The Impact of Kidney Transplants on Pregnancy Risks in Assisted Reproductive Technology

Women who have undergone kidney transplants and are using assisted reproductive technology (ART) to conceive may face elevated risks of certain pregnancy complications. A recent study conducted by researchers at the University of Cincinnati College of Medicine offers one of the first comprehensive analyses of pregnancy outcomes in this specific group.

Chronic kidney disease often hampers a woman's fertility, but many women experience restored fertility following a kidney transplant, enabling natural conception. Nevertheless, others still encounter infertility challenges and turn to ART such as fertility medications, intrauterine insemination (IUI), or in vitro fertilization (IVF) to achieve pregnancy.

Led by Dr. Silvi Shah in collaboration with the Transplant Pregnancy Registry International (TPRI), the study analyzed data spanning over five decades (1968-2022) involving 130 ART pregnancies in 77 women with kidney transplants across North America. These outcomes were compared with those of pregnancies conceived naturally within the same group. The findings revealed that ART pregnancies in kidney transplant recipients are associated with higher incidences of pregnancy-related hypertension, increased cesarean section rates, preterm births (before 37 weeks), and lower birth weights.

Importantly, despite these elevated risks, the research showed no significant difference in live birth rates or long-term kidney function—specifically, two-year transplant survival—between ART and natural conception groups. This suggests that ART remains a safe option for women with stable kidney transplants, provided they maintain good health, controlled blood pressure, and proper immunosuppressant management.

Dr. Shah emphasized that proper preconception health management is crucial and that these findings can guide clinicians in counseling women about family planning options. Although pregnancy in kidney transplant recipients has long been viewed as high-risk, this new evidence indicates that with careful medical oversight, ART can be safely pursued without compromising long-term kidney health or transplant success.

This research bridges a significant knowledge gap, offering reassurance and guidance for women with kidney transplants considering assisted reproductive methods, ultimately supporting informed reproductive choices.