerular filtration rate in the third trimester with return to normal after delivery (Caplan et al, 1970;Merkatz et al, 1971). Others found no change in transplant function (Board et al, 1967;Kaufman et al, 1967).…”

Section: Discussionmentioning

confidence: 96%

“…Renal transplantation is the most effective method for restoring reproductive function in women with end-stage renal failure. Resumption of regular menstruation and ovulation depends on the level of renal function achieved by the graft (Merkatz et al, 1971). The disproportionate frequency of childbirth in living donor recipients may be attributed to better renal function and lower steroid dosage as well as to their younger age and longer survival.…”

Section: Discussionmentioning

confidence: 99%

“…The following year the first successful pregnancy following transplantation of a cadaver kidney occurred (Caplan et af, 1970). Since then, individual patients in Europe have been documented in detail (Gevers et af, 1971 ;Horbach et al, 1973;Robertson et al, 1974;Jacob et al, 1974) and a few small series presented (Merkatz et al, 1971;Penn et af, 1971;Merrill et af, 1973;Sciarra et al, 1975). Experience of centres reporting to the Human Kidney Transplant Registry was reviewed by Golby (1970); Nolan et af (1974) brought together published information on 23 patients, adding two of their own, and Rifle and Traeger (1975) presented an international survey.…”

mentioning

confidence: 99%

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Successful Pregnancies in Women Treated by Dialysis and Kidney Transplantation

1980

BJOG

224

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Summary The Registry of the European Dialysis and Transplant Association collected information on 120 successful pregnancies in women treated by dialysis and transplantation in 19 countries. Ninety‐seven women with transplants gave birth to 110 babies including five multiple pregnancies. The incidence of severe congenital malformation in these children was not substantially increased. There was evidence of damage to the transplant occurring either during or after pregnancy in 22 of the mothers. Sixteen successful pregnancies occurred in women on dialysis, all of whom had some residual renal function.

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Resumption of Female Reproductive Function Following Renal Transplantation

Cited by 59 publications

References 13 publications

Ovarian function after renal transplantation: comparison of cyclosporin A with azathioprine and prednisone combination regimens

Ovarian function after renal transplantation: comparison of cyclosporin A with azathioprine and prednisone combination regimens

Pregnancies and Gynecological Follow-Up after Solid Organ Transplantation: Experience of a Decade

Successful Pregnancies in Women Treated by Dialysis and Kidney Transplantation

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