Fertility and Conception Following Kidney Transplantation: A Narrative Review

Author(s): Abdulrahman Ishag, Farah Mohamed, Mohammad Hatem Alrawi, Muhanned Faisal Sulieman Towfig, Yousra Mohammed Alkhatim, Duaa Khaled Mokhtar

Individuals with chronic kidney disease often experience sexual disorders and infertility, which can significantly impact their quality of life. The cause of infertility in CKD patients is multifactorial, resulting from sexual dysfunction, hormonal disturbance, and uraemia-induced gonadal toxicity. Kidney transplantation can significantly improve this pathological state, although complete restoration of fertility may not occur. Conceiving after kidney transplantation carries a slightly higher maternal and fetal risk compared to the normal population, with neonates of kidneytransplanted mothers showing an increased risk of prematurity and low birth weight. The use of steroids in infants was found to be safe, while mycophenolate mofetil was associated with fetal and infant toxic events and is, therefore, not recommended for breastfeeding mothers following kidney transplantation. Nevertheless, studies have indicated the safety of using azathioprine in breastfeeding kidney-transplanted mothers. Notably, limited data is available on the use of immunosuppressive drugs during pregnancy and poses an area for further research.